title: Patient participation in postoperative pain assessment after spine surgery in a recovery unit.
abstract: OBJECTIVE
  To explore how patients undergoing spine surgery participated in postoperative pain assessment in a recovery unit.
  
  
  BACKGROUND
  Despite advances in medicine, pharmaceutical and technical knowledge, patients report considerable postoperative pain after spine surgery. Research shows that patients require efficient individual pain treatment and that their participation has a positive effect on pain treatment.
  
  
  METHODS
  This study was based on a phenomenological hermeneutic design.
  
  
  METHODS
  Fifteen qualitative interviews were conducted in 2014. Meaning condensation was used to analyse data.
  
  
  RESULTS
  Three themes emerged: (1) communication and knowledge; anaesthesia, analgesics and severe pain affected patients' ability to assess and communicate their pain. (2) Pain assessment using a numerical rating scale; this theme was characterised by individual differences in rating perception. Also, new postoperative pain sensations were described as different kinds of pain and variation in the pain intensity during activity. (3) Patient-nurse relationship; this theme was characterised by reports of frequent and direct contact on the part of the nurses about pain assessment. Patients' lack of knowledge about pain treatment resulted in inactivity and uncertainty of when to ask for analgesics.
  
  
  CONCLUSIONS
  This study indicates that nurses and patients would benefit from building a mutual understanding of pain perceptions and numerical rating scale as this would pave the way for a more accurate pain assessment. Patients' ability to participate in pain assessment was affected by anaesthesia, analgesics and severe pain. Patients needed knowledge about complications and needed to understand when they should ask for analgesics.
  
  
  CONCLUSIONS
  Results indicate that patient perceptions of numerical rating scale and variation in patients' ability to communicate in the initial postoperative period should be given more attention to underpin patients' pain assessment. This may be a key factor in ensuring patient participation in pain assessment and thereby improving postoperative pain management.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Kaptain
authors.affiliation: Department of Paediatrics, Aarhus University Hospital, Aarhus N, Denmark.
authors.forename: Vibeke
authors.initials: V
authors.lastname: Bregnballe
authors.affiliation: Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus C, Denmark.|Section of Nursing, Institute of Public Health, University of Aarhus, Aarhus C, Denmark.
authors.forename: Pia
authors.initials: P
authors.lastname: Dreyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D003142:Communication; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000451:nursing*; D010358:Patient Participation; D011184:Postoperative Period; D036301:Qualitative Research; D013131:Spine / Q000601:surgery*; D055815:Young Adult
chemical_list: D000700:Analgesics
keywords: communication; interviews; nurse-patient relationship; pain assessment; pain measurement; patient participation; postoperative nursing; postoperative pain; qualitative study; surgery