Making sense of patients' use of analgesics following day case surgery

This paper is a report of a study exploring patients' use of analgesics following day case surgery, with particular focus on patients' decision-making about analgesic use.

Day case and ambulatory surgery continue to be the preferred format for many elective surgical procedures. However, many patients' experience unacceptable postoperative pain when they return home after day surgery. Previous research investigating barriers to pain management suggests that patients may not use their analgesics appropriately.

A qualitative approach using interpretative phenomenological analysis was used to explore the experiences of 28 patients admitted for day case surgery. The patients were interviewed on the fourth postoperative day. Data were collected in 2005-06.

We identified an explanatory framework with three high level themes and 12 mid-level themes, with the mid-level themes broken down into a number of lower level themes. Patients' use of analgesics was a complex intentional decision-making process based on a matrix of beliefs surrounding pain, analgesics and day surgery. They did not always adhere to their analgesic regimes at home, many describing how they avoided analgesics and often withstood high levels of postoperative pain.

Interventions need to go beyond the provision of pain management information (as in current practice), and overcome some of the erroneous beliefs held by patients. Further research is required to identify ways in which these erroneous beliefs can be overcome.