Anticipating and experiencing post-operative pain: the patients' perspective

This study uses a qualitative approach to explore patients' expectations and experiences of pain, factors contributing to the effective/ineffective management of their pain and strategies patients reported as helpful when experiencing pain. Ten patients on a mixed surgical ward at a District General Hospital in the south of England participated in the study. Pain scores, using a visual analogue scale, were obtained for 'expected' pain preoperatively and 'worst pain experienced'. A taped in-depth interview exploring patients' experience of pain after surgery took place on the fifth post-operative day. Details of analgesia were also collected for the 5 days following surgery. Patients expected pain after surgery but the intensity of the pain they experienced was often significantly greater than anticipated. Lack of information, inadequate pain assessment and ineffective pain control contributed to this finding. It is suggested that new pain technology, such as epidural and patient-controlled analgesia, may not change the prevalence and incidence of pain unless the systems these technologies are placed within also change.