Bakgrund: Opioider är en viktig del inom behandling av postoperativ smärta. Det är viktigt att patienten erhåller adekvat information om opioder för att bespara patienten lidande och för att minimera riskabelt bruk. Syfte: Syftet var att beskriva patienters erfarenheter av att behandlas med opioider för postoperativ smärta. Metod: Studien utfördes som en allmän litteraturstudie med induktiv ansats. Litteraturstudien består av 17 vetenskapliga artiklar. Resultat: Resultatet genererade tre kategorier. Patienters fysiska erfarenheter innefattar patienters somatiska erfarenheter, hur de upplevde opioiders effekter och bieffekter. Patienters känslomässiga erfarenheter rymmer känslor som patienterna upplevde i samband med opioidbehandling och förutfattade meningar. Patienters erfarenheter av information omfattar vilken utbildning patienter hade erhållit av sjuksköterskan och vilka kunskapsbehov som upplevdes. Konklusion: Det var vanligt att patienterna upplevde biverkningar och uttryckte en oro över att uppleva biverkningar och att utveckla beroende. Patienterna hade även negativa föreställningar om opioider, vilket kunde resultera i att patienterna självmant reducerade sina doser eller slutade helt med sin behandling utan att rådfråga läkare. Bristfällig information om opioider resulterade i inadekvat smärtlindring. Sjuksköterskan är i behov av mer kunskap kring postoperativ opioidbehandling för att på så sätt kunna minska patienters oro, optimera smärthanteringen och minimera riskabelt handhavande av opioider. / Background: Opioids are an important part in the treatment of postoperative pain. It is important that patients receive adequate information regarding opioids to spare suffering and to minimize potentially dangerous use. Aim: The aim was to describe patients’ experiences of being treated with opioids for postoperative pain. Method: The method used was a literature review with an inductive approach, which consist of 17 scientific articles. Result: The result generated three categories. Patients’ physical experiences includes patients’ somatic experiences, how they experienced the opioids’ effects and side-effects. Patients’ emotional experiences contains emotions that patients experienced when being treated with opioids, as well as preconceptions. Patients’ experiences of information includes what education patients had received from the nurse and what knowledge they perceived to be lacking. Conclusion: It was common that patients experienced opioid-related side effects. Patients expressed fear of side effects and to become addicted. Patients’ negative views of opioids could result in poor prescription compliance. Either by reducing their dosages or quitting completely, without consulting a physician. Patients received inadequate information regarding opioids that resulted in insufficient pain treatment. The nurse is in need of more knowledge regarding postoperative opioid treatment, in order to reduce patients’ worry, optimise pain management and minimize unsafe use, storage and disposal of opioids.

Bakgrund: Florence Nightingale (1820 - 1910) förespråkade vikten av vårdmiljön kring patienten för ett optimalt återhämtande. Den moderna vårdmiljön består av fysisk och psykosocial del där båda dessa delar är avgörande för patientens välmående. Postoperativ smärta som följer ett operativt ingrepp upplevs individuellt. Det är sjuksköterskans ansvarsområde i postoperativ omvårdnad att sörja för en god smärtlindring; omvårdnadsmässigt, genom manipulation av vårdmiljön och farmakologisk smärthantering.Syfte: Syftet är att beskriva vårdmiljöns betydelse för att lindra nyopererade patienters postoperativa smärtaMetod: En litteraturöversikt med kvalitativ ansats. Studiens resultat baseras på 15 vetenskapliga artiklar som är kvalitetsgranskade. De vetenskapliga artiklarna söktes på CINAHL, PubMed, Web of Science samt via manuell sökning.Resultat: I litteraturöversikten identifierades kategorierna fysisk vårdmiljö med underkategorierna patientrummet och kontakt med extern miljö. I kategorin psykosocial vårdmiljö framträdde underkategorierna; känsla av kontroll, relationer och musik som distraktion som smärtlindrande alternativ.Slutsats: Den fysiska och psykosociala vårdmiljön har en distraherande effekt och/eller har en lindrande effekt på postoperativ smärta. / Background: Florence Nightingale (1820 - 1910) was a major advocate for the importance of environment for optimal patient recovery. The modern healthcare environment typically consists of two components, one physical and one psychosocial, where both parts are considered crucial for the patient’s return to health. This is particularly important to bear in mind in the postoperative context and with the experience of postoperative pain, which varies from patient to patient. Nurses are responsible for providing postoperative pain relief, chiefly by nursing, utilizing the health care environment and administering pharmacological painkillers.Aim: The purpose of the study is to describe the importance of the health care environment in relieving newly operated patients postoperative pain.Method: A literature review with qualitative design. The results of the study are based on 15 scientific articles that have been quality reviewed. The scientific articles were searched on CINAHL, PubMed, Web of Science and via manual search.Results: The literature review identified physical care environment with subcategories; patient room and contact with the external environment. In the category psychosocial care environment subcategories; sense of control, relationships and music as distraction as pain-relieving alternatives.Conclusion: The physical and psychosocial health care environment act as a distractive element on the patient and/or have a relieving effect on the postoperative pain.

Bibliographische Beschreibung: Sontowski, Thomas Analyse der intra- und postoperativen Schmerztherapie bei Kindern mit leichten bis mittelstarken postoperativen Schmerzen an der Universität Leipzig im Zeitraum von 2005 bis 2007 Universität Leipzig, Dissertation 106 Seiten, 120 Literaturangaben, 10 Abb., 41 Tab., 9 Anlagen Kurzreferat: In der vorliegenden Arbeit erfolgte die Analyse der intra- und postoperativen Schmerztherapie sowie die nachfolgende Schmerzsituation im Aufwachraum des Fachbereichs Kinderanästhesiologie der Klinik und Poliklinik für Anästhesiologie und Intensivtherapie an der Universität Leipzig bei Operationen mit leichten bis mittelstarken postoperativ zu erwartenden Schmerzen. Ziel war es, einen Beitrag zur Weiterentwicklung des internen Qualitätsmanagements in der Kinderschmerztherapie zu erarbeiten, da externe Studien zeigten, dass dies oftmals erhebliche Mängel aufweist, und nicht die Standard- und Qualitätskriterien erfüllt, wie sie bei Erwachsenen vorhanden sind. Insgesamt wurden 420 kinderchirurgische Patienten im Zeitraum von Juni 2005 bis Juli 2007 ausgewertet, wobei sich die Untersuchung in einen prospektiven und in einen retrospektiven Teil untergliederte. Es zeigte sich, dass intraoperativ ein Großteil der Kinder (89,3%) ein Opioid erhielt (am häufigsten Alfentanil) und ebenso ein hoher Anteil der Kinder intraoperativ ein Nichtopioid erhielt (am häufigsten Metamizol (94%)). Techniken der Regionalanästhesie fanden innerhalb des Untersuchungszeitraumes selten Anwendung (2,9%). Die intraoperative Standardschmerztherapie, welche die Kombination eines Opioids mit einem Nichtopioid im Sinne einer multimodalen Analgesie vorsah, wurde in 66,4% der Fälle durchgeführt. Postoperativ erhielt ein Großteil der kinderchirurgischen Patienten (75,0%) eine medikamentöse Schmerztherapie. 71,0% der Kinder bekamen nach der Operation ein Opioid verabreicht. Der klinikeigene postoperative Schmerztherapiestandard, der eine zeitnahe gewichtsadaptierte intravenöse Gabe von Piritramid im Sinne einer präventiven Analgesie vorsah, wurde bei 66,9% der behandelten Kinder angewandt. Weiterhin wurden verschiedene Gruppenvergleiche vorgenommen (ambulant vs. stationär, leichte vs. mittelstark zu erwartende postoperative Schmerzen und pro- vs. retrospektiv). So bekamen stationär aufgenommene Kinder im Vergleich zu ambulanten Patienten intraoperativ signifikant häufiger Opioide und größere Mengen an Alfentanil appliziert. Im Aufwachraum erhielten die stationären Patienten signifikant häufiger eine Schmerztherapie, die Standardschmerztherapie sowie höhere Dosen an Piritramid. Bei Operationen mit mittelstarken zu erwartenden Schmerzen im Vergleich zu Eingriffen mit leichter Schmerzintensität erfolgte intraoperativ signifikant häufiger die Verabreichung von Opioiden und postoperativ eine signifikant häufigere Applikation der Standardschmerztherapie sowie höhere Dosen von Piritramid. Die prospektive Gruppe erhielt während der Operation signifikant häufiger die Standardschmerztherapie im Vergleich zur retrospektiven Patientengruppe. Analog erfolgte postoperativ signifikant häufiger die Applikation der Standardschmerztherapie sowie höhere Dosen an Piritramid. Erstmalig wurde im prospektiven Teil dieser Studie die Schmerzsituation im Aufwachraum mittels eines speziell entwickelten Schmerzerfassungsbogen untersucht. Die Schmerzerfassung erfolgte hierbei mithilfe der Kindlichen Unbehagen- und Schmerzskala (KUSS) nach Büttner, der Smiley-Analog-Skala sowie der Schulnotenskala, wobei die Beurteilung präoperativ, direkt bei Ankunft im Aufwachraum sowie nach ein und zwei Stunden postoperativ stattfand. Ein zentrales Untersuchungsergebnis dieser Studie zeigt, dass für durchschnittlich 84,8% der Kinder die Schmerzsituation während des Aufenthaltes im Aufwachraum ausreichend gut war. Ein Vergleich zwischen Patienten mit ausreichender und noch verbesserungswürdiger Schmerztherapie - vorgenommen innerhalb der prospektiven Studiengruppe - zeigte, dass die intraoperative Verabreichung von Opioid- und Nichtopioidanalgetika den Zufriedenheitsgrad in der Schmerzsituation tendentiell optimierte bzw. bei der Durchführung der intraoperativen Standardschmerztherapie das Schmerzoutcome signifikant verbesserte. Weiterhin war die Schmerzsituation bei Patienten im Aufwachraum, denen Piritramid nach postoperativem Schmerztherapiestandard verabreicht wurde, signifikant besser. Anhand dieser Arbeit wird die Bedeutung der Anwendung einer multimodalen Analgesie und präventiven Schmerztherapie sowie der hohe Stellenwert der Einführung bzw. Realisierung von Therapie- und Überwachungsstandards, Schmerzerfassung und -dokumentation für eine qualitativ ausreichende, gute intra- und postoperative Schmerztherapie bei Kindern deutlich.

Background: Postoperative pain is a global issue. Although knowledge of the issue is well known and measures have been taken to reform the care, a large proportion of surgical patients experience severe postoperative pain. Without adequate pain relief, recovery might be postoperatively inhibited or prolonged. Aim: To explore patients' experiences of being cared for because of postoperative pain. Method: To answer the aim of the study, a qualitative literature study has been chosen as a method. The analysis of the articles was carried out according to Friberg´s five-step model. In total, three systematic searches were conducted in order to find articles that responded to the study's aim. Finally, ten articles representing the study´s result were selected. Results: Information before surgery was considered an important component for patients to feel safe, well prepared and able to manage the postoperative pain. When patients were provided with adequate information, their ability to influence decisions regarding the design of care increased. The result also showed that some patients felt overlooked, resulting in feelings of vulnerability. The pain experience was reduced and in order to avoid conflicts patients chose to endure the pain in silence. Conclusion: The experience of care is reflected in how the patient was treated and the nurse's ability to see the patient as a whole person. Our conclusion is that the postoperative care has failed and that there is need for nurses in the field to receive further education regarding the matter.

Managing postoperative pain continues to be a challenging public health problem. The organization under study was experiencing a prolonged length of hospital stay (LOS) in the post-total knee and hip replacement surgery population that was causing system-wide patient flow issues. The purpose of this quality improvement project was to educate patients through an established education class on pain expectations, strategies on managing pain, discharge planning, and physical therapy expectations with a goal of reducing pain and LOS. The health belief model was used as a guide to incorporate new content into the educational program that addressed patient knowledge on pain, concerns, fears, and misconceptions related to surgery. New content was added to the class on strategies to improve postoperative pain to help the organizational need to meet 2- to 3-day LOS. The project compared differences in pain levels and LOS in participants who completed the preoperative education and those who did not. The project methodology was a retrospective nonexperimental pretest and posttest design, and a quantitative analysis was used to compare pain levels measured by visual analog scale in documented charts during hospital stay. LOS was measured from data collected from chart review. The findings revealed lower pain levels during the hospital stay of those who completed the educational program. The patients who did not attend the class had an average mean LOS of 5 days as compared to 3 days LOS for those who attended the preoperative class. The project impacts social change on an organizational level by demonstrating that patients undergoing joint replacement surgery benefit from the revised educational plan, which results in early mobility, better pain control, and decreased LOS.

No description available.

Background: Thousands of Canadians undergo cardiac surgery each year with the aim of relieving symptoms (e.g., angina) and improving health-related-quality-of-life (HRQoL). Despite the demonstrated symptom-related benefits of these surgeries, evidence suggests that the development of chronic post-surgical pain (CPSP) is a major clinical problem. To date, several perioperative factors have been examined for their potential to confer risk for CPSP. Purpose: The purpose of the study was to explore the association between preoperative moderate to severe anxiety and depressive symptoms; moderate to severe acute postoperative pain; and cumulative opioid dose consumption with the development of CPSP at six months and 12 months after cardiac surgery. Method: Design. This thesis was a prospective observational cohort sub-study of adults undergoing cardiac surgery in a tertiary care hospital setting (n=735), recruited from Hamilton Health Sciences, Canada over a five year period. Measures. The independent variables included state anxiety, depressive symptoms, acute postoperative pain intensity, and opioid dose consumption. At baseline, the Spielberger State-Trait Anxiety Inventory (STAI) assessed state anxiety and the Hospital Anxiety and Depression Scale (HADS) assessed depressive symptoms. The Brief Pain Inventory-Short Form (BPI-SF) assessed acute postoperative pain intensity on postoperative days three (in-hospital) and 30 (at home via telephone). All instruments have established reliability and validity in cardiac surgery patients (e.g., STAI Cronbach’s alpha (α) =0.82; HADS α=0.81; BPI-SF α=0.87). Medical records were reviewed and total dose of opioids consumed up to three days postoperatively, were collected via analgesic chart audit and converted into milligrams of parenteral morphine equivalent dose using standard dosage tables. Dependent variable. The primary outcome of CPSP was assessed dichotomously (i.e., yes/no) at six months and 12 months after cardiac surgery. If present, CPSP was assessed via the BPI-SF. At baseline, data was collected on pre-specified model covariates (e.g., age, sex). Data Analyses. Logistic regression was used to model the primary outcome with the presence of CPSP at six months and 12 months, while adjusting for model covariates. Secondary linear regression models were constructed to examine the effect of the independent variables on the severity of CPSP with statistical significance set at p-values <0.05. Results: The incidence of CPSP was 8.7% at six months and 4.1% at 12 months after cardiac surgery. Baseline demographics (i.e., age, sex) and medical status (i.e., diabetes mellitus) were significantly associated with the presence of CPSP. Moderate to severe preoperative anxiety was not significantly associated with CPSP at six months (adjusted OR 0.629, 95% CI [0.300, 1.322], p=0.222) or 12 months (adjusted OR 0.743, 95% CI [0.242, 2.285], p=0.604). Moderate to severe preoperative depressive symptom was not significantly associated with CPSP at six months (adjusted OR 0.676, 95% CI [0.152, 3.005], p=0.607) or 12 months (adjusted OR 3.216, 95% CI [0.835, 12.382], p=0.089). Acute postoperative pain rated as pain ‘right now’ on day three was significantly associated with CPSP at six months (adjusted OR 2.263, 95% CI [1.255, 4.081], p=0.007) and 12 months (adjusted OR 2.749, 95% CI [1.174, 6.441], p=0.020). Acute postoperative pain ‘right now’ on day 30 was significantly associated with CPSP at six months (adjusted OR 2.913, 95% CI [1.304, 6.505], p=0.009). Cumulative opioid dose consumed was significantly associated with the development of CPSP at six months (adjusted OR 1.001, 95% CI [1.000, 1.002], p=0.003) and 12 months (adjusted OR 1.001, 95% CI [1.000, 1.001], p=0.033) after cardiac surgery. Significance: The findings demonstrate that acute postoperative pain ‘right now’ and cumulative opioid dose consumed are risk factors for CPSP after cardiac surgery. These findings offer targets for nursing staff to identify potentially at-risk patients, implement evidence-based pain management strategies, as well as contribute to nursing-led research designed to target CPSP after cardiac surgery. / Dissertation / Doctor of Philosophy (PhD)

Isaksson, H & Olsson, J. Upplevelse och behandling av postoperativ smärta. En litteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng. Malmö högskola: Fakulteten för Hälsa och Samhälle, Institutionen för vårdvetenskap, 2012.Smärta är en upplevelse som är personlig och individuell. Det finns en rad olika faktorer som påverkar upplevelsen av smärta i den postoperativa processen. I denna process har sjuksköterskan ett ansvar att behandla smärta genom sitt omvårdnadsarbete, men trots detta upplever patienter att denna omvårdnad är bristfällig. Syftet med denna litteraturstudie var att undersöka hur postoperativ smärtbehandling utfördes av sjuksköterskorna och hur patienter kan uppleva detta. Metoden var en litteraturstudie med systematisk ansats. Nio artiklar av både kvantitativ och kvalitativ ansats användes. Sökningarna skedde i databaserna Cinahl och PubMed. Resultatet visade att patienterna upplevde att den postoperativa smärtbehandlingen var i behov av förbättring när det gällde individualisering, samt att sjuksköterskorna hade olika attityder till postoperativ smärta vilket gjorde att patienterna fick olika uppfattningar om hur sjuksköterskan behandlade deras smärta. Nyckelord: kirurgi, omvårdnad, postoperativ smärta, smärtbehandling, upplevelse. / Isaksson, H & Olsson, J. Experience and treatment of postoperative pain. A literature review. Degree Project, 15 Credits Points. Nursing Programme, Malmö University: Faculty of Health and Society, Department of Health Care, 2012.Pain is a personal and individual experience. There are several factors that affect the experience of pain in the postoperative process. In this process the nurse has a responsibility to treat pain, despite that; patients perceive this care as defective. The purpose of this study was to explore how the nurses performed postoperative pain treatment and how patients can experience it. The method of this study was a literature review with a systematic approach. Nine studies of both quantitative and qualitative design were used. The searches were performed in two databases, Cinahl and PubMed. The results showed that patients felt that the postoperative pain treatment need of improvement when it comes to individualization and that nurses have different attitudes to postoperative pain, which gave the patients different perceptions of how the nurses treated their pain.Keywords: care, experience, pain treatment, postoperative pain, surgery

Bakgrund: Postoperativ smärta och illamående så kallad postoperative nausea and vomiting (PONV) är bland de vanligaste postoperativa komplikationerna och är kopplat till fördröjd återhämtning med ökad komplikationsrisk. Individuella- och processrelaterade faktorer påverkar förekomst av postoperativ smärta och PONV. Tarmopererade patienter skattar jämförelsevis hög postoperativ smärta. Anestesisjuksköterskan har ett stort ansvar att tillgodose god smärtlindring och postoperativ omvårdnad. Syfte: Beskriva fördelning av postoperativ smärta, PONV, patientkaraktäristika i förhållande till kön hos tarmopererade patienter. Även att identifiera könsskillnader relaterat till postoperativ smärta och PONV samt samband mellan postoperativ smärta, PONV, patientkaraktäristika och processdata. Metod: En retrospektiv studie med kvantitativ ansats, patientdata från Svenskt Perioperativt Register (SPOR) användes. Patienter som genomgick operation på tunn- och tjocktarm (KVÅ-kod JF) på ett länssjukhus i Sverige åren 2019 och 2022 inkluderades, totalt 420 patienter. Data redovisades med deskriptiv och analytisk statistik. Resultat: Flera signifikanta samband påvisades; högre ålder korrelerade med lägre skattad postoperativ smärta och längre operationstid korrelerade med högre skattad postoperativ smärta. Patienter med generell anestesi utan tillägg av regional anestesi, elektiv operation och PONV skattade högre postoperativ smärta. Resultatet visade en signifikant könsskillnad, kvinnor drabbades i större utsträckning av PONV än män. Slutsats: Dessa samband och skillnader belyser att postoperativ smärta är komplext. Fler studier bör utföras i syfte att klargöra riskfaktorer för postoperativ smärta och PONV, och för att förstå underliggande mekanismer. Det är viktigt att vårdpersonal i ett tidigt skede förebygger, identifierar och behandlar postoperativ smärta och PONV utifrån patientens bakgrund och kända riskfaktorer. För att detta ska ske måste en individbaserad strategi utarbetas, för god behandling och återhämtning. / Background: Postoperative pain and postoperative nausea and vomiting (PONV) are among the most common postoperative complications and is associated with prolonged recovery. Individual and surgery-related predictors affect the prevalence of postoperative pain and PONV. Patients who underwent bowel surgery rated postoperative pain comparatively high. The anesthetic nurse has a responsibility in providing effective pain treatment and qualitative postoperative care. Purpose: To describe the distribution of postoperative pain, PONV, patient characteristics in relation to gender among patients undergoing bowel surgery. Also, to identify gender differences related to postoperative pain and PONV, but also correlations between postoperative pain, PONV, patient characteristics and surgery related factors. Methods: A retrospective register study with a quantitative approach, data from the Swedish Perioperative Registry (SPOR) were used. Patients included underwent bowel surgery in an operating ward at a county hospital in Sweden by 2019 or 2022, resulting in 420 patients. Data was performed with descriptive and analytic statistics. Findings: Findings demonstrated several significant correlations; higher age correlated with lower postoperative pain and longer duration of surgery correlated with higher postoperative pain. Patients with general anesthesia without complementary regional anesthesia, elective operation or PONV rated higher postoperative pain. Findings demonstrated a significant difference in gender, women tended to experience PONV more frequently than men. Conclusion: Findings illustrate the complexity of postoperative pain. More studies must be done to clarify risk factors for postoperative pain and PONV and understanding their underlying mechanisms. It’s essential that caregivers prevent, identify, and treat postoperative pain and PONV based on patient background and known risk factors. An individual-based strategy needs to be developed; to provide effective treatment and recovery.

Barn och ungdomar har rätt till en god hälso- och sjukvård som bygger på evidens. I rollen som anestesisjuksköterska innefattas det flera utmanande beslut för att behandla postoperativ smärta. Vården är komplext då det är flera aspekter som behöver tas i beaktning. Patientgruppen har en ständigt pågående kognitiv utveckling vilket innebär att farmaka, bemötande av barn och föräldrar samt det multidisciplinära teamet behöver anpassas för ett välfungerande samspel i strävan mot patientens förbättrade hälsa. Syftet var att beskriva sjuksköterskors upplevelser av att vårda barn och ungdomar med smärta inom postoperativ vård. En systematisk litteraturöversikt valdes för att besvara syftet. Databaserna Cinahl, PubMed och Word web of Science användes. Litteraturöversikten inkluderade totalt 11 artiklar som analyserades med Bettany-Saltikov och McSherrys nio-stegsprocess. Resultatet framkom till tre huvudkategorier: föräldrars inkludering i det multidisciplinära teamet, där framhävs vikten av kommunikation och föräldrar som bidrar till trygghet hos barnet, samt hur ett ansvar läggs på föräldrarna. Nästa var sjukvårdens förutsättningar, som belyser strukturella hinder och barriärer i organisationen, såsom hög arbetsbelastning och tidsbrist vilket påverkade den postoperativa vården. Den sista huvudkategorin blev smärtans uttryck och dess olika behandlingsstrategier, som beskriver upplevelsen av olika fysiologiska och beteendemässiga indikationer som mått på smärta, samt dess behandlingsstrategier. Slutsatsen belyser föräldrars betydande roll i mötet med sjuksköterskan. Vidare framhävs sjuksköterskornas begränsade tid och kunskapsbrist i den postoperativa vården, där erfarenhet spelade en avgörande roll i hur smärthantering implementerades. / Children and adolescents have the right to good healthcare that is based on evidence. In the role of a nurse anesthesia, several challenging decisions are involved in guiding the patient group towards improved health. Healthcare is complex as multiple aspects need to be considered. The patient group is undergoing continuous cognitive development, meaning that pharmacology, interactions with children and parents, and the multidisciplinary team need to be adapted for a well-functioning interaction in the pursuit of the patient's improved health. The aim was to describe nurses' experiences in caring for children and adolescents with pain in postoperative care. A systematic literature review was chosen to address this purpose. The databases Cinahl, PubMed, and Web of Science were used. The literature review included a total of 11 articles that were analyzed using Bettany-Saltikov and McSherry's nine-step process. The results led to three main categories: the inclusion of parents in the multidisciplinary team, highlighting the importance of communication and parents providing comfort to the child, as well as placing responsibility on the parents. The next main category was healthcare conditions, illustrating structural obstacles and barriers in the organization, especially high workload and time constraints affecting postoperative care. The main category was the expression of pain and its various treatment strategies, describing the experience of different physiological and behavioral indications and measures of pain, as well as its treatment strategies. In conclusion, the significant role of parents in the interaction with nurses is emphasized. Furthermore, the limited time and knowledge gap of nurses in postoperative care are highlighted, where experience played a crucial role in the implementation of pain management.