published_or_final_version / Nursing Studies / Master / Master of Nursing

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Postoperative pain is a major concern to patients undergoing surgical procedures but little research has been conducted on pain management after hospital discharge for orthopaedic patients. Since pain medication is a key component of pain management, it is important to study medication usage from a patient’s perspective, for greater patient–health care provider concordance. A qualitative descriptive approach was taken to investigate the experience of 14 participants with managing pain at home immediately after total knee arthroplasty. Most participants limited their consumption and weaned themselves off prescription analgesics and used over-the-counter pain medications. The participants adapted their regimens in response to several factors and generally were content to self-manage their pain but required access to professional support. The study suggests that when developing postoperative pain management plans, health care providers may need to increase the time they spend addressing patients’ concerns and considering patients’ preferences.

Postoperative pain is a major concern to patients undergoing surgical procedures but little research has been conducted on pain management after hospital discharge for orthopaedic patients. Since pain medication is a key component of pain management, it is important to study medication usage from a patient’s perspective, for greater patient–health care provider concordance. A qualitative descriptive approach was taken to investigate the experience of 14 participants with managing pain at home immediately after total knee arthroplasty. Most participants limited their consumption and weaned themselves off prescription analgesics and used over-the-counter pain medications. The participants adapted their regimens in response to several factors and generally were content to self-manage their pain but required access to professional support. The study suggests that when developing postoperative pain management plans, health care providers may need to increase the time they spend addressing patients’ concerns and considering patients’ preferences.

The purpose of this study was to compare the cost-effectiveness between the 2 types of general anesthesia, namely, laryngeal mask (LMA) and endotracheal intubation (ETT). The study included 353 patients who received general anesthesia during operation in a medical center in Kaohsiung City. Of these, 183 patients were assigned to the LMA group, while the remaining 170 were assigned to the ETT group. The norm of cost adopted by this study was calculated as the average expense per hour incurred by using the anesthetic and hygienic materials for medicinal use. The indices of effectiveness were physical reactions that were tracked at 2 h and 8¡V10 h postoperatively; these indices were acute pain, dizzyness, sore throat, nausea, and vomiting. These 5 indices were rated on a scale of 0¡V10. A low score was considered to represent lesser side-effects and greater effectiveness of the anesthetic. Besides, the shorter the recovery time of the patient was, the higher the effectiveness would be. The conclusion showed that the cost of the average expense per hour produced by the anesthesia and hygienic materials of medicinal use in the LMA group was 531 dollars while in the ETT group was 1,017 dollars. In the LMA group, at 2 h postoperatively, the mean tracking score for acute pain was 2.9 ¡Ó 2.6; for dizzyness, 1.4 ¡Ó 1.9; for sore throat, 0.4 ¡Ó 1.1; for nausea, 0.5 ¡Ó 1.4; and for vomiting, 0.2 ¡Ó 0.9. In the LMA group, at 8¡V10 h postoperatively, the mean tracking score for acute pain was 0.9 ¡Ó 1.5; for dizzyness, 0.6¡Ó1.3; for sore throat, 0.2 ¡Ó 0.7; for nausea, 0.1 ¡Ó 0.6; and for vomiting, 0.07 ¡Ó 0.4. In the ETT group, at 2 h postoperatively, the mean tracking score for acute pain was 4.9 ¡Ó 3.2; for dizzyness, 2.6 ¡Ó 2.5; for sore throat, 2.0 ¡Ó 2.1; for nausea, 1.3 ¡Ó 2.4; and for vomiting, 0.7 ¡Ó 1.9. In the ETT group, at 8¡V10 h postoperatively, the mean tracking score for acute pain was 2.82¡Ó 2.5; for dizzyness, 1.9 ¡Ó 1.9; for sore throat, 1.3 ¡Ó 1.9; for nausea, 1.1 ¡Ó 2.1; and for vomiting, 0.7 ¡Ó 1.9. The mean postoperative recovery time of the patients in the LMA group was 11.5¡Ó13.2 min and that for the patients in the ETT group was 25.9¡Ó16.0 min. T-test was performed to examine the hypothesis that LMA is more cost-effective than ETT when the same variables as those mentioned above are used; the results of all variables support the hypothesis that the p-value of every index was .000. Results of stepwise regression showed that LMA plays a significant positive role in every cost-effectiveness index.

Thesis (M.A.)--York University, 2008. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 86-93). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR45952

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Pain and anxiety are common among patients having surgery and education is essential in enabling patients to cope with postoperative pain and anxiety and improve outcomes. Since there is a trend for shorter hospital stays and a scarcity of supportive healthcare resources, patients will be required to be more self-sufficient. Testing of a randomized preoperative education program was conducted, to see if the program improves the thoracic surgical patients ability to improve their postoperative pain, anxiety and Quality of Life. This study found that there was no statistically significant difference in pain, anxiety or Quality of Life (with the exception of diarrhea) scores between the education intervention group and the standard group. There were significant clinical alterations in postoperative scores from baseline. Further research is needed to determine if other specific treatments for pain, anxiety and Quality of Life are warranted.

Diss. (sammanfattning) Linköping : Univ., 2001. / Härtill 5 uppsatser.