DIMENSIONS AND PREDICTORS OF PAIN IN CRITICALLY ILL THORACOABDOMINAL SURGICAL PATIENTS (INTENSIVE CARE NURSING, POST OPERATIVE PAIN).
Contributors: University of California, San Francisco.
Published: 1991
Number of pages: 173
Subjects: Health Sciences, Nursing.
Description: Pain is a significant stressor for critically ill patients. Yet the nature of their pain remains poorly understood. To address this problem, dimensions of post-surgical and procedural pain in critical care patients were studied. Also investigated were predictors of pain and relationships of pain to morbidity factors.

The sample consisted of 74 cardiovascular surgical patients. Tonic post-surgical pain was measured over three immediate postoperative days. Procedural pain from chest tube removal and endotracheal suctioning was also measured. Dimensions of pain examined were its intensity and extent as well as its sensory (e.g. throbbing or sharp) and affective qualities. Pain measures included the McGill Pain Questionnaire-Short Form and pain intensity scales. Predictors included personality adjustment measured by the California Q-Set, age, gender, and amount of analgesics. Morbidity factors were also determined through chart review.

Results indicated that patient tonic pain intensity was moderate but did not diminish over three days. Patient pain was quite localized. Patients used few sensory and affective pain descriptors, indicating that physical sensations and emotional tension associated with pain caused little distress. Vascular surgery patients reported significantly more pain than cardiac surgery patients, and chest tube pain was significantly more intense than endotracheal suctioning or tonic pain. The more pain intensity associated with chest tube removal, the less pain relief obtained from analgesics.

Overall, patients received very little analgesics. However, analgesic amount was a primary and significant pain predictor. Gender was a significant predictor of degree of sensory pain, suggesting that women may be more bothered by physical sensations of pain than men. Personality factors did not predict any pain dimension.

The longer a patient needed to be intubated, the less s/he was bothered by physical sensations of pain, suggesting that severity of illness might influence pain perception. Patients with higher pain intensity were significantly more likely to have atelectasis. However, other morbidity factors, such as length of critical care stay and psychological disturbances, were not associated with patient pain.

Research results demonstrated that pain can be assessed comprehensively with critically ill patients even when they are intubated. Findings suggest the need to develop and test more effective interventions for critical care patient pain relief.
Notes: Source: Dissertation Abstracts International, Volume: 52-03, Section: B, page: 1357.

Thesis (D.N.S.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1991.

School code: 0034.