Evaluating surgeons’ knowledge, attitude, and practice in managing acute pain in post-operative patients

Abstract

The aim of this study was to understand the knowledge, attitudes, and practices that surgeons in Malta have pertaining to the administration of analgesia for acute pain in post-operative patients. This study enquired about the different types of analgesics available, commonly known as analgesia. In conjunction with secondary data researched and primary data acquired from the participants of this study, this dissertation highlights the importance of proper assessment prior to prescribing analgesics. Data about pain assessment, pain management, the variety of analgesia in conjunction with co-morbidities, and the role of healthcare professionals in pain management was collected from surgeons coming from different medical fields and working in Mater Dei Hospital. The total number of participants who took part in this study was five, thus having a response rate of 33%. The primary data was acquired by conducting semi-structured one-to-one interviews with the participants. The participant was encouraged to provide personal attitudes and beliefs, in conjunction with knowledge pertaining to the research topic. From the interviews it was concluded that many surgeons liaise with an anaesthesiologist when prescribing post-operative analgesics for acute pain. The role physiotherapists and nurses during a patient’s post-operative stay at the hospital was given importance. A physiotherapist can contribute to the mitigation of pain by providing a non-pharmacological approach through therapy. Nurses, being the closest point of reference for patients, can contribute to both pain management and pain assessment as they are usually the ones that can identify any behavioural changes in patients that usually translate to unrelieved pain. Moreover, nurses are usually the ones who provide an explanation to patients about the medications they would be prescribed. Explanations are usually accompanied with a reassurance to the patient when one has both fears and concerns. Concerns are usually about any adverse reactions that can be caused by medications. The interviews also highlighted different modes of pain assessments. Pain can be measured objectively by taking the readings of parameters to check for any abnormalities such as tachycardia and shortness of breath or perspiration. A subjective method of assessment is by asking patients whether they are in pain or not. This can take several forms, such as providing the patient with a Visual Analogue Scale (VIS) where the patient is to choose a face that best resembles how he is feeling, ask the patient to provide a number between one and ten with one being the least pain and ten being the most pain possible, otherwise asking patients whether mobility was painful. Providing sound explanations and allowing patients to discuss medications proved very important in giving the patients an opportunity to contribute to their own care plan. This study appreciated how each patient is different and unveiled how undertreatment and overtreatment, albeit rare, can sometimes happen. This research provided an overview of how post-operative pain is handled nationally. When compared with secondary data that provided information on an international basis, a lot of similarities were noticed. In conclusion, pain management and pain assessment training should be given more importance by all healthcare professionals. Additionally, the implementation of Continuous Professional Development (CPD) courses to all healthcare professionals that are in direct communication with patients and their care can prove vital to providing better a better service and experience to the patient.