American Pain Society Patient Outcome Research Articles

Acute Pain Services and pain-related patient-reported outcomes in Hungarian hospitals

BackgroundPostoperative pain management is an important part of surgical care, where Acute Pain Service offers added value in terms of patient outcomes and costs. The technology, however, has hardly been adopted in Hungary, with only two hospitals operating Acute Pain Service and whose performance has not been evaluated yet. This research compared pain management outcomes of surgical, orthopedic, and traumatology patients in Hungarian hospitals with and without Acute Pain Service.MethodsWe recruited 348 patients, 120 in the APS group and 228 in the control group, whose experience was surveyed with an adapted version of the American Pain Society Patient Outcome Questionnaire. The questionnaire covered pain intensity, pain interference with physical and emotional functions, side effects, patient satisfaction, information received, and participation in treatment decisions. The differences were analyzed by Fisher’s exact test and Mann–Whitney U test.ResultsThe APS group showed better results with lower pain intensity scores regarding worst postoperative pain (χ2 = 18.919, p = 0.0043). They reported less pain interference with activities in bed (χ2 = 21.978, p = 0.0006) and out of bed (χ2 = 14.341, p = 0.0129). Furthermore, patients in the APS group experienced fewer pain-management-related side effects, like nausea (χ2 = 15.240, p = 0.0101), drowsiness (χ2 = 26.965, p = 0.0001), and dizziness (χ2 = 13.980, p = 0.0124). However, patient information (χ2 = 3.480, p = 0.0945) and patient satisfaction (χ2 = 5.781, p = 0.2127) did not differ significantly between the two groups.ConclusionsOur findings confirm earlier international evidence on the benefits of Acute Pain Service in postoperative pain management and support the wider adoption of the technology in Hungarian hospitals. Nevertheless, close attention should be paid to patient information and involvement as better outcomes alone do not necessarily increase patient satisfaction.

Perioperative Intravenous Dexamethasone Significantly Reduces Postoperative Opioid Requirement and Nausea After Unilateral Elective Hip Arthroscopy: A Randomized Double-blinded Placebo-controlled Trial

Background: Previous studies have shown that dexamethasone has a positive effect on postoperative pain control, opioid consumption, nausea, and vomiting and length of hospital stay after arthroplasty surgery. Purpose/Hypothesis: The purpose of this study was to assess whether adding perioperative dexamethasone to our current pain regimen after hip arthroscopy is more effective than a placebo. It was hypothesized that dexamethasone would reduce postoperative pain, reduce opioid consumption, improve subjective pain and nausea scores, and reduce the number of vomiting events. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 50 patients requiring unilateral elective hip arthroscopy were randomized to receive intravenous dexamethasone immediately before induction of anesthesia and at 8 am on the first postoperative day (2 ×12 mg) or a placebo (sodium chloride 0.9%). The patient, the surgeons, the treating anesthesiologist, and the involved nursing and physical therapy personnel were blinded to group assignment. The primary outcome was postoperative pain, and secondary outcomes were opioid consumption and nausea scores—assessed using a translated revised version of the American Pain Society Patient Outcome Questionnaire 6 hours postoperatively and on days 1 and 2—and vomiting events. A clinical follow-up was performed 12 weeks postoperatively to assess adverse events. Results: The mean age at inclusion was 29 years in both groups. Postoperative pain levels did not differ significantly in most instances. Opioid requirements during the hospitalization in the dexamethasone group were significantly lower than those in the placebo group (31.96 ± 20.56 mg vs 51.43 ± 38 mg; P = .014). Significantly fewer vomiting events were noted in the dexamethasone group (0.15 ± 0.59 vs 0.65 ± 0.91; P = .034). Descriptive data and surgical parameters did not differ significantly. Conclusion: Perioperative intravenous dexamethasone significantly reduced postoperative opioid consumption by 40% without compromising pain level and safety, as no corticosteroid-related side effects were observed. Dexamethasone may be a valuable adjuvant to a multimodal systemic pain regimen after hip arthroscopy. Registration: NCT04610398 (ClinicalTrials.gov identifier).

Enhancing pain care with the American Pain Society Patient Outcome Questionnaire for use in the emergency department (APS-POQ-RED): validating a patient-reported outcome measure

BackgroundIn general, the quality of pain care in emergency departments (ED) is poor, despite up to 80% of all ED patients presenting with pain. This may be due to the...

Outcomes of Pain Management Among Postoperative Patients: A Cross-sectional Study

PurposePostoperative pain management has always been a significant challenge for both hospital staff and surgical patients. Determination of pain management outcomes among surgically treated patients may help develop pain management strategies, improve health services that would yield better outcomes, and increase patient satisfaction. This study aimed to assess the outcomes of pain management among postoperative patients. DesignThe study was a descriptive cross-sectional study. MethodsThe research was performed on postoperative patients at two university hospitals in North Cyprus from July to September 2019. The study sample consisted of 90 patients from both hospitals. The Turkish Version of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR) was used for data collection. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used to report the present study. FindingsThis study showed that the overall mean for pain severity and the worst pain experienced by patients after 24 hours was slightly higher than medium. Examination of interference of the pain with functions demonstrated that patients experienced problems with physical activities and sleeping. The most experienced side effects were nausea and drowsiness, and the most common emotions were anxiety and helplessness during the postsurgery period. The satisfaction rate of the patients with postoperative pain management was relatively high. ConclusionsA holistic approach with evidence-based practices is crucial for adequate postoperative pain management. The recommendations include the development of individual pain outcome strategies to improve overall satisfaction with pain management among postoperative patients.

Comparison of the effects of subcostal anterior quadratus lumborum block and thoracic paravertebral block in laparoscopic nephrectomy: a randomized study.

Thoracic paravertebral block (TPVB) may provide sufficient postoperative analgesia in laparoscopic nephrectomy (LSN) by ensuring ipsilateral somatic and visceral analgesia. However, there are serious reservations due to the complexity of the technique, and various complications thereof. Subcostal anterior quadratus lumborum block (S-QLB3) may be a safe alternative in LSN procedures. Therefore, this study aimed to compare the postoperative analgesic effects of TPVB and S-QLB3. This prospective, randomized, double-blind study included 60 patients aged 18-70 years who were planned to undergo LSN. The patients were randomly assigned to receive either unilateral ultrasound-guided S-QLB3 or TPVB. The primary outcome was postoperative cumulative 24-h morphine consumption. In addition, numeric rating scale (NRS) scores at rest/activity and the American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR) scores were also evaluated. While postoperative cumulative 24-h morphine consumption was lower in the TPVB group compared to the other group (mean±SD, 12±3.4 mg vs. 15.4±7.8 mg, P=0.03), NRS pain scores at rest/activity were similar in both groups at all measurement points. Considering the postoperative APS-POQ-R-TR data, only the score related to the pain-daily activity relationship was high in the S-QLB3 group (median [Q1-Q3], 0 [0-1] vs. 2 [0-5], P=0.004), whereas there was no difference between the other scores. In this study, NRS and APS-POQ-R-TR scores were similar in the S-QLB3 and TPVB groups, whereas cumulative morphine consumption was modestly lower in the TPVB group. This suggested that S-QLB3 could be an alternative to TPVB in patients undergoing LSN.

The Effects of Intraoperative Local Pain Cocktail Injections on Early Function and Patient Reported Outcomes: A Randomized Controlled Trial.

To determine if a peri-operative pain cocktail injection improves post-operative pain, ambulation distance and long-term outcomes in hip fracture patients. Prospective, single-blinded, randomized controlled trial. Academic Medical Center. Patients with OTA/AO 31A1-3 and 31B1-3 fractures undergoing operative fixation, excluding arthroplasty. Multimodal local injection of bupivacaine (Marcaine), morphine sulfate (Duramorph), ketorolac (Toradol) given at the fracture site at the time of hip fracture surgery (Hip Fracture Injection, HiFI). Patient-reported pain, American Pain Society Patient Outcome Questionnaire (APS-POQ), narcotic usage, length of stay, post-operative ambulation, Short Musculoskeletal Function Assessment (SMFA). 75 patients were in the treatment group and 109 in the control group. Patients in the HiFI group had a significant reduction in pain and narcotic usage compared to the control group on post-operative day (POD) 0 (p<0.01). Based on the APS-POQ, patients in the control group had a significantly harder time falling asleep, staying asleep, and experienced increased drowsiness on POD 1 (p<0.01). Patient ambulation distance was greater on POD 2 (p<0.01) and POD 3 (p<0.05) in the HiFI group. The control group experienced more major complications (p<0.05). At six-weeks post-op, patients in the treatment group reported significantly less pain, better ambulatory function, less insomnia, less depression, and better satisfaction than the control group as measured by the APS-POQ. The SMFA bothersome index was also significantly lower for patients in the HiFI group, p<0.05. Intraoperative HiFI not only improved early pain management and increased ambulation in patients undergoing hip fracture surgery while in the hospital, it was also associated with early improved health related quality of life following discharge. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

STRATEGI MANAJEMEN NYERI BERKORELASI DENGAN INTENSITAS NYERI PADA PASIEN POST OPERASI FRAKTUR EKTREMITAS BAWAH

Surgery can cause very severe pain in patients due to surgical incisions. To treat pain in fracture patients, effective pain management is needed. The pain management provided must be able to meet the patient's needs, one of which is the need for comfort. namely pharmacology and non-pharmacology. This study aims to identify the relationship between pain intensity and pain management strategies in post lower extremity fracture patients. This research is quantitative analytic in nature with a cross sectional approach. The sampling technique used purposive sampling with a total sample of 43 postoperative lower extremity fracture respondents. The instrument in this study used a pain scale for pain intensity, while the pain management strategy used the American pain society patient outcome questionnaire revised, with interview collection techniques. The results of the study showed that there was a relationship between pain intensity and pain management strategies in postoperative lower extremity fracture patients. 15 people (60.0%) experienced severe pain with good pain management strategies, 10 people (40.0%) had severe pain with sufficient pain management strategies, while 17 people had moderate pain with good pain management strategies (94.4%), and moderate pain with sufficient pain management strategies in 1 person (5.6%). This is based on the results of the calculation of the chi-square statistical test obtained Pvalue = 0.014 &lt;α = 0.05. There is a relationship between pain intensity felt by patients with pain management strategies in postoperative lower extremity fracture patients at Meuraxa Hospital Banda Aceh.

Evaluating patient outcomes in postoperative pain management according to the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)

BackgroundIn the first 24 h after surgery, it is necessary to evaluate the patient responses to pain, analgesia and patient satisfaction to prevent complications related to the pain management process. AimTo evaluate patients' outcomes (pain qualities, side effects of the pain management, pain treatment satisfaction, non-pharmacological pain treatment methods, predictors of pain management satisfaction and percentage of pain relief) according to the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) in the first 24 h. DesignCross-sectional study. MethodsThe study sample was comprised of 700 patients, who were surgically treated at the surgical clinics of a university hospital and completed the first postoperative 24 h. The data was collected through the “Patient Information Form” and the “Turkish version of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)”. ResultsThe medians of the lowest and the worst postoperative pain severity level were 3.0 and 7.0, respectively. Patients experienced severe pain in 60 % of the first postoperative 24 h and reported that 70 % of their pain eventually decreased. A positive and significant correlation was found between pain interference, pain-affected mood/emotions, the severity of pain-related side effects, the least and worst pain severity levels and severe pain, and the percentage of time experienced with severe pain. ConclusionsMost of the patients experienced severe pain, which restricted their daily life activities and led to negative emotions. Acute postoperative pain may negatively affect patient outcomes and delay postoperative recovery during the early period. Therefore, pain should be managed in the early period to prevent physical and psychological side effects.

Trajectory of worst pain within the first two weeks following pelvic and sacral tumor surgery and long-term outcome: a pilot observational prospective cohort study

BackgroundPain management after pelvic and sacral tumor surgery is challenging and requires a multidisciplinary and multimodal approach. Few data on postoperative pain trajectories have been reported after pelvic and sacral tumor surgery. The aim of this pilot study was to determine pain trajectories within the first 2 weeks after surgery and explore the impact on long-term pain outcomes.MethodsPatients scheduled for pelvic and sacral tumor surgery were prospectively recruited. Worst/average pain scores were evaluated postoperatively using questions adapted from the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) until pain resolution was reached or up to 6 months after surgery. Pain trajectories over the first 2 weeks were compared using the k-means clustering algorithm. Whether pain trajectories were associated with long-term pain resolution and opioid cessation was assessed using Cox regression analysis.ResultsA total of 59 patients were included. Two distinct groups of trajectories for worst and average pain scores over the first 2 weeks were generated. The median pain duration in the high vs low pain group was 120.0 (95% CI [25.0, 215.0]) days vs 60.0 (95% CI [38.6, 81.4]) days (log rank p = 0.037). The median time to opioid cessation in the high vs low pain group was 60.0 (95% CI [30.0, 90.0]) days vs 7.0 (95% CI [4.7, 9.3]) days (log rank p < 0.001). After adjusting for patient and surgical factors, the high pain group was independently associated with prolonged opioid cessation (hazard ratio [HR] 2.423, 95% CI [1.254, 4.681], p = 0.008) but not pain resolution (HR 1.557, 95% CI [0.748, 3.243], p = 0.237).ConclusionsPostoperative pain is a significant problem among patients undergoing pelvic and sacral tumor surgery. High pain trajectories during the first 2 weeks after surgery were associated with delayed opioid cessation. Research is needed to explore interventions targeting pain trajectories and long-term pain outcomes.Trial registrationThe trial was registered at ClinicalTrials.gov (NCT03926858, 25/04/2019).

Translation and validation of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) for evaluating the effectiveness of acute pain services in the Indian population.

Translation and validation of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) for evaluating the effectiveness of acute pain services in the Indian population.

Patients' satisfaction with post-operative pain management in Ayder Comprehensive Specialized Hospital, Ethiopia: a cross-sectional study.

surgical patients often suffer from inadequate treatment of post-operative pain which potentially results in numerous adverse medical consequences and is a recurring source of patients' dissatisfaction. Thus, this study aimed to investigate patient's satisfaction with their post-operative pain management and its determinants among surgically treated patients in a specialized hospital within Ethiopia. an institutional-based prospective cross-sectional study was conducted in the surgical ward of Ayder Comprehensive Specialized Hospital. Data were collected using a semi-structured questionnaire, which was an adoption of the 2010 version of the American Pain Society Patient Outcome Questionnaire, and by reviewing the medical charts of the patients. A stepwise linear regression model was used to analyze the data. among the 144 patients approached in this study, 112 (77.8%) of them categorized their postoperative pain as moderate to severe. The mean patient satisfaction with their pain management was 7±2.3 on 0-10 numerical rating scale. Despite high levels of pain, the majority of patients (90.3%, n=131) were moderately or completely satisfied with their pain management. Stepwise linear regression analysis found that the determinants of patients' satisfaction were prior chronic pain, prior surgical history, and substance use (F (3,140) = 5.364, adjusted R2= 0.084, P=0.02). the patients were moderately and completely satisfied with their pain management in spite of expressing moderate and severe level of pain intensity. Pain still remains a concern among surgical patients, and effective pain management strategies should be practiced to manage pain and its functional interferences more effectively.

Comparison of the effectiveness of transversus abdominis plane block with laparoscopy or ultrasonography in laparoscopic cholecystectomy operations.

This study aims to compare the effectiveness of the Transversus Abdominis Plane (TAP) block applied to reduce postoperative pain in laparoscopic cholecystectomy surgery by ultrasonography (USG) and laparoscopy. A total of 170 patients who underwent laparoscopic cholecystectomy were divided into three groups. Group L received TAP block by laparoscopy, Group U received TAP block by USG, and the control group (Group C) did not receive TAP block. Bilateral subcostal 15 mL 0.5% bupivacaine was used for the TAP block. We recorded patients' demographic data and hemodynamic parameters, surgery time, anesthesia time, time of first postoperative analgesic need, visual analog scale (VAS) scores, time to first flatulence and stool, degree of nausea-vomiting, and the Turkish Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-T) scores. We observed no statistically significant differences between the groups in terms of age, gender, or American Society of Anesthesiologists scores, and body mass index was higher in Group U compared to the other groups (p<0.05). The VAS score was significantly higher in the control group at all times compared to the other two groups (p<0.001). VAS measurements were higher in Group U at postoperative 1st and 12th h compared to Group L (p<0.001). Surgery time and anesthesia time were significantly different between the groups (p=0.001). Group C showed high VAS scores, high pain severity by APS-POQ-R-T at the 24th postoperative hour, and low sleep quality and patient satisfaction. For laparoscopic cholecystectomy surgery, applying TAP block with the help of USG is effective in postoperative pain management. Applying TAP block with laparoscopy is easy since it does not require additional preparation or equipment during the procedure and may be preferred in the absence of a USG device.

Assessment of In-Hospital Pain Control after Childbirth and Its Correlation with Anxiety in the Postpartum Period: A Cross-Sectional Study at a Single Center in the USA

Anxiety is common during the antepartum, intrapartum, and postpartum period. While the relationship between obstetric pain and depression is well characterized, there are few publications examining the relationship between obstetric pain and anxiety. Our objective was to characterize the association, if any, between postpartum pain and anxiety. This was a survey-based cross-sectional study. The general anxiety disorder (GAD)-7 and American Pain Society patient outcome questionnaire (APS-POQ) were completed by 64 postpartum participants at hospital discharge. Associations between anxiety and pain control were assessed. Participants with moderate to severe scores (greater or equal to 10) on the GAD-7 had more maximum pain scores (0 to 10 scale) in the severe range (greater or equal to 7) in the first (p = 0.049) and second (p = 0.010) 24 h periods after delivery and were more likely to have spent more time in severe pain within these time frames (p = 0.007 and p = 0.010, respectively). Similar relationships were observed when classifying anxiety ordinally. In conclusion, higher postpartum pain scores were associated with greater anxiety in the postpartum period.

Postoperative Gabapentin's Effect on Opioid Consumption and Pain Control Following Sinonasal Surgery.

This study investigates the impact of postoperative gabapentin on opioid consumption and pain control following endoscopic sinus surgery (ESS) and/or septoplasty. Patients who underwent ESS and/or septoplasty at a single institution from 2021 to 2022 were enrolled. All patients received postoperative hydrocodone-acetaminophen for pain control. Half of the patients were also prescribed gabapentin for the first postoperative day in addition to hydrocodone-acetaminophen. Subjects completed the Revised American Pain Society Patient Outcome Questionnaire 24 h and 7 days after surgery. We conducted a multivariable regression analysis to assess opioid consumption and improvement in pain scores in the first week between gabapentin and non-gabapentin groups. A total of 102 subjects, 51 in each arm, were enrolled. The mean age was 52 years and 53% of participants were female. Controlling for important baseline demographic, clinical, and surgically related variables, the addition of postoperative gabapentin was associated with a 44% (9.5 mg from 21.6 mg) reduction in opioids consumed in the first postoperative week (B=-9.54, 95% C.I.=[-17.84, -1.24], p=0.025). In addition, patients in both arms exhibited similar improvement in pain severity and sleep interference in the first 7 days (B=-1.59, 95% C.I.=[-5.03, 1.84], p=0.36). To the best of our knowledge, this is the first study to investigate the impact of postoperative gabapentin on opioid consumption and pain control following ESS and/or septoplasty. Our analysis demonstrated that postoperative gabapentin effectively reduced opioid use during the first postoperative week without compromising pain control. 3 Laryngoscope, 133:1065-1072, 2023.

Effects of Transcutaneous Electrical Nerve Stimulation on Mastectomy Pain, Patient Satisfaction, and Patient Outcomes

Mastectomy is one of the most painful surgical procedures. Postoperative pain guidelines recommend transcutaneous electrical nerve stimulation (TENS) as a reliable non-pharmacological analgesic method. The aim of this study was to investigate the effects of TENS on postoperative pain and outcomes in patients undergoing modified radical mastectomy (MRM). A single-center, single-blind, prospective, randomized-controlled study. This single-center, single-blind, randomized-controlled study included a total of 80 patients who underwent MRM at general surgery clinic of a tertiary center were included. The pain management of the patient outcomes were evaluated using the Turkish Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR). The pain levels of the intervention group were lower than the control group. There were significant improvements in the patient outcomes such as mobilization, position, sleep, anxiety, and fear in the intervention group. Our study results suggest that TENS reduces MRM pain. Thus, TENS can be recommended as a useful analgesic method in MRM.

The perceptions and practices of parents and children on acute pain management among hospitalized children in two Botswana referral hospitals

BackgroundPerceptions and practices of parties in pediatric pain are critical in children's access to adequate acute pain management. The personal factors of the child and parents have been shown to be central to pediatric pain management by the Symptom Management Theory. AimTo describe children and parents/guardians' perceptions (knowledge, attitudes and beliefs) and practices regarding pediatric acute pain management and explain the influence of socio-cultural and environmental factors on those perceptions and practices. MethodsDescriptive cross-sectional survey using modified versions of the American Pain Society Patient Outcome Questionnaire-Revised among parents/guardians and children. ResultsA convenience sample of 275 parents/guardians and 42 children aged 8 to 13 years admitted between date November 2018 and February 2019 to two Botswana tertiary hospitals completed the surveys. Forty-seven percent (n = 129) of parents/guardians reported the child to be in moderate-severe pain, while 38% (n = 16) of children reported pain as moderate-severe at the time of the survey. The children mean scores for cm-APS-POQ-R were 113(33) while parents/guardian's guardians for m-APS-POQ-R were 123(26). The subscales except for the parents/’guardians' pain interference (p = .96) were statistically significant (p = .000), showing adequate knowledge, positive attitudes and high pain intensity for both parents/guardians and children. ConclusionParent/guardians and children reported a high incidence of acute pain, were content with pain management services, and showed adequate knowledge of pediatric pain and its management. The incongruence between the intensity of pain, satisfaction on the adequacy of pain management and knowledge and attitudes demonstrated in this study need further inquiry.

Evaluation of a whole process management model based on an information system for cancer patients with pain: A prospective nonrandomized controlled study

ObjectiveThe aim of this study was to evaluate the effects of whole process management model interventions based on information system benefits reported by patients with cancer pain. MethodsWe performed a quantitative, prospective nonrandomized controlled design from June to October 2020. A total of 124 cancer patients with pain were enrolled. Patients in the experimental group received a whole process management model intervention based on an information system compared to the control group who received routine cancer pain management. Data were collected at baseline and after a four-week follow-up, acting as a test-retest control. The primary outcome was pain management quality, which was measured using the American Pain Society Patient Outcome Questionnaire-Chinese version (APS-POQ-C). Secondary outcomes were patient-related attitudinal barriers and analgesic adherence. The Barrier Questionnaire (BQ) and a single-item questionnaire were used. Chi-square tests were used to compare the pain intensity and analgesic adherence, independent sample t-test and Mann–Whitney U test were performed to test the differences in the pain management quality and patient-related attitudinal barriers between control and experimental groups. ResultsBaseline characteristics and outcomes of the participants did not differ significantly (P ​> ​0.05). Primary outcomes were changes in four aspect of the quality of pain management (APS-POQ-C) between the two groups (P ​< ​0.05). Patients in the whole process management group reported significantly better pain control and perception of care than the control group. With respect to secondary endpoints, a significant difference in favor of the experimental group was found for barriers (P ​< ​0.05) and medication adherence (60.0% vs. 40.0%; P ​< ​0.05) after the interventions. ConclusionsThe whole process management of patients with cancer pain effectively improves patient-reported quality of pain management, reduces patient-perceived barriers, enhances patient adherence to analgesic drugs and is worthy of clinical application.

Patient Satisfaction With a Nurse-Led Pain Management Program: A Quasi-Experimental Study in Ethiopia.

Patient satisfaction is one of the important indicators of quality care. To examine patient ratings of pain management satisfaction before and after introducing a nurse-led management program. A quasi-experimental design with three cross-sectional surveys between October 1, 2016 and June 15, 2017. A total of 845 patients admitted to the four inpatient departments (medicine, surgery, maternity, and gynecology) of Jimma University Medical Centre were invited to participate in the study. A questionnaire adapted from the American Pain Society Patient Outcome Questionnaire, Pain Treatment Satisfaction Scale, and related literature was used for the survey. Data were analyzed using the chi-square test (categorical variables), t-tests for continuous variables, and robust regression to determine the effect of nurse-led management program on patient satisfaction. For all tests, p-values <.05 were considered statistically significant. Of the 845 patients invited, 782 (92.5%) participated in the surveys-Survey 1: N = 256; Survey 2: N = 259; Survey 3: N = 267. The proportion of patients who perceived that staff responded within 30 min increased from 67.8% in Survey 1 to 71.1% in Survey 2 and 74.2% in Survey 3. On a scale of 1 to 5 (1 = strongly dissatisfied and 5 = strongly satisfied), the overall mean patient satisfaction with pain management was 3.61 (SD 0.80) in Survey 1, 3.81 (SD 0.86) in Survey 2, and 4.10 (SD 0.64) in Survey 3. Moreover, the patients scored significantly higher on all satisfaction items in Survey 2 (B ranged between 0.12 and 0.41) and Survey 3 (B ranged between 0.24 and 0.74) compared to Survey 1. The patients' ratings of their satisfaction and staff nurse responsiveness following the nurse-led pain management program have increased compared to the levels before the intervention. However, further studies, including those with a control group, are warranted to confirm the results.

The Prevalence of Pain in the First 24 Hours After Surgery: A Multicenter Study

This study was conducted to determine the prevalence and severity of postoperative pain in the first 24 hours after surgery and to emphasize the importance of postoperative pain assessment. A descriptive study. This study was carried out on May 21, 2019 with 898 patients who had completed the postoperative 24th hour in the surgical clinics of 10 training and research hospitals in Istanbul, the capital of Turkey. Point prevalence was used in the study. Data were collected using a questionnaire developed by the researchers and the Revised American Pain Society Patient Outcome Questionnaire. Descriptive statistics were presented as frequency, percentage, mean, and standard deviation. Nonparametric tests were used for data without normal distribution (Kolmogorov-Smirnov Test, P < .05). Two-group comparisons were performed using the Mann-Whitney U test. The Kruskal Wallis-H test was used for the comparison of three or more groups. Statistical significance was set as P < .05. The three main types of surgery were general surgery with 31.8%, gynecologic surgery with 12.9%, and orthopedic surgery with 12.7%. The mean lowest level of pain felt by the patients included in the study in the first 24 hours was 3.90 ± 2.94, and the mean highest level of pain was 6.38 ± 4.45. Postoperative pain is a subjective phenomenon and may be affected by factors such as type of surgery, previous experience of surgery, duration of surgery, the length of the surgical incision, the type of anesthesia, the quality of postoperative care, individual characteristics and experiences, and fear anxiety; thus, the experience of pain may vary from person to person.

The Opioid Crisis and Radiation Therapy: A Patient Survey to Identify Best Practices for Pain Management

<h3>Purpose/Objective(s)</h3> The American opioid epidemic has reached a critical point in our nation's history. Long-term opioid use among cancer survivors is associated with a variety of worse long-term outcomes. We used a questionnaire to evaluate patient perspectives of their pain control during radiation in our department. It aimed to ascertain patient understanding of opioid prescribing practices and alternative pain control methods. <h3>Materials/Methods</h3> The questionnaire was based on the revised American Pain Society Patient outcome questionnaire. The survey was composed of 16 questions focusing on pain levels during radiation, interference with daily activities, effect on mood and emotions, alternative pain treatment methods, and opioid amount prescribed. The data was collected from patients with a head and neck cancer diagnosis who completed radiation treatment between May 2020 and January 2021. The survey was completed at their one-month follow-up visit. Data is recorded using descriptive statistics. <h3>Results</h3> We collected data from 60 patients. Using a 10-point scale, patients on average reported a 5.3 as the worst level of pain during radiation therapy. Pain at the one-month follow-up dropped down to a 2.1 average. During radiation, patients reported having severe pain 28% of a 24 hour/day timeframe. Patients reported 69% pain relief with their current pain regimen. Patients reported an average of 7.5 feeling like they were involved with their pain treatment decisions. Using a 10-point scale, patients were fairly satisfied with their pain management with an average response of 7.7. Of the patients surveyed, 52 (87%) reported that they received information about their pain treatment options. Only 44 (73%) of the patients used non-medicine methods to relieve their pain. On average they used 2.3 other techniques included meditation, listening to music, prayer, relaxation, walking, watching TV, reading, heat/cold, massage. Thirty-eight percent of patients reported never having a nurse or doctor discuss non-medication methods, 40% said sometimes, and 22% said often. In the survey, 72% of patients reporting using non-narcotic medication such as Tylenol or Ibuprofen. Of the 50 patients who were prescribed opioid analgesics, 24 (48%) had medication left over. On average, patients had 13 tablets left over. Of the 24 patients, 15 said they simply "kept" the medication and 9 said they "threw it away". <h3>Conclusion</h3> We aim for all providers to include patients in creating a personalized pain management plan. Better education needs to be provided to patients to help them build a foundation of pain control with non-opioid medications and techniques. Oncology patients are at particular high risk of prolonged opioid use/abuse. Patient education and prescription guidelines are paramount to improve patient perception of the need for opioids and alternatives to their pain control. These survey results will act as a cornerstone in developing these guidelines for a radiation oncology department.