Title : The effectiveness of a pain management teaching intervention on post-operative cardiac patients in a tertiary care hospital of Karachi, Pakistan
Background: Cardiovascular diseases (CVD) are regarded as a major cause of death worldwide; around 18 million people die annually due to cardiovascular diseases. Most of the patients feel higher intensity of pain during the initial post-operative day and this gradually decreases over time. This pain increases during 5-12 post op days, but 40% of the pain is relieved by the time of discharge. If pain is not managed adequately, it can increase a patient’s length of stay (LOS), enhance clinical complications, escalate recurrent admissions, and decrease patients’ satisfaction. The aim of this pilot study was to assess the effectiveness of a pain management teaching intervention on post-operative cardiac patients, in a tertiary care hospital of Karachi, Pakistan. Moreover, this study also aimed to assess the feasibility of initiating a nurse-led pre-operative clinic in a tertiary care hospital of Karachi, Pakistan.
Methodology: A quantitative quasi experimental design, with comparison groups, was used to achieve the objectives of the study. This was a feasibility study conducted at a single period of time, where randomization could not be achieved and patients were recruited in time interval blocks. The study was conducted at the Aga Khan University Hospital, Karachi (AKUH), which is a tertiary care hospital. A consecutive sampling method was used. The sample size was 43; out of which 23 were in the control and 21 in the intervention group. The control group was given the routine care, as per the hospital policies and protocols while the intervention group was given pre-operative teaching a day prior to the surgery. Descriptive analysis and advanced analysis were carried out. Advance analysis included t-test for independent samples.
Results: The study showed significant difference in pain reporting as the pain reporting improved after the intervention. Moreover, patients were more satisfied with pain management in the intervention group. They also asked for pain medication more after being taught about the importance of pain reporting. There was significant reduction in anxiety in the intervention group. However, readiness for rehabilitation remained statistically insignificant.
Conclusion: This pilot study showed the effectiveness of pre-operative pain education on post-operative pain and other outcome variables. Therefore, results of this study suggest that a large-scale study can be conducted.