Dental and Medical Problems
2017, vol. 54, nr 2, April-June, p. 135–141
Publication type: original article
The assesment of the quality of postoperative pain management in patients with maxillofacial injury
Ocena bólu u pacjentów po zabiegach z zakresu chirurgii szczękowo-twarzowej
1 Department of Didactics in Intensive Medical Care and Emergency Medicine, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
2 Department of Anesthesiological and Intensive Care Nursing, Poznan University of Medical Sciences, Poznań, Poland
3 Department of Nursing, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland
4 Department of General of Nursing, Medical University of Gdansk, Gdańsk, Poland
5 Department of Emergency Medicine, Faclty of Medicine, University of Rzeszów, Rzeszów, Poland
Background. Postoperative pain is acute pain. Its prevalence is associated not only with the course of the disease but also with surgical damage to the tissue or the organs as well as the surgical wound.
Objectives. The aim of the paper is to evaluate the quality of perisurgical care in the aspect of postoperative pain in patients with a maxillofacial injury.
Material and Methods. The study involved 198 patients. The research included all the patients diagnosed with a maxillofacial injury who were admitted to the Clinical Ward of Maxillofacial Surgery.
Results. The average score in the clinical quality indicators in postoperative pain management was 47.89 and did not reach the minimal level of 63. A current intensification of pain amounted to 2.14 on average ± 1.54. In the 24 h time period the most severe postoperative pain was 4.55 ± 2.03, whereas the mildest pain experienced came to 2.4 ± 2.36. Satisfaction with the pain alleviation method was high, 7.71 ± 1.97. It has been proven that there is a correlation between the general score of the clinical quality indicators in postoperative pain management and the pain level according to the VAS scale, which as evaluated during the first 24 h after the surgery proved a significant dependency (p = 0.0000). The surveyed patients, who gave higher notes to the quality of pain treatment experienced pain amounting up to 4 pts. (minor pain) on the VAS scale.
Conclusion. Generally, the quality of the nursing care considering the postoperative pain management received average notes. The level of experience in postoperative pain management is higher in younger patients, who are university graduates suffering from mild pain as well as the patients with upper face injury.
postoperative pain, perisurgical care, care quality
ból pooperacyjny, opieka okołooperacyjna, jakość opieki
- Mędrzycka-Dąbrowska W, Ogrodniczuk M, Dąbrowski S, Basiński A. The organization and functioning of postoperative pain management in the UK. Anestezjol Rat. 2012;6:475–483 (in Polish).
- Mędrzycka-Dąbrowska W, Ogrodniczuk M, Dąbrowski S. The role of nurses in the treatment of postoperative pain – part I. Anestezjol Rat. 2012;6:332–338 (in Polish).
- Misiołek H, Mayzner-Zawadzka E, Dobrogowski J, Wordliczek J. The 2011 guidelines for acute pain and post-operative pain management. Ból. 2011;12:9–33 (in Polish).
- Misiołek H, Cettler M, Woroń J, Wordliczek J, Dobrogowski J, Mayzner-Zawadzka E. The 2014 guidelines for post- operative pain menagement. Anaesthesiol Intens Ther. 2014;46:221–244.
- Idvall E, Hamrin E, Unosson M. Development of instrument to measure strategic and clinical quality indicators In postoperative pain management. J Adv Nurs. 2002;37:532–540.
- Crowe L, Chang A, Fraser Ja, Gaskill D, Nash R, Wallace K. Systematic review of the effectiveness of nursing interventions in reducing or relieving post-operative pain. Internat J Evid Bas Healthcare. 2008;6: 396–430.
- Klopfenstein CE, Herrmann FR, Mamie C. Pain intensity and pain relif after surgery. Acta Anaesthesiol Scand. 2000;44:58–62.
- Sloman R, Rosen G, Rom M, Shir Y. Nurses’ assessment of pain in surgical patients. J Adv Nurs. 2005;52:125–132.
- Walker JA. What is the effect of preoperative information on patient satisfaction? Br J Nurs. 2007;16:27–32
- Buckley H. Nurses management of post- operative pain. Contempor Nurse. 2000;9:148–154.
- Dahl JL, Gordon D, Ward S, Skemp M, Wochos S, Schurr M. Institutionalizing pain management: The post-operative pain management qua improvement project. J Pain. 2003;4:361–371.
- Idvall E, Hamrin E, Sjöström B, Unosson M. Patient and nurse assessment of quality of care in postoperative pain management. Quality Safety Health Care. 2002;11:327–334.
- Tymecka I, Flis E. Diagnozing pain in children (pilot study). Ann Uniwersit Mariea Curie-Skłodowska. 2000;64:323–329 (in Polish).
- Wasilewski T. Subjective assessment of selected aspects of satisfaction with hospital stay in patients of surgical wards. Pieleg Chirurg Angiol. 2008;3:81–86 (in Polish).
- Machata AM, Kabon B, Willschke H, et al. A new instrument for pain assessment in the immediate postoperative period. Anesth. 2009;64:394–398.
- Hjermstad M-J, Fayers P, Haugen D, Garaceni A. Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: A systematic literature review. J Pain Symptom Manag. 2011;41:1073–1093.
- Jaracz K, Wdowczyk K, Górna K. Evaluation of the quality of care in terms of postoperative pain using the Polish version of the scale of clinical indicators of management quality of postoperative pain. Pielęg Pol. 2005;19:9–14 (in Polish).
- Juszczyk K. Factors influencing patient satisfaction with nursing care in light of the research. Pieleg Chirurg Angiol. 2013;8,115–117 (in Polish).
- Juszczyk K. The role of nurse In postoperative pain management. Pieleg Chirurg Angiol. 2009;4:131–134 (in Polish).
- Wanyura H. Facial skull injuries. Kryst L. (ed.). Chirurgia Szczękowo-twarzowa. PZWL. Warszawa 2007 (in Polish).
- Gunningberg L, Idvall E. The quality of postoperative pain management from the perspectives of patients, nurses and patient records. J Nurs Manag. 2007;15:756–766.
- Idvall E, Hamrin E, Rooke L, Sjostrom B. A tentative model for developing strategic clinical nursing quality indicators: Postoperative pain management. Internat J Nurs Pract. 1999;5:216–226
- Bączyk G, Ochmańska M, Stępień S. Subjective assessment of the quality of nursing care in terms of postoperative pain in patients treated surgically. Probl Pieleg. 2009;17:173–177 (in Polish).
- Herrera-Espineira C, Del Mar Rodriguez Del Aguila M, Rodriguez Del Castillo M, Fernandez Valdivia A, Reyes Sanchez I. Relationship between anxiety level of patients and their satisfaction with different aspects of healthcare. Health Policy. 2009;89:37–45.
- Sierpińska L, Dzirba A. The level of patient satisfaction with nursing care on surgical wards. Pieleg Chirurg Angiol. 2011;6:18–22 (in Polish).
- Idvall E. Quality of care in postoperative pain management: What is realistic in clinical practice? J Nurs Manag. 2004;12:162–166.
- Idvall E, Mamrin E. Quality indicators In postoperative pain management: A validation study. Scand J Caring Sci. 2001;15:331–338.
- Soderhamm O, Idvalle. Nurses` influence on quality of care In postoperative pain management: A phenomenological study. Internat J Nurs Pract. 2003;9:26–32.
- Gutysz-Wojnicka A, Dyk D, Cudak E, Ozga D. Measuring patient satisfaction with the Polish version of the Newcastle Satisfaction with Nursing Scale. Scand J Caring Sci. 2013;27:311–318.