• Document: The impact of preoperative education by a nurseled Acute Pain Service on pain management for cardiac surgical patients.
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The impact of preoperative education by a nurse- led Acute Pain Service on pain management for cardiac surgical patients. Snezana Stolic, Bachelor of Nursing (NTU) Queensland University of Technology School of Nursing 2004 This thesis is submitted in fulfillment of the requirements for the award of the Master of Applied Science (Research) in the Faculty of Health Queensland University of Technology. 1 Abstract The aim of this research was to compare the pain experience of cardiac surgical patients who attended the Acute Pain Service (APS) education program with cardiac surgical patients who did not attend the APS. The participants of both groups, pain levels, consumption of total analgesia, anxiety levels, satisfaction with pain management, ratios of self-administered bolus doses and failed attempts on Patient Controlled Analgesia (PCA) device and their length of hospital stay were compared. The findings indicated no statistical significant differences between the two groups being investigated in relation to pain levels, total analgesia consumed, anxiety levels, satisfaction with pain management, total demands and delivery attempts on the PCA and their length of hospital stay. The clinical implications are significant. The preoperative pain management education program provided by APS clinical nurses for cardiac surgical patients does not have the positive outcomes expected. Key words: pain levels, anxiety, satisfaction, Patient Controlled Analgesia (PCA), Acute Pain Service (APS), analgesia, Adult Learning Theory 2 Statement of Original Authorship The work contained in this thesis has not been previously submitted for a degree or diploma at any other higher education institution. This thesis contains no material previously published or written by another person that I am aware of except where due references are made. Signed: Date: 3 Acknowledgements I wish to acknowledge my supervisors Dr Judy Wollin, Ms Lindy Humphreys-Reid and statistician Dr Stephen Cox in the School of Nursing for their thoughtful guidance, support and encouragement to complete this thesis. I would like to thank the American Pain society for permission to use the Inpatient- Outcome Questionnaire and Charles Spielberg for permission to use the State-Trait Anxiety Inventory as part of this study. Special thanks are given to Dr E Stafford (Executive Director of Cardiac Surgery at The Prince Charles Hospital), Mr Charles Ma (Director of Medical Records at The Prince Charles Hospital), Ms Cheryl Burns (Executive Director of Nursing Services at The Prince Charles Hospital) and to all the nurses, receptionists and cardiac surgical patients who supported and participated in this research. My appreciation is extended to my mother, brother-in-law, sisters and especially to my daughter Tegan for their understanding, generosity, patience and support during the difficult time of studying. Thank you all, Snezana Stolic 4 Table of Contents Chapter One- Introduction 11 1.1. Introduction 11 1.2. Background to the research 11 1.3. Methodology 17 1.3.1 Instruments 18 1.3.2. Data collection process 21 1.3.2.1. Recruitment of participants 21 1.3.2.2 Phase I Pre-operative interview 21 1.3.2.3 Phase II Post operative interview 22 1.3.2.4 Phase III Post discharge data collection 22 1.4. Data Analysis & Results 23 1.5. Ethical Considerations 30 1.6. Outline of the thesis 31 1.8. Conclusion 32 Chapter Two - Literature Review 35 2.1. Introduction 35 2.2. Pain 35 2.2.1. Definition of pain 35 2.2.2. Cardiac Surgical Patients Pain 37 2.2.3. Summary of Pain 40 2.3. Pain Management 40 2.3.1. Assessment of Pain 41 2.3.2. Pain relief interventions 42 2.3.3. Evaluation of pain relief intervention 48 2.3.4. Summary o

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