Women's descriptions of postoperative pain and pain management after discharge from cardiac surgery.

AIM AND OBJECTIVES: To provide new insights into the postoperative pain experiences of women after coming home following cardiac surgery.

BACKGROUND: Studies show that many patients experience postoperative wound discomfort after cardiac surgery and women experience more pain than men before discharge. Male experiences have shaped the accepted biomedical theories on how cardiac surgery influences the lives of women. This has led to more cardiac studies with only female respondents in the past 10 years, but few focus on pain and pain management after early discharge.

METHODS: The study reported here is part of a larger qualitative descriptive study. A self-developed pain diary measured pain intensity, types and amount of pain medication and its effectiveness at bedtime every day after returning home from hospital. The Brief Pain Inventory - Short Form provided a basis for comparison with the pain scores rated in the diaries from the final sample of nine women. Semi-structured interviews gave illuminating statements.

RESULTS: The women had pain in the chest almost every day the first two weeks at home and this was expected. The pain in their neck, shoulders and back was unexpected and this pain worried them more. The women wanted to take as little medication as possible. Regular intake of pain medication resulted in more even pain scores, but not necessarily lower pain scores.

CONCLUSIONS: The study adds new insights into how women experience postoperative pain upon returning home. Findings indicate that the women did not follow the recommended pain medication despite reporting worst pain as moderate or more during the whole period.

RELEVANCE TO CLINICAL PRACTICE: Early discharge from hospitals gives patients more responsibility for taking care of themselves. Patients need more specific information about taking pain medication on a specified schedule to control pain.