Patients' Perceptions of Postoperative Analgesic Monitoring in Elective General Surgery

Patients' Perceptions of Postoperative Analgesic Monitoring in Elective General Surgery: A Mixed-Methods Structural Equation Modeling Study

This study examines how patients perceive postoperative analgesic monitoring during routine care in elective general surgery. Postoperative pain monitoring is a standard nursing practice, but patients may experience it as either supportive or stressful. These perceptions may influence patients' trust in nursing care, anxiety related to monitoring, and willingness to report pain accurately.

The study uses a mixed-methods observational design. In the quantitative phase, patients complete questionnaires about their experiences with pain monitoring, communication with nurses, trust, anxiety, and pain reporting during the first days after surgery. In the qualitative phase, selected patients participate in interviews to further explain and contextualize the survey findings. No changes are made to standard care, and no experimental treatments are used.

Postoperative analgesic monitoring is a routine component of nursing care in elective general surgery and is essential for patient safety and effective pain management. Although monitoring practices are intended to support patients, they may also be perceived as stressful or controlling, depending on how they are experienced and communicated. These perceptions may influence psychosocial processes such as trust in nursing care, anxiety related to monitoring, and patients' willingness to disclose pain.

This study is designed as a prospective observational mixed-methods study conducted in elective general surgery wards. No intervention is applied, and all participants receive standard postoperative care according to institutional protocols. The quantitative phase involves patient-reported questionnaires administered during the first 72 hours after surgery. These measures assess perceptions of postoperative analgesic monitoring, trust in nursing care, monitoring-related anxiety, pain disclosure behavior, and perceived quality of nursing communication.

Structural equation modeling is used to examine the relationships among these variables and to test hypothesized pathways between monitoring perceptions and pain disclosure behavior. The qualitative phase consists of in-depth interviews with a purposive subsample of participants selected based on contrasting survey responses. These interviews are used to explain and enrich the quantitative findings by exploring patients' experiences and interpretations of analgesic monitoring and communication.

Quantitative and qualitative findings are integrated during interpretation to provide a comprehensive understanding of how postoperative analgesic monitoring is perceived by patients and how these perceptions may influence communication and behavior related to pain management. The study aims to generate evidence that can inform patient-centered approaches to postoperative analgesic monitoring while maintaining routine clinical practice.

Inclusion Criteria:

• Adults aged 18 years or older
• Undergoing elective general surgery requiring postoperative inpatient care
• Receiving routine postoperative analgesic monitoring as part of standard clinical care
• Clinically stable during the postoperative data collection period
• Able to read and communicate in Turkish
• Able and willing to provide written informed consent

Exclusion Criteria:

• Emergency or urgent surgical procedures
• Postoperative admission to an intensive care unit
• Requirement for mechanical ventilation
• Documented cognitive impairment, acute delirium, or severe psychiatric illness
• Inability or unwillingness to complete study questionnaires or interviews