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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Elective General Surgery Patients | Adult patients undergoing elective general surgery who receive routine postoperative analgesic monitoring as part of standard clinical care. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No intervention (observational study) | Other | No intervention is applied in this study. Participants receive standard postoperative care, including routine analgesic monitoring, as part of usual clinical practice. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Disclosure Behavior | Pain disclosure behavior is measured using the Pain Disclosure Behavior Scale (PDB), a self-report questionnaire consisting of 3 items. Each item is rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Total scores range from 3 to 15, with higher scores indicating greater willingness to report pain accurately and to request analgesia when needed. | Postoperative days 1 to 3 |
| Measure | Description | Time Frame |
|---|---|---|
| Trust in Nursing Care | Trust in nursing care is assessed using the Trust in Nursing Care Scale (TNC), a 3-item self-report instrument. Items are rated on a 5-point Likert scale from 1 (very low trust) to 5 (very high trust). Total scores range from 3 to 15, with higher scores indicating greater trust in nursing competence, intentions, and clinical judgment. | Postoperative days 1 to 3 |
| Measure | Description | Time Frame |
|---|---|---|
| Patient Experiences of Postoperative Analgesic Monitoring | Qualitative experiences of postoperative analgesic monitoring are collected through semi-structured interviews. Data are recorded as verbatim textual transcripts and analyzed thematically. No numerical unit of measurement is applied. | Up to 48 hours following surgery |
Inclusion Criteria:
Exclusion Criteria:
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The study population consists of adult patients undergoing elective general surgery who are hospitalized postoperatively and receive routine analgesic monitoring as part of standard nursing care in a tertiary university hospital.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ağrı Training and Research Hospital | AĞRI | Merkez | 04100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24237004 | Background | Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin. 2014 Jan;30(1):149-60. doi: 10.1185/03007995.2013.860019. Epub 2013 Nov 15. | |
| 9251999 | Background | Salmon P, Manyande A. Good patients cope with their pain: postoperative analgesia and nurses' perceptions of their patients' pain. Pain. 1996 Nov;68(1):63-68. doi: 10.1016/S0304-3959(96)03171-5. |
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Individual participant data (IPD) will not be shared. The study involves patient-reported perceptions, psychosocial measures, and qualitative interview data collected in a postoperative clinical setting. Sharing IPD could pose a risk to participant confidentiality and privacy. Only aggregated and anonymized results will be reported in publications.
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D019370 | Observation |
| ID | Term |
|---|---|
| D008722 | Methods |
| D008919 | Investigative Techniques |
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| Monitoring-Related Anxiety | Monitoring-related anxiety is measured using the Monitoring-Related Anxiety Scale (MRA), a 3-item self-report questionnaire. Each item is scored on a 5-point Likert scale from 1 (not anxious at all) to 5 (extremely anxious). Total scores range from 3 to 15, with higher scores indicating greater anxiety related to postoperative analgesic monitoring. | Postoperative days 1 to 3 |
| Perceived Surveillance-Oriented Analgesic Monitoring | Perceived surveillance-oriented analgesic monitoring is assessed using the Perceived Surveillance of Analgesic Monitoring Scale (PSAM). The scale consists of 3 items rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). Total scores range from 3 to 15, with higher scores reflecting stronger perceptions of monitoring as controlling or surveillance-oriented. | Postoperative days 1 to 3 |
| Perceived Supportive Analgesic Monitoring | Perceived supportive analgesic monitoring is measured using the Perceived Supportive Monitoring Scale (PSM), a 3-item self-report instrument. Items are scored on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). Total scores range from 3 to 15, with higher scores indicating greater perception of analgesic monitoring as supportive and reassuring. | Postoperative days 1 to 3 |
| Perceived Nursing Communication Quality | Nursing communication quality is assessed using a validated Nursing Communication Quality Scale consisting of 4 items. Each item is rated on a 5-point Likert scale from 1 (very poor communication) to 5 (excellent communication). Total scores range from 4 to 20, with higher scores indicating better perceived communication quality. | Postoperative days 1 to 3 |
| 19672167 | Background | Ip HY, Abrishami A, Peng PW, Wong J, Chung F. Predictors of postoperative pain and analgesic consumption: a qualitative systematic review. Anesthesiology. 2009 Sep;111(3):657-77. doi: 10.1097/ALN.0b013e3181aae87a. |
| 39104294 | Background | Qaddumi J, Arda AM, Alkhawaldeh A, ALBashtawy M, Abdalrahim A, ALBashtawy S, Al Omari O, Bashtawi M, Masa'deh R, ALBashtawy Z, Mohammad KI, ALBashtawy B, Aljezawi M, Khatatbeh H, Ta'an W, Suliman M, Al Dameery K, Bani Hani S. Preoperative anxiety, postoperative pain tolerance and analgesia consumption: A prospective cohort study. J Perioper Pract. 2025 Oct;35(10):426-436. doi: 10.1177/17504589241253489. Epub 2024 Aug 6. |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009422 | Nervous System Diseases |