This study tested the effect of a preoperative pain communication intervention on older adults’ ability to obtain pain relief after a total knee arthroplasty. A posttest-only experimental design was used to compare older adults randomly assigned to (a) view a pain management and pain communication film, (b) view the pain management film only, or (c) receive standard care only. Initial method adjustments decreased potential error in the study. Adjustments included testing only total knee arthroplasty patients receiving standard physical therapy and omitting unreliable measures from the analyses. Recruitment of the standard care group was halted when differences emerged between the remaining groups. Older adults in the communication group reported significantly less sensory pain on postoperative Day 1 than older adults in the pain management only group. Teaching older adults both pain communication skills and pain management information before surgery might result in greater pain relief during the early postoperative period.
Bolton, J. (1999). Accuracy of recall of usual pain intensity in back patients. Pain, 83, 533-539.
2.
Closs, S. (1999). Implementation of research findings to reduce postoperative pain at night. International Journal of Nursing Studies, 36, 21-31.
3.
Coupland, N., Coupland, J., Giles, H., & Henwood, K. (1988). Accommodating the older adult: Invoking and extending a theory. Language in Society, 17, 1-41.
4.
Dahl, J., Rosenberg, J., Hansen, B., Hjortso, N., & Kehlet, H. (1992). Differential analgesia effects of low-dose epidural morphine and morphine-bupivacaine at rest and during mobilization after major abdominal surgery. Anesthesia & Analgesia, 74, 362-365.
5.
de Rond, M., de Wit, R., van Dam, F., & Muller, M. (2000). A pain monitoring program for nurses: Effects on communication, assessment and documentation of patients’ pain. Journal of Pain & Symptom Management, 20, 424-439.
6.
Dudgeon, D., Raubertas, R.,& Rosenthal, S. (1993). The short-form McGill Pain Questionnaire in chronic cancer pain. Journal of Pain & Symptom Management, 8, 191-195.
7.
Farrar, J., Young, J., LaMoreaux, L., Werth, J., & Poole, M. (2001). Clinical importance of changes in chronic pain intensity measured on an 11-point numerical rating scale. Pain, 94, 149-158.
8.
Ferrell, B., Rhiner, M., & Ferrell, B. (1993). Development and implementation of a pain education program. Cancer, 72, 3426-3432.
9.
Kelly, A. (1998). Does the clinically significant differences in visual analog scale pain scores vary with gender, age, or cause of pain?Academic Emergency Medicine, 5, 1086-1090.
10.
Lund, C., Morgensen, T., Hjortso, N., & Kehlet, H. (1985). Systematic morphine enhances spread of sensory analgesia during postoperative epidural bupivacaine infusion. Lancet, 2, 1156-1157.
11.
McCaffery, M., & Ferrell, B. (1995). Nurses’ knowledge about cancer pain: A survey of five countries. Journal of Pain & Symptom Management, 10, 356-367.
12.
McDonald, D., Freeland, M., Thomas, G.,& Moore, J. (2001). Testing a preoperative pain management intervention for older adults. Research in Nursing & Health, 24, 402-409.
13.
McDonald, D., McNulty, J., Erickson, K.,& Weiskopf, C. (2000). Communicating pain and pain management needs after surgery. Applied Nursing Research, 13, 70-75.
14.
McDonald, D., & Sterling, R. (1998). Acute pain reduction strategies used by well older adults. International Journal of Nursing Studies, 35, 265-270.
15.
Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1, 277-299.
16.
Melzack, R. (1987). The short-form McGill Pain Questionnaire. Pain, 30, 191-197.
17.
Miaskowski, C., Dodd, M., West, C., Schumacher, K., Paul, S., Tripathy, D., et al. (2004). Randomized clinical trial of the effectiveness of a self-care intervention to improved cancer pain management. Journal of Clinical Oncology, 22, 1713–1720.
18.
Neelon, V., Champagne, M., Carlson, J., & Funk, S. (1996). The NEECHAM Confusion Scale: Construction, validation, and clinical testing. Nursing Research, 45, 324-330.
19.
Neelon, V., Champagne, M., McConnell, E., Carlson, J., & Funk, S. (1992). Use of the NEECHAM Confusion Scale to assess acute confusional states of hospitalized, older patients. In S. Funk, E. Tornquist, M. Champagne, & R. Wiese (Eds.), Key aspects of older adult care: Managing falls, incontinence, and cognitive impairment(pp. 278-289). New York: Springer.
20.
Oliver, J., Kravitz, R., Kaplan, S., & Meyers, F. (2001). Individualized patient education and coaching to improve pain control among cancer outpatients. Journal of Clinical Oncology, 19, 2206-2212.
21.
Powell, R.,& Single, H. (1996). Focus groups. International Journal of Qualitative Health Care, 8, 499-504.
22.
Tabachnick, B., & Fidell, L. (1996). Using multivariate statistics(3rd ed.). New York: Harper Collins College Publishers.
23.
Tafas, C., Patiraki, E., McDonald, D.,& Lemonidou, C. (2002). Testing an instrument measuring Greek nurses’ knowledge and attitudes regarding pain. Cancer Nursing, 25, 1-7.
24.
Todd, K., Funk, K., Funk, J., & Bonacci, R. (1996). Clinical significance of reported changes in pain severity. Annals of Emergency Medicine, 27, 485-489.
25.
Walmsley, P., Brockopp, D.,& Brockopp, G. (1992). The role of prior pain experience and expectations on postoperative pain. Journal of Pain & Symptom Management, 7, 34-37.
26.
Ward, S., Donovan, H., Owen, B., Grosen, E., & Serlin, R. (2000). An individualized intervention to overcome patient-related barriers to pain management in women with gynecologic cancers. Research in Nursing & Health, 23, 393-405.
27.
Wilkie, D., Williams, A., Grevstad, P., & Mekwa, J. (1995). Coaching persons with lung cancer to report sensory pain. Cancer Nursing, 18, 7-15.
28.
Zubieta, J., Heitzeg, M., Smith, Y., Bueller, J., Xu, K., Koeppe, R., et al. (2003). COMT val 158 met genotype affects µ-opioid neurotransmitter responses to a pain stressor. Science, 299, 1240-1243.
