The Impact of Preoperative Distress: A Qualitative analysis of the Perioperative Pain Self-Management Intervention.
Kenda Stewart Steffensmeier, Jennifer Van Tiem, Ashlie Obrecht and 3 others
PMID 34215528WHAT IT FOUND
Veterans distressed before surgery valued help reframing pain and a trusting relationship.
Non-distressed Veterans valued practical relaxation skills. Both groups found goal setting hardest. These are reported experiences, not proof PePS reduces pain.
Key findings
01Veterans classified as distressed before surgery emphasized reframing pain and the therapeutic relationship, while non-distressed Veterans emphasized relaxation practice.
02Across distressed and non-distressed groups, participants found social support helpful and goal setting the most challenging part.
03Some participants found PePS repetitive or unnecessary because they already had skills or support.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a qualitative sub-analysis of a pilot study, not a trial of pain outcomes, so it cannot show that PePS reduces pain or improves recovery. Only 21 Veterans randomized to PePS were interviewed, and the sample came from one Midwestern Veterans Affairs medical center. Participants were rural-dwelling Veterans, mostly White and cisgender male, so preferences may not transfer to other populations. All participants knew they were in a pilot study intended to help fellow Veterans, which may have increased engagement and positive reports. PePS included several components delivered together, so the contribution of any single component cannot be separated. The interviewer was a woman, and participants likely identified her by voice, which may have affected candor.
Declared interests
The paper is listed as supported by NIH extramural and non-U.S. government research support. No author conflict-of-interest declaration is given.
The easy way to misread this
Do not conclude that PePS reduces post-surgical pain or that tailoring it to distress level improves outcomes. This paper reports experiences from 21 Veterans in a small pilot sample, and PePS included several components delivered together, so the contribution of any single component cannot be separated.