Authors (including presenting author) :
Yeung LY(1), Kong PY (1), Chan LY(1), Tsui CH(1), Zhang J(1), Tang SS(1), Lam N(1), Wan HYS(1), Fung SS(1), Leung KNS(1), Wong LY(1)
Affiliation :
Department of Cardiothoracic Surgery, Queen Mary Hospital
Keyword 1: :
pain management
Keyword 2: :
cardiothoracic surgical nursing
Keyword 3: :
core competence
Keyword 4: :
holistic person-centered care
Keyword 5: :
quality service
Keyword 6: :
nurse empowerment
Introduction :
Postoperative pain management is a critical determinant to achieve successful postoperative care and early recovery among adult cardiothoracic surgical (CTS) patients considering prolonged pain after particularly invasive procedures. Effective pain control optimizes patients’ clinical outcomes, reduces complications, and enhances functional recovery. Nurses have unique pivotal role in effective pain recognition, patient communication, and timely intervention. Nevertheless, postoperative pain is frequently under-assessed and inadequately managed among nurses globally that may compromise quality service and patient safety, which remains a knowledge-practice-service gap towards optimal postoperative care.
Objectives :
(1) to enhance postoperative pain management through a nurse-led educational intervention under Knowledge–Attitude–Practice (KAP) model. (2) to strengthen nurses’ pain-related knowledge, foster proactive attitudes, and promote patient-centered pain management aligned with Enhanced Recovery After Surgery (ERAS) principles. (3) to bridge the knowledge-practice gap and promote holistic pain management plans
Methodology :
This pilot study utilized the Knowledge–Attitude–Practice (KAP) theoretical framework to design and evaluate a educational seminar on postoperative pain management. Using convenience sampling, ICU and general ward nurses were recruited from CTS department in an univeristy-afflicted hospital. The structured seminar comprised knowledge-based lecture on pain pathophysiology, pharmacological, non-pharmacological, multidisciplinary interventions, and standardized assessment tools, attitude-focused scenario discussions, and evidence-based clinical application strategies. Pre- and post-intervention electronic assessments referenced Knowledge and Attitudes Survey Regarding Pain (KASRP). Data were analysed using paired t-tests in SPSS version29, with statistical significance set at p< 0.05.
Result & Outcome :
Among 12 nurses (63.6% female; 45.5% with ≤2 years’ experience), overall competency scores improved significantly from 5.5±1.88 to 8.42±0.1 out of 10 (mean difference 2.92±2.31; 95% CI 1.45–4.39; p=0.001). Significant improvements were observed in pain-related and pharmacological knowledge (0.67±1.07, d=0.62; 1.17±1.03, d=1.13; both p< 0.05), as well as pain management practices (0.58±0.51, d=0.51; p< 0.05). Positive and respectful attitude shifts toward patient-reported pain, together with increased confidence in the nursing role, were the most positively rated outcomes reported by participants. Although improvement in nurse role interpretation did not reach statistical significance (0.33±0.65, d=0.65; p>0.05), this finding highlights an important direction for future training to address role-related practice barriers. Prior to training, 72.8% of participants reported inadequate pain management in previous institutions; following the intervention, all participants reported improved knowledge, confidence, and practical skills. Overall, this KAP-model-based educational approach was effective in enhancing nurses’ postoperative pain management competency and supports sustainable practice improvement to optimise patient experience and postoperative recovery.
