Women's experience of acute and chronic pain following breast cancer surgery

Authors

  • Inger L Hovind MSc, RN, CRNA,

    Nurse Anesthetist, Corresponding author
    • Division of Emergencies and Critical Care, Department of Nurse Anesthesia, Oslo University Hospital-Ullevål, Oslo, Norway
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  • Inger S Bredal PhD, RN, CCN,

    Associate Professor
    1. Oslo University Hospital/Institute of Health and Society, University of Oslo, Oslo, Norway
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  • Alfhild Dihle PhD, RN, CRNA

    Associate Professor
    1. Institute of Nursing and Health, Diakonhjemmet University College, Oslo, Norway
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Correspondence: Inger L Hovind, Nurse Anesthetist, Oslo University Hospital-Ullevål, P. O. Box 4950 Nydalen, N-0424 Oslo, Norway. Telephone: +47 615 02770.

E-mail: ilhovind@start.no

Abstract

Aims and objectives

To gain knowledge of how women experience pain and pain treatment after breast cancer surgery and to identify areas of pain management that they believe could be improved.

Background

According to the literature, 20–60% of patients develop chronic pain after breast cancer surgery and treatment. Because of the short length of hospitalisation in Norway, breast cancer patients are left responsible for most of their own pain management.

Design

An explorative and qualitative design was chosen.

Methods

In-depth interviews were conducted with eight women who experienced chronic pain rated at 3–5 on a 11-point numerical rating scale one year or more after breast cancer surgery. This study is part of a larger, quantitative study assessing pain after surgery. The interviews were taped, transcribed and analysed according to qualitative content analysis.

Results

The interviewees had expected pain in the acute postoperative period, but had not expected that pain would persist. None of the women recalled having received information about pain. They took few analgesics and were generally sceptical about medication, mostly because of earlier reactions to drugs. They received no explanations for and little help with chronic pain. Most of them were active and worked outside the home.

Conclusions

After short hospital stays, adequate information and follow-up after discharge may optimise pain management regimens. Those who develop chronic pain need more information and help to manage their pain.

Relevance to clinical practice

Finding the appropriate time for information about postoperative pain management is necessary to optimise a good analgesic regimen. Multimodal and aggressive treatment of acute pain should be emphasised.

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