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Military Veterans' Perspectives on Postoperative Opioid Use: A Secondary Analysis of Qualitative Data.

Conrad M, Steffensmeier KS, Van Tiem J, Obrecht A, Mares J, Mosher HJ, Weg MWV, Sibenaller Z, Stout L, Patel P, Hadlandsmyth K. Military Veterans' Perspectives on Postoperative Opioid Use: A Secondary Analysis of Qualitative Data. Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses. 2023 Jun 1; 38(3):483-487.

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PURPOSE: This qualitative analysis of interviews with surgical patients who received a brief perioperative psychological intervention, in conjunction with standard medical perioperative care, elucidates patient perspectives on the use of pain self-management skills in relation to postoperative analgesics. DESIGN: This study is a secondary analysis of qualitative data from a randomized controlled trial. METHODS: Participants (N  =  21) were rural-dwelling United States Military Veterans from a mixed surgical sample who were randomized to receive a manual-based, telephone-based Perioperative Pain Self-management intervention consisting of a total of four pre- and postoperative contacts. Semi-structured qualitative interviews elicited participant feedback on the cognitive-behavioral intervention. Data was analyzed by two qualitative experts using MAXQDA software. Key word analyses focused on mention of analgesics in interviews. FINDINGS: Interviews revealed a dominant theme of ambivalence towards postoperative use of opioids. An additional theme concerned the varied ways acquiring pain self-management skills impacted postoperative opioid (and non-opioid analgesic) consumption. Participants reported that employment of pain self-management strategies reduced reliance on pharmacology for pain relief, prolonged the time between doses, took the "edge off" pain, and increased pain management self-efficacy. CONCLUSIONS: Perioperative patient education may benefit from inclusion of teaching non-pharmacologic pain self-management skills and collaborative planning with patients regarding how to use these skills in conjunction with opioid and non-opioid analgesics. Perianesthesia nurses may be in a critical position to provide interdisciplinary postoperative patient education that may optimize postoperative pain management while minimizing risks associated with prolonged opioid use.

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