ENGLISH TASK

JOURNAL ANALYSIS
Lecturer Supervisor: Allen Rufaida Purianingtyas, S.Pd., M.Pd

Disusun Oleh:
Muhamad Zaenal Abidin
NIM. P1337420616032
Profesi Ners

NERS STUDY PROGRAM SEMARANG

NURSING DEPARTEMENT SEMARANG
HEALTH POLYTECHNIC MINISTRY OF HEALTH SEMARANG
2022
 ANSWER THE FOLLOWING QUESTION

1. Does this journal connect with something else that you have read? Why? Yes, this journal is
related to what I read recently because of my final project papper about Postoperative Pain
Management And Documentation
2. Does it give you some new knowledge related to the subject? Why? Yes, this journal gave me
new knowledge about what i need for my final project papper, such as Inadequate post
operative pain management is an international problem and the need to improve its
management is well documented.
3. Is the abstract good enough? Why?
In my opinion the journal abstract has explained the entire contents of the journal.
4. Has the journal explain the gap related to the previous researches? In this journal also explain
the gaps from previous research such as:
a. Inadequate postoperative pain management is an international problem and the need to
improve its management is well documented.
b. The reports related to the patients’ pain intensity and quality, concomitant symptoms, use
of scales in pain assessment, and compliance with the national guideline after surgery.
5. What question would you like to ask to the researcher? Write a sentence! The question that I
want to ask the researcher is: What is the interesting thing that catches your attention? and
Why you take this title or topic as the title of your research?

DIFFICULT WORDS IN THE JOURNAL

1. Inadequate = Tidak Memada

2. Concomitant Symptoms = Gejala Bersamaan
3. Compliance = Kepatuhan
4. Retrospective = Pedoman
5. Incorporated = Tergabung
6. Recognition = Pengakuan
7. Depends = Tergantung
8. Relieves Suffering = Meringankan Penderitaan
9. Prolonged Length Of Stays = Masa Inap Yang Lama
10. Poor Clinical Outcomes = Hasil Klinis Yang Buruk
11. Emphasis = Penekanan
12. Still Experience = Masih Mengalami
13. Essential = Penting
14. Consider = Pertimbangkan
15. Inevitable = Tak Terhindarkan
16. Alleviate = Meringankan
Postoperative Pain

DOI: 10.5455/msm.2016.28.36-40
Received: 19 October 2015; Accepted: 05 January 2016

© 2016 Foozieh Rafati, Maryam Soltaninejad, Mohamad Reza Aflatoonian, Fatemeh Mashayekhi
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License
(http://creativecommons.org/licenses/bync/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the
original work is properly cited.

ORIGINAL PAPER Mater Sociomed. 2016 Feb; 28(1): 36-40

POSTOPERATIVE PAIN: MANAGEMENT AND

DOCUMENTATION BY IRANIAN NURSES
Foozieh Rafati1,2, Maryam Soltaninejad3, Mohamad Reza Aflatoonian4, Fatemeh Mashayekhi5
1Razi Nursing and Midwifery College Kerman, Iran
2Psychiatric Nursing Lecturer, Faculty Member of Jiroft University of Medical Sciences, Jiroft, Iran
3Critical Care Nursing, Department of Nursing and Midwifery, Kerman University of Medical, Kerman, Iran

4Department of Infectious and Tropical Disease Research Center, HSR Research Committee, Kerman University of

Medical Sciences, Kerman, Iran

5Msc Critical Care Nursing Lecturer, Faculty Member of Jiroft University of Medical Sciences, Jiroft, Iran

Corresponding author: Fatemeh Mashayekhi, Department of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft,
Iran. Tel : +989133482130. E- mail: fatememashayekhi1970@gmail.com

ABSTRACT
Background: Pa i n i s one of the most common symptoms experienced by pa tients after s urgeries. Inadequate postoperative pain
ma nagement is an international problem and the need to improve i ts management is well documented. The aim of the study was to
a s sess nursing reports related to the patients’ pain intensity a nd quality, concomitant s ymptoms, use of s cales i n pain assessment,
a nd compliance with the national guideline a fter s urgery. Methods: Thi s s tudy wa s a retrospective cohort; s amples were nurse
records of patients who had elective surgery. Result: Onl y 6% of the patients’ pain records included pain intensity which was not
mea sured with standard scales. More than half of all i njections were opioid a nalgesic which is in contrast to the guidelines of the
Ira nian Mi nistry of Health. Pain a ssessment was higher in women a nd by nurses with more than 15 years of working experience.
Conclusion: to concl ude, the patients’ pain was not a ssessed properly i n terms of i ntensity, quality, a nd a ssociated s ymptoms.
Therefore, tra ining and motiva ting nurses is very i mportant i n this context and should be i ncorporated
i n nurses’ academic and continuous educational courses. Key the hospital stay; both patie nts and the organization may
words: Nursing, Pain, Patient Records, Postoperative. suffe r. Activation of sympathe tic system, increased

re admissions, prolonge d le ngth of stays and poor clinical

1. INTRODUCTION
The re has be e n a growing re cognition that pain is a
comple x pe rceptual e xpe rience influe nced by a wide range
of psychosocial factors including e motions, social and
e nvironme ntal conte xt, socio cultural background, the
me aning of pain to the pe rson, be lie fs, attitude s, and
e xpe ctations, as we ll as biological factors (1). In fact, pain is
one of the most common symptoms that cause patients to
se e k he alth care and a chie f proble m in surgical patie nts;
thus, it should be managed (2, 3). Succe ssful pain
management de pe nds on he alth care pe rsonnel’s
coope rative e ffort in assessing and controlling the pain (4).
Manage ment of postope rative pain re lie ves suffering and
le ads to e arlie r mobilization, shorter hospital stay, re duced
hospital costs, and increased patie nt satisfaction (5).
Ine ffe ctive management of pain is a world-wide
phe nome non. When pain is not e ffectively managed during
outcome s are possible outcomes (6-10). De spite advances in
re ce nt researches, availability of a large amount of analgesic
me dications and incre ased e mphasis on pain management
including e nhanced aware ness and the de ve lopment of
tools and scale s to assist nurses in the care of patients, many
patie nts still e xpe rie nce mode rate to se vere pain (11-13).
Se ve nty-four pe rce nt of patie nts discharged from
e me rgency de partments tole rate moderate to severe levels
of pain (14), and more than 50% of cance r patie nts report
ine ffe ctive management of pain (15).
Postope rative pain management is an e ssential care
compone nt in surgical wards. As such, it should re ceive
particular atte ntion whe n ide ntifying pote ntial are as for
improve ment (16). The conte nt of the docume ntation
include s e xplanation about the patie nt’s condition,
re sponses to illne ss, and the care that is provide d. Finally,
the de finitive purpose of pain assessment, re cording and

38 ORIGINAL PAPER • Mater Sociomed. 2016 Feb; 28(1): 36-40

management is promotion of the quality of care. Findings
show that patie nts may avoid to e xpre ss the ir pain or
conside r pain an ine vitable conse quence of surgery;
the re fore, nurses should asses the patie nts’ pain and their
knowle dge about pain control me thods. The rapeutic pain
management is divide d into two main groups:
pharmacologic and non-pharmacologic or alternatives (17).
Non pharmacologic me asures used by nurse s to alle viate
pain include positioning, music the rapy, distraction,
massage and othe r non-invasive me thods (18, 19).
The pain management guide line that was publishe d in
2004 is the only standard protocol in Iran by Iran Ministry
of He alth and Me dical Education (Figure 1). Other available
protocols are not popular and may be administe red in
re gional hospitals.
In our country, physicians usually do not assess pain
compre hensively and orde r analge sics to be use d whe n
re quire d. The re is also no formal audit to re port and
docume nt pain postope ratively in Iran (20). Conside ring
the importance of pain management as one of principle
patie nt rights, it is ve ry important to assess pain and pain
management alternatives.
2. METHOD
A de scriptive and re trospective approach was use d in
assessing the re cords and colle cting information about
Postope rative pain, management and Docume ntation by
nurse s. 2.1. Sample, Patients
The study population comprise d 1540 patie nt charts in
ge ne ral surgery, ENT and orthope dic wards from March to
August 2012 in Imam Khome ini Hospital of Jiroft, a
southe ast city of Iran. The sample size was calculated 385
patie nt re cords using SSC software (Precision=5%, expected
ratio= 50, confi de nce le vel= 95%, population size = 1540) for
statistical analysis among the total 1540 e xisting re cords.
Patie nts who we re selected for this study had an e lective
admission and unde rwent general anesthesia and neither to
have history of diabe te s nor cancer. Be sides, the patients
who we re inve stigated in this study we re hospitalize d at
le ast for 48 hour. Our data we re based on the hospital statics
and docume ntation of database de partment. 2.2. Instrument
Re se archers made the che ck list afte r re vie wing
lite rature s and Iran Ministry of He alth and Me dical
Education guide line for postope rative pain management
(Figure 1).
Figure 1. Postoperative Pain Management Guideline by Iran
Ministry of Health and Medical Education
Postoperative Pain
The che cklist consisted of ite ms like assessment of pain
inte nsity, quality, location and concomitant symptoms by
nurse s, type of analge sic me dication, route of drug
administration (for the fi rst and the se cond time if the pain
did not alle viate ), and the patient’s(age, gender and type of
the surge ry) and nurse ’s de mographic information.
Whe ther pain inte nsity and quality was assessed by the
nurse and use of a standard scale was e valuated with
ye s/no questions. If the answe r was yes, then the method of
pain assessment, type of analge sic me dication, route and
fre que ncy of drug administration according to the patient’s
die t (allowance to e at) we re include d in the che cklist. 2.3.
Data Collection
Thre e hundre d e ighty fi ve subje cts we re assessed
randomly among the fi rst 48 hours postope rative. This
pe riod of time de scribes postoperative duration. Patie nts,
anonymity was obse rved during the study. Data was
colle cte d by a member who was blind to the me thodology
and aim of the study and was not e mploye d at the hospital.
Finally, the nurse s ‘de mographic factors (like age,
e ducation le vel and ye ars of working in surge ry ward) was
aske d from nurse s who docume nted pain and still were
working at the hospital afte r fi nishing re trospective chart
re vie w. 2.4. Data analysis
Data we re analyze d using de scriptive statistics (mean
and standard de viation (SD)), Chi squared, Inde pe ndent
Ke ndal te st, spe arman and Pe arson corre lation te sts to
compare the re lationship be twe e n patie nt’s and nurses
de mographic factors with type of the analge sics. For
e stimating the odds ratio and factors aff e cting the
assessment of pain inte nsity by nurses, a binary logistic and
backward me thod was use d. All statistical analyses were
pe rformed using SPSS software (v21.0; PASW Statistics). A
p value of le ss than 0.05 was conside red statistically signifi
cant.
Postoperative Pain
3. RESULT surge ry and medication administered (p< 0.001) (Table 2).
A total of 385 re cords we re assessed. About 48.6% of the Pe arson corre lation te st showe d a ne gative re lation
re cords belonged to orthope dic patients, 35.5% to ge neral be twe e n the patient’s age and use of opioids. It me ans that
surge ry, and 15.8% we re ENT and urology surge ry re cord. opioid administration re duced in olde r ages (p< 0.001, r =-
The me an age of the patie nts was 34.55 ±11.94 ye ars, and 0.214).
22.3% we re fe male and 77.7% we re male. Forty fi ve nurses Analysis of the re lationship be twe e n the nurse’s
who wrote down the note s had an age range of 21 to 50 e ducational le ve l and compliance with the guide line
ye ars old (Table 1). indicate d a signifi cant diff e re nce using k2 test (p= 0.01). The
compliance of the nurses with a bachelor’s de gree was poor
Information and the y use d opioid me dications for the fi rst time after the
Nurses Frequency Percent Mean SD
patie nt’s pain re port (Table 3). In addition, the diff e rence
Age - - 34.51±8.84 be twe e n the nurse ’s age and the type of analge sics was
signifi cant (p=0.04, r= 0.1). Non opioid analgesic
male 16 29.6 - administration was more common among olde r nurses
Diploma 17 31.5 - who we re more e xpe rie nced. Actually, the more
Gender female 38 70.4 - e xpe rie nced the nurse was, the more compliance was
obse rved with the national guide line (p=0.024, r=0.11).
Symptom and signs re lated to pain we re not me ntioned
Education Bachelor 37 68.5 in 281 re cords (73%) and we re le ss docume nted at night
Experience shifts whe n te sted with spe arman re gression (p<0.01, r =–
Table 1. Nurse’s demographic factors 0.13). Pain inte nsity was re corded only in 23 (6%) cases but
standard scale s we re not used for assessing the le vel of pain
Findings re ve aled that opioids we re administered more inte nsity. Pain inte nsity was re pre sented with ge ne ral
than othe r drugs that it is contrary to the Iran Ministry of
He alth and Me dical Education guide line (Figure 2). There
was a signifi cant re lationship be tween the patient’s sex and
type of the me dication, using k2 te st (p< 0.001). Women
administe red parenteral opioids more fre quently.
The re was a signifi cant re lationship be twe en the type of

Mater Sociomed. 2016 Feb; 28(1): 36-40 • ORIGINAL PAPER 37

analgesic Drugs Oral Suppository Parenteral Intramuscular opioid Parenteral opioid Total
Admissions Analgesics parasetamol analgesics analgesics
Orthopedic 7(3.7%) 41(22%) 114(61%) 3(1.6%) 22(11.7%) 187(100%)
General Surgeries 0 21(15.3%) 21(15.3%) 56(40.9%) 39(28.5%) 137(100%)
ENT 2(3.3%) 8(13.1%) 12(19.7%) 15(24.6%) 24(39.3%) 61(100%)
Table 2. Type of the analgesics and type of the surgery

analgesic Drugs Oral Education Nurses Suppository Parenteral Intramuscular opioid Parenteral opioid Total
analgesics parasetamol analgesics analgesics
Diploma 2(2.4%) 11(12.9%) 50(58.8%) 8(9.4%) 14(16.5%) 85(100%)
Bachelor 7(2.3%) 59(19.7%) 97(32.3%) 66(22%) 71(23.7%) 300(100%)
Table 3. Analgesics drugs and level of nursing education
Variable Reference group Odds Ratio P 200
150
Gender of pa- Female 2.53 0.001
100
50
tients
0 npo
Males
po
Age of patients >30 9.9 0.002
<60
Type of analgesics
30-59 9.1 0.009
Figure 2. Type Of The Analgesics
Nurses Experience <6 te rms and subjectively. The patient’s age and pain inte nsity
years
assessment we re positive ly correlated (p=0.049, r=0.142).
6-15 1.6 0.04
The quality of pain was docume nte d in only 20 patients
>15 3.7 0.042 (5.2%). In contrast, the pain location was docume nted in
almost all of the re cords. Non pharmacological pain
Table 4. Results of binary logistic regression for estimating factors management me thods we re used in none of the cases. In
that aff ect pain intensity assessment addition, a corre lation was found be twe en the patie nt’s sex

40 ORIGINAL PAPER • Mater Sociomed. 2016 Feb; 28(1): 36-40

and pain inte nsity (p= 0.04, r=–0.102) and quality (p= 0.013,
r=–0.127) via Ke ndal te st. The re was no re lationship among
the nurse ’s se x and e ducation le ve l, pain inte nsity and
quality assessment, and associated symptoms.
Finally, for e stimating the odds ratio and factors aff
e cting the assessment of pain inte nsity by nurses, a binary
logistic and backward me thod was used. Variations like the
patie nt’s age, sex, and nurse’s e xperie nce we re introduced
to the mode l after six steps (Table 4). According to the Table
4, the odds of assessing pain in wome n we re 2.53 times
more than men. It was also 2.37 time s highe r in nurse s with
more than 15 ye ars of working e xpe rie nce than nurses with
6 ye ars of e xpe rie nce or le ss. Logistic re gression was also
re pe ated for pain quality. The patie nt’s se x was the only
variation introduce d afte r six ste ps. The odds of the
assessment of the quality of the ir pain we re 2.62 times
highe r in wome n than me n.
4. DISCUSSION
Findings showe d that opioid analgesics we re the most
fre que nt drugs used postoperatively, which is contrary to
the guide line . A study by Idvall and Ehre nbe rg who
worke d re trospectively on patie nts’ re cords by nurses
re ve aled about 73% compliance with the local guide line
(21). The re ason for this dive rsity in our study is possibly
the unfamiliarity of physicians with the protocol, shortage
of knowle dge about pain management amongst nurses,
and authoritie s’ lack of conce rn.
Fe male patie nts re ce ived more analge sics than male
patie nts in the pre sent study. One possible inte rpretation is
that wome n usually e xpre ss their fe elings more than men
and the othe r is the homoge neousness of nurse s and
patie nts which re sults in a type of sympathy. Another point
of vie w is that re striction in the re lationship of the opposite
se xe s in the Muslim context can be a potential obstacle for
me n to complain about the ir pain to fe male nurses,
e spe cially if the y are both young, since 98%of the Iranians
are Muslim. The numbe r of the fe male patie nts was also
highe r in our study. Ne gative mispe rceptions and biases
was introduce d a pre ve ntive factor for the provision of
ade quate pain control in othe r studie s as we ll (22)
Colle ctive ly, nurses with bache lor’s de grees did most of
the opioid drugs administration that may be due to the ir
e ngagement in practical aspects and documentation other
than nurse s with lowe r le ve ls of e ducation. More over, the
pain location was recorded in most cases, which was similar
to othe r studie s (23, 24). Howe ve r, the nurse s did not use a
scale for assessing pain in almost none of the re cords. It
might be the consequence of shortage of knowle dge among
nurse s although assessment is the most important part of
pain management. In fact, pain is a subje ctive e xperience
and re porting the patie nts’ own words for de scribing their
pain is the be st me thod for docume ntation (25). Patie nts
usually avoid e xpre ssing their pain in the fe ar of drugs side
e ffe cts or being popular as the bothering clie nt among busy
nurse s (26). Chon e t.al re sult was far more diffe rent from
ours. The y found that 45.5% of the nurse s used nume rical
scale s for rating the pain le vel (23). Edde r also revealed that
23% of the nurse s used scales in patie nts suffering pain after
surge ry (27). Howe ve r, the curre nt re sults showe d the
Iranian nurse ’s poor function in pain management and
docume ntation.
In our study, only 6% of the re cords include d the
inte nsity of pain using ge ne ral te rms. Guning and Idvall
found that 41% of the re cords in ge ne ral surge ry ward and
6% in thoracic surge ry ward include d pain inte nsity (28).
The y re ported that 73% of the concomitant symptoms and
94.8% of quality of pain was not docume nte d by nurses.
The se statistics represent a huge difficulty for he alth care
pe rsonnel in promoting he alth and quality of life among
post-ope rative patie nts. Re vie w of the lite rature suggests
that pain should be assessed and document so that it can be
unde rstandable for all of te am me mbers (21). Scott
de monstrated that nursing records of pain would increase
patie nt satisfaction with his or he r pain management
proce ss. Although some times nurse s act appropriately to
manage patient’s pain but the y are too busy to re cord what
the y have done in the ir notes by detail (29). Re ports of the
pain de cre ased at night shifts in our study that was similar
to the re sults of a study by Brigs (30).
Nurse s’ de mographic factors had no re lationship with
any cate gory of pain management, probably be cause the
nurse s are not we ll traine d in this re gard in the unive rsity
and continuing e ducation courses in our country; the refore
ye ars of working or age did not influe nce nurse ’s skills for
assessment, management and docume ntation about pain.
Some studie s ide ntify the lack of formal e ducation nurses
re ce ive in pain and pain management (31, 32). While pain
assessment and management is taught as part of the
curricula of many nursing programs, it is ofte n not e nough
in te rms of time allotted and de pth of academic inquiry to
be e ffe ctive (33). It is unfortunate ly the same in Iran. Thus,
it is important to se t up e ducational course s for pain
management in the unive rsity and the n during the work
and strict protocols must be followe d in hospitals to
improve the quality of care in our country.
5. CONCLUSIONS
Nursing docume ntation concerning postoperative pain
management showe d many shortcomings in te rm of
conte nt and compre hensiveness. The se findings draw
atte ntion to Mater Sociomed. 2016 Feb; 28(1): 36-40 • ORIGINAL
PAPER
Postoperative Pain
the fact that nurse s face lack of knowle dge in this fie ld. To
maintain a profe ssional role in future he alth care, nurses
have to be accountable for the ir practice and provide good
care and information to the patie nt. To improve the quality
of pain management, continuous fe e dback to clinicians
based on re cord audits may be a use ful me thod. A
Postoperative Pain
compre hensive re vie w of the lite rature sugge sts that
barrie rs to providing good pain control may be the lack of
ongoing e ducational e xpe rience for he alth care providers
and innovations re late d to the manage ment of pain,
advances in pharmacology, and improve ments in
assessment te chnique s need to be taught on a re gular basis
in post-ope rative care settings (34).
- Acknowledgment Res earchers of the Kerman University of
Medi cal Sci ences do a ppreciate the res earch a ssistant for
thei r fi nancial s upport of this research project. They also
tha nk the nurs es a nd hos pital a rchi ve s ta ff for their
col l aboration.
- Author’s contribution: Al l a uthors in this paper have con-
tri buted in all phases in it’s preparing. First author made final
proof reading.
- Conflict of interest: none declared.
REFERENCES
1. Turk DC, Okifuji A. Psychological factors in chronic
pain: e volution and re volution. Journal of consulting
and clinical psychology. 2002; 70(3): 678.
2. Brunne r LS, Sme ltze r SCC, Bare BG, Hinkle JL,
Che e ver KH. Brunne r & Suddarth’s te xtbook of
me dical-surgical nursing. Vol 1: Lippincott Williams &
Wilkins, 2010.
3. Al-Shae r D, Hill PD, Ande rson MA. Nurses’
knowle dge and attitude s re garding pain assessment
and inte rve ntion. Me dsurg nursing: official journal of
the Acade my of Me dical-Surgical Nurse s. 2010; 20(1):
7-11.
4. Harkre ade r HC, Hogan MA, Thobabe n M.
Fundame ntals of nursing: caring and clinical
judge me nt: Else vier Saunders, 2007.
5. Re cart A, Duche ne D, White PF, Thomas T, Johnson
DB, Cade ddu JA. Efficacy and safe ty of fast-track
re covery strategy for patients unde rgoing laparoscopic
ne phre ctomy. Journal of Endourology. 2005; 19(10):
1165-9.
6. Dunwoody CJ, Kre nzische k DA, Pase ro C, Rathmell
JP, Polomano RC. Asse ssment, physiological
monitoring, and conse quences of inade quately treated
acute pain. Journal of Pe riAne sthe sia Nursing. 2008;
23(1): S15-S27.
7. Gillaspie M. Be tte r pain management after total joint
re placement surge ry: a quality improvement
approach. Orthopaedic Nursing. 2010; 29(1): 20-4.
8. Gupta A, Daigle S, Mojica J, Hurle y RW. Patient
pe rce ption of pain care in hospitals in the United
State s. Journal of pain re search. 2009; 2: 157.
9. Michae ls TK, Hubbartt E, Carroll SA, Hudson-Barr D.
Evaluating an e ducational approach to improve pain
assessment in hospitalize d patie nts. Journal of nursing
care quality. 2007; 22(3): 260-5.
10. Polomano RC, Dunwoody CJ, Kre nzische k DA,
Rathme ll JP. Pe rspe ctive on pain management in the
21st ce ntury. Pain management nursing. 2008; 9(1): 3-
10.
11. Mac Le llan K. Postope rative pain: strategy for improv-
42
39
ing patie nt e xpe riences. Journal of Advance d Nursing.
2004; 46(2): 179-85.
12. Salinas GD, Abdolrasulnia M. Effe ctive ness of
INROADS into pain management, a nursing
e ducational inte rve ntion. Journal of continuing
e ducation in nursing. 2011; 42(7): 328-36.
13. Wysong PR. Nurse s’ Be lie fs and Se lf-Re ported
Practice s Re lated to Pain Asse ssment in Nonve rbal
Patie nts. Pain Management Nursing. 2012.
14. Nursing IoMCotRWJFIotFo. The future of nursing:
Le ading change , advancing he alth: National
Acade mie s Press, 2011.
15. Van de n Be uke n-van Everdingen M, De Rijke J, Kessels
A, Schoute n H, Van Kle e f M, Patijn J. Pre vale nce of
pain in patie nts with cancer: a systematic re vie w of the
past 40 ye ars. Annals of oncology. 2007; 18(9): 1437-49.
16. Idvall E, Be rg A. Patie nt assessment of postope rative
pain management - Orthopaedic patients compared to
othe r surgical patie nts. Journal of Orthopaedic
Nursing. 2008; 12(1): 35-40.
17. Taylor A, Stanbury L. A re vie w of postoperative pain
management and the challe nges. Curre nt Anaesthesia
& Critical Care . 2009; 20(4): 188-94.
18. Be rnatzky G, Pre sch M, Ande rson M, Pankse pp J.
Emotional foundations of music as a non-
pharmacologic pain management tool in modern
me dicine . Ne uroscience and Biobe havioral Re views.
2011; 35: 1989-99.
19. Je nsen KB, Be rna C, Loggia ML, Wasan AD, Edwards
RR, Gollub RL. The use of functional ne uroimaging to
e valuate psychological and other non-pharmacological
tre atments for clinical pain. Ne uroscience le tters. 2012;
520(2): 156-64.
20. Sae edi M. Inve stigation on the e ffe cts of pain
assessment workshop on knowle dge , attitude , and
practice of nurse s in Valie -Asr Hospital in Arak.
Mode rn Care Journal. 2014; 10(3): 183-91.
21. Be rry PH, Dahl JL. The ne w JCAHO pain standards:
implications for pain management nurse s. Pain
Manage ment Nursing. 2000; 1(1): 3-12.
22. Pizzo PA, Clark NM. Alle viating suffe ring 101–pain
re lie f in the Unite d States. N Engl J Me d. 2012; 366(3):
197-9.
23. Chanve j L, Pe tpiche tchian W, Kovitwanawong N,
Chaibandit C, Vorakul C, Khunthong T. A chart audit
of postope rative pain assessment and documentation:
the first ste p to imple me nt pain assessment as the fifth
vital sign in a Unive rsity Hospital in Thailand. Journal
of the Me dical Association of Thailand. Chotmaihet
thangphae t. 2004; 87(12): 1447-53.
24. Ene KW, Nordbe rg G, Be rgh I, Johansson FG, Sjöström
B. Postope rative pain management - the influe nce of
surgical ward nurse s. Journal of clinical nursing. 2008;
17(15): 2042-50.
25. Sloman R, Rose n G, Rom M, Shir Y. Nurses’
assessment of pain in surgical patie nts. Journal of
Advance d Nursing. 2005; 52(2): 125-32.
ORIGINAL PAPER • Mater Sociomed. 2016 Feb; 28(1): 36-40
26. Manias E, Botti M, Bucknall T. Obse rvation of pain
assessment and manage ment - the comple xities of
clinical practice . Journal of clinical nursing. 2002; 11(6):
724-33.
27. Ede r SC, Sloan EP, Todd K. Docume ntation of ED
patie nt pain by nurse s and physicians. The American
journal of e me rgency medicine. 2003; 21(4): 253-7.
28. Gunningbe rg L, Idvall E. The quality of postope rative
pain management from the pe rspe ctives of patie nts,
nurse s and patie nt re cords. Journal of nursing
management. 2007; 15(7): 756-66.
29. Scott IE. Effe ctive ness of docume nte d assessment of
postope rative pain. British journal of nursing (Mark
Alle n Publishing). 1993; 3(10): 494-501.
30. Briggs M, De an KL. A qualitative analysis of the
nursing docume ntation of post-ope rative pain
management. Journal of clinical nursing. 1998; 7(2):
155-63.
31. Abdalrahim MS, Majali SA, Stomberg MW, Bergbom I.
The e ffe ct of postoperative pain management program
on improving nurse s’ knowle dge and attitude s toward
pain. Nurse e ducation in practice. 2011; 11(4): 250-5.
32. Sie dle cki SL, Modic MB, Be rnhofe r E, Sorre ll J,
Strumble P, Kato I. Exploring how Be dside Nurses
Care for Patie nts with Chronic Pain: A Grounded
The ory Study. Pain Manage ment Nursing. 2013.
33. Goodrich C. Stude nts’ and faculty me mbers’
knowle dge and attitude s re garding pain management:
a de scriptive survey. The Journal of nursing education.
2006; 45(3): 140-2.
34. Grinste in-Cohen O, Sarid O, Attar D, Pilpe l D,
Elhayany A. Improvements and difficultie s in
postope rative pain management. Orthopaedic
Nursing. 2009; 28(5): 232-9.