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Pain Experiences of Men and Women After Coronary Artery Bypass Graft Surgery

Parry, Monica RN, PhD, CCN(C); Watt-Watson, Judy RN, PhD; Hodnett, Ellen RN, PhD; Tranmer, Joan RN, PhD; Dennis, Cindy-Lee RN, PhD; Brooks, Dina PhD

Journal of Cardiovascular Nursing: May/June 2010 - Volume 25 - Issue 3 - pp E9-E15
doi: 10.1097/JCN.0b013e3181cd66be
Articles

Background and Research Ojectives: Individuals with coronary artery disease undergo coronary artery bypass graft (CABG) surgery to relieve symptoms, improve quality of life, and reduce early death. Pain is the most prevalent symptom identified by persons after CABG surgery. The objective of the study was to compare the prevalence and severity of pain and pain-related interference with activities in men and women 9 weeks after CABG surgery.

Subjects and Methods: Participants included men (n = 78) and women (n = 17) who were having first-time nonemergency CABG surgery. Pain outcome data were collected via telephone using the McGill Pain Questionnaire and the Brief Pain Inventory-Interference Subscale.

Results and Conclusions: Forty-seven percent of the women (n = 8) had moderate to severe pain described as the "worst pain in previous 24 hours with movement" 9 weeks following discharge from CABG surgery. More women were divorced, widowed, or single (P = .0002). There was a statistically significant between-groups difference, with more women reporting moderate to severe pain with movement (P = .03), as well as greater interference with walking (P = .01) and sleeping (P = .01) due to pain. Further research with larger sample sizes should investigate what conditions lead to the sex differences in the pain experience after CABG surgery, what mechanisms and support structures underlie these differences, and how these differences can inform the clinical management of pain.

Background and Research Ojectives: Individuals with coronary artery disease undergo coronary artery bypass graft (CABG) surgery to relieve symptoms, improve quality of life, and reduce early death. Pain is the most prevalent symptom identified by persons after CABG surgery. The objective of the study was to compare the prevalence and severity of pain and pain-related interference with activities in men and women 9 weeks after CABG surgery. Subjects and Methods: Participants included men (n = 78) and women (n = 17) who were having first-time nonemergency CABG surgery. Pain outcome data were collected via telephone using the McGill Pain Questionnaire and the Brief Pain Inventory-Interference Subscale. Results and Conclusions: Forty-seven percent of the women (n = 8) had moderate to severe pain described as the "worst pain in previous 24 hours with movement" 9 weeks following discharge from CABG surgery. More women were divorced, widowed, or single (P = .00002). There was a statistically significant between-groups difference, with more women reporting moderate to severe pain with movement (P = .03), as well as greater interference with walking (P = .01) and sleeping (P = .01) due to pain. Further research with larger sample sizes should investigate what conditions lead to the sex differences in the pain experience after CABG surgery, what mechanisms and support structures underlie these differences, and how these differences can inform the clinical management of pain.

Monica Parry, RN, PhD, CCN(C) Assistant Professor and Director, Nurse Practitioner Programs, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; Advanced Practice Nurse, Cardiac Surgery, Kingston General Hospital, Ontario, Canada.

Judy Watt-Watson, RN, PhD Professor Emerita, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada.

Ellen Hodnett, RN, PhD Professor and Heather M. Reisman Chair in Perinatal Nursing Research, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada.

Joan Tranmer, RN, PhD Associate Professor, School of Nursing, Queen's University, Kingston, Ontario Canada; Career Investigator, Ontario Women's Health Council/Canadian Institutes of Health Research.

Cindy-Lee Dennis, RN, PhD Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada; Canada Research Chair in Perinatal Community Health.

Dina Brooks, PhD Associate Professor, Department of Physical Therapy, University of Toronto, Ontario, Canada; Canadian Institutes of Health Research Career Scientist.

Funding was received from the Heart and Stroke Foundation of Canada, Canadian Institutes of Health Research FUTURE Program for Cardiovascular Nurse Scientists, Cardiac Science Medtronic Research Grant/Kingston General Hospital, Canadian Council of Cardiovascular Nurses Research Grant, Nurse Practitioner Association of Ontario Cardiovascular Acute Care Nurse Practitioner Pfizer Award, and a Canadian Pain Society Nursing Research Award.

Correspondence Monica Parry, RN, PhD, CCN(C), 155 College St, Suite 130, Toronto, ON, Canada M5T 1P8 (monica.parry@utoronto.ca).

© 2010 Lippincott Williams & Wilkins, Inc.