The Effect Of Resilience And Emotional States On Changes Of Postoperative Pain In Patients With Fractrures

Objective:This study aims to investigate the feature of postoperative pain among patients with traumatic fractures,and to explore the relationship between resilience,emotional state and postoperative pain,which provide theoretical basis for reducing postoperative pain effectively and new ideas for pain management in hospital.Methods:According to the convenient sampling method,90 cases of traumatic fractures patients in a tertiary hospital of Shandong province were recruited,and they were investigated with the form of questionnaire.Measurement tools included Self-designed General Information Questionnaire,Connor-Davidson Resilience Scale(CD-RISC10),Positive and Negative Affect Scale(PANAS)and Pain Assessment Scale.The data were analyzed by software SPSS 22.0,and the statistical methods mainly included descriptive statistics,t test,ANOVA and so on.Then the data from SPSS 22.0 were transformed into HLM 7.0,which continued to the process of statistical analysis.Results:1.General demographic characteristics and clinical information100 questionnaires were involved in this study,after rejecting invalid questionnaires,the total number of valid return was 90,and the valid return rate was 90%.The mean age of patients was(43.38±14.18)(ranging from 18 to 70 years).Among them,61.1%were male,51.1%were above senior high school education,86.7%were married,67.8%lived in the city and town,64.6%of the patients had medical insurance,66.7%of the patients were lower limb fractures.2.Changes of pain in fracture patients within 7 days after operationThe highest average scores were(5.83±1.70)in the pain degree at the first postoperative day,the pain scores gradually declined during 2～6 days and the lowest average scores were(0.57±0.67)on the 7th postoperative day.In aspect of the characteristic of pain,the patients performed knife-like pain within 2 days after operation,and it accounted for 53.3%;the dull pain got the highest scores on the 4th-7th postoperative day,and it accounted for 82.2%.In aspect of the time of pain,the persistent pain got the highest scores within two days after operation,and it accounted for 56.7%;the highest pain scores were occasional or active pain during the 5th-7th day,and it accounted for 81.1%.In aspect of analgesia methods,pain pumps got the highest score within two days after operation,and it accounted for 53.3%;without any analgesics,there were the highest scores during the 4th-7th postoperative day,and it accounted for 82.2%.3.The predictors of postoperative pain based HLM modelIn the HLM model,postoperative pain scores were regarded as the dependent variable.Firstly,when only the time factor was taken into the HLM model,the results showed:the time had main effect on the changes of pain,and the pain scores declined over time(the average of pain score fell 0.90 points with every day increasing).Then,on the basis of the first step,the predictable factors was taken into the second equation one by one,which extracted statistically significant predicting variables(family economy,preoperative pain,resilience and negative emotion),these predicting variables were put into the second floor of the full HLM model,the results showed that the downward trend of pain scores with time remained,at this point,the average scores of pain fell 0.50 points with every day increasing,but it did not reach prominently statistical significance.Simultaneously,the higher resilience was,the more the pain perceived,but the pain scores fell faster among patients with high resilience;positive emotions had no main effect on postoperative pain perception at the first day,but positive emotion had interaction effect on time,the higher positive emotion was,the faster the pain scores decline over time;Similarly,the higher negative emotion was,the slower the pain scores decline over time.Conclusions:1.The postoperative pain degree of traumatic fracture patients gradually decreased to the lowest level in a week,and the characteristic of pain,pain duration and analgesic ways showed regular transformation.2.The postoperative pain of traumatic fracture patients was positively correlated to resilience on the first day,and the scores of pain fell faster over time among patients with high resilience.Similarly,the pain declined faster over time among individuals with higher positive emotion;the pain declined slower over time among individuals with higher negative emotions.