Pain Management and Outcomes Among Patients After Thoracic or Abdominal Surgery


  • Siranun Janchum Faculty of Nursing, Prince of Songkla University, Hat Yai campus
  • Wipa Sae-sia Faculty of Nursing, Prince of Songkla University, Hat Yai campus
  • Praneed Songwathana Faculty of Nursing, Prince of Songkla University, Hat Yai campus


Pain management, Pain outcomes, Post-thoracotomy, Post-abdominal surgery


This descriptive and correlational study aimed to examine nurses’ management using clinical nursing practice guidelines (CNPG) for pain management among patients within 72 hours after thoracic or abdominal surgery. The sample was comprised of 150 patients who underwent thoracic or abdominal surgery, and 90 nurses working in one tertiary care hospital in Southern Thailand. The research instruments consisted of the CNPG questionnaire (which collected data on pain management); the Short Form of the Thai version of the Pain Intensity Questionnaire (which collected data on pain outcomes), the Pain Interference Questionnaire, and the Mobility Record. Data were analyzed using descriptive statistics and Spearman’s rank correlation.

           The results showed that:

  1. Nurses’ application of CNPG for pain management was at a good level, overall, and for each dimension.
  2. Pain intensity at 24 hours after surgery was at a moderate level and had decreased to a mild level by 72 hours after surgery. Pain interference 24 hours to 72 hours after surgery was at a mild level, whereas patients’ mobility increased from 24 hours after surgery through 72 hours later.
  3. Pain intensity showed a positive correlation with pain interference at 48 hours after surgery (p < .001) and had a negative association with mobility at 72 hours after surgery (p < .001).

             This study indicates that application of CNPG leads to good pain outcomes among patients after thoracic or abdominal surgery.


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Akhani, P., Mendpara, S., Palan, B., & Harsoda, J. (2014). Gender differences in response to experimental pain among medical students from a Western State of India. The International Journal of Medical Students, 2(1), 13-17.

American Lung Association. (2019). Complication after thoracotomy. Retrieved from

Chaudakshetrin, P. (2009). Validation of the Thai version of brief pain inventory (BPI-T) in cancer patients. Journal of the Medical Association of Thailand, 19(2), 34-40. (in Thai)

Cleeland, C. S., Ladinsky, J. L., Serlin, R. C., & Nugyen, C. T. (1988). Multidimensional measurement of cancer pain: Comparisons of US and Vietnamese patients. Journal of Pain Symptom Management, 3, 23-27.

Chou, R., Gordon, D. B., de Leon-Casasola, O. A., Rosenberg, J. M., Bickler, S., Brennan, T., … Wu, L. C. (2016). Guideline of management of postoperative pain. The Journal of Pain, 17(2), 131-157.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York: Academic.

Dinic, V. D., Stojanovic, M. D., Markovic, D., Cvetanovic, V., Vukovic, A. Z., & Jankovic, R. J. (2018). Enhanced recovery in thoracic surgery: A review. Frontiers in Medicine, 5(14), 2-7. doi:10.3389/fmed.2018.00014

Holzemer, W. L. (1994). The impact of nursing care in Latin America and the Caribbean: A focus on outcomes. Journal of Advance Nursing, 20(1), 5-12.

Longwet, O., Srimoragot, P., Danaidutsadeekun, S., Airamaneera, C. (2020). Impact of early rehabilitation programme on post-open abdominal surgery gastrointestinal patients’ ability to perform activities of daily living. Journal of Thailand Nursing and Midwifery Council, 35(2), 32-51. (in Thai)

Meepap, L., Methakanjanasak, N., & Saensom, D. (2017). Clinical nursing practice guideline for acute pain management in critically ill patients. Srinagarind Medical Journal,32(6), 561-570. (in Thai)

Mesbah, A., Yeung, J., & Gao, F. (2016). Pain after thoracotomy. British Journal of Anaesthesia Education, 11(1), 1-7. doi.10.1093/bjaceaccp/mkv005

Öğüt, S., & Dağ, G. S. (2019). Pain characteristics and pain interference among patients undergoing open cardiac surgery. Journal of PeriAnesthesia Nursing, 34 (4), 757-766.

Pengkaew, S. (2015). Effects of foot reflexology on abdominal distention and postoperative recovery in elderly patiets with abdominal surgery (Master’sThesis, Prince of Songkla Universiy). Retrieved from (in Thai)

Polit, D. F., & Beck, C.T. (2018). Essentials of nursing research: Appraising evidence for nursing practice (9 th ed.). Philadelphia: Wolters Kluwer.

Royal College of Anesthiologist of Thailand and Thai Association for the Study of Pain. (2019). Clinical guidance for acute postoperative pain management. Bangkok: Beyond Enterprise. (in Thai)

Saeangchai, J., Piyasut, C., Kaewkulpat, S. (2019). Multimodal pain management: Goal setting for postoperative pain. Boromarajonani College of Nursing, Uttaradit Journal, 11(2), 161-171. (in Thai)

Sawangchai, J., & Ngamkham, S. (2017). Postoperative pain in patients after abdominal surgery at Sawanpracharak Hospital. Journal of Health Science Research, 11 (Suppl 1), 1-10. (in Thai)

Shargall, Y., & Litle, V. R. (2018). European perspectives in Thoracic Surgery, the ESTS venous thromboembolism (VTE) working group. Journal of Thoracic Disease, 10(8), 963–968. doi:10.21037/jtd.2018.04.70

Steven, B., & Peter, G. (2005). Transverse verses midline incisions for abdominal surgery. Cochrane Database of Systematic Reviews (Online). 19. CD005199. 10.1002/14651858.CD005199.pub2.

Suwannarurk, K., Kasemsin, P., Pongrojpaw, D., Chanthasenanont, A., Lertvutivivat, S., Pattaraarchachai, J., & Bhamarapravatana, K. (2017). Post-cesarean pain associated with skin incision: Vertical versus pfannenstiel. Journal of Medical Association of Thailand, 100 (Suppl. 5), S162-S167.

Theoret, C. (2017). Physiology of wound healing in C. Theoret & J. Schumacher (Eds.), Equine Wound Management (3 rd ed). New Jersey: John Wiley & Sons.

Wang, H., Li, S., Liang, N., Lui, W., Lui, H., & Lui, H. (2017). Postoperative pain experiences in Chinese adult patients after thoracotomy and video-assisted thoracic surgery. Journal Critical of Nursing, 26(17), 2744-2754. doi: 10.1111/jocn.13789. Epub 2017 May 3

Yamane, T. (1973). Statistics: An introductory analysis (3 rd ed). New York: Harper & Row.





Research Article