Determinants of satisfaction with patient controlled analgesia

Abstract

The purpose of the study was to determine the relationship between subjects' health locus of control, pain and satisfaction with intravenous patient controlled analgesia (PCA) after total hip or total knee replacement surgery. The Multidimensional Health Locus of Control Questionnaire (MHLC) with three subscales was used. Persons who believe that their behaviors influence their health are classified as internal while those who feel that their health is related to those in positions of power are classified as powerful others. Persons with a chance health locus of control believe that their health is the result of luck or fate. A convenience sample of 72 subjects completed the MHLC and answered questions about expectations for postoperative pain and pain with movement. Pain intensity was measured using a pain visual analog scale (VAS) postoperatively at 2 and 4 hours after admission to the postanesthesia care unit and at 0800 and 1400 hours the next day. The short-form McGill Pain Questionnaire (sf-MPQ) was completed at 1400 hours along with an investigator created satisfaction survey and a satisfaction VAS. A multiple regression approach was used answer the research hypotheses. Patient expectation scores were not correlated with any of the study variables. A direct entry multiple regression showed that the subscale scores, sf-MPQ scores, the amount of opiates used, the number of attempts at using PCA, the number of injections from PCA, and the number of complications from PCA were not related to satisfaction as measured by VAS (R =.487, p =.0567). The sf-MPQ was the only significant variable (F = 4.093, p=.0481). Pain VAS scores were not related to satisfaction (R2 =.139, p =.1066). There was a significant relationship between the satisfaction survey and satisfaction VAS scores (r =.428). These results suggest that multidimensional health locus of control does not predict satisfaction with PCA.