Surgical Nurses' Pain Management Self-Efficacy and Patients' Postoperative Pain Outcomes

Background: Postoperative pain continues to be inadequately managed in many surgical settings, and nurses play a central role in pain assessment and management. Nurses' pain management self-efficacy, defined as their confidence in their own ability to assess and manage patients' pain effectively, may influence the quality of pain care patients receive. Few studies have directly linked nurse-level self-efficacy to patient-level pain outcomes using a dyadic (nurse-patient paired) design.

Aim: This descriptive, analytic, cross-sectional nurse-patient dyad study aims to examine the relationship between surgical nurses' pain management self-efficacy and their postoperative patients' pain management outcomes.

Design and Methods: Nurses working in the general surgery clinics of two training and research hospitals (Agri Training and Research Hospital and Taksim Training and Research Hospital, Turkey) will be invited to participate. Each participating nurse will complete the Pain Management Self-Efficacy Questionnaire (PMSEQ). Postoperative surgical patients cared for by these nurses will complete the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R), together with a sociodemographic and clinical data form. Patient responses will be linked to their assigned nurse to form nurse-patient dyads. Because patients are clustered within nurses, multilevel (mixed-effects) statistical modeling will be used to account for the nested data structure and to examine associations between nurse-level self-efficacy and patient-level pain outcomes, while controlling for relevant patient and nurse characteristics.

This is an observational, non-interventional study; no experimental treatment, medication, device, or randomization is involved. All participants (nurses and patients) will provide informed consent, and the study will be conducted in accordance with the Declaration of Helsinki.

Inclusion criteria

Surgical Nurses:

• Currently employed as a registered nurse
• Working in the general surgery clinic where the study is conducted
• Actively involved in postoperative patient care
• Employed in the relevant clinic for at least 3 months
• Voluntarily agrees to participate in the study

Surgical Patients:

• 18 years of age or older
• Has undergone a surgical procedure
• Receiving postoperative care in the general surgery clinic where the study is conducted
• Within the first 24 postoperative hours
• Able to communicate in Turkish
• Conscious and cognitively able to answer study questions
• Voluntarily agrees to participate in the study

Exclusion criteria

Surgical Nurses:

• On extended leave or medical report during the data collection period, resulting in no active clinical care
• Does not complete the data collection form during the study period

Surgical Patients:

• Followed in the intensive care unit
• Impaired consciousness that prevents assessment
• Serious cognitive or communication impairment that prevents communication
• Underwent emergency surgery
• Unable to complete the study data collection forms