Pain Management Nursing最新文献

{"title":"The Ethical Responsibility to Advocate for Change in End-of-Life Pain Management.","authors":"Eugenia Welch, Suzanne Parkman, Gloria Duke","doi":"10.1016/j.pmn.2026.08.018","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.08.018","url":null,"abstract":"<p><strong>Background: </strong>Despite the moral and ethical imperative to provide effective pain relief, many people around the world continue to die in pain. This paper examines the historical and current forces that shape these challenges across practice, policy, ethics, and research, with the goal of offering actionable recommendations to transform the current landscape of pain management.</p><p><strong>Methods / approach: </strong>The issue was analyzed by synthesizing historical and current forces across clinical practice, health policy, ethical frameworks, and research. The strategic framework builds upon raising awareness of decades-long stagnation in overcoming known barriers and explicitly framing ongoing failures as breaches of ethical care. The literature was synthesized to develop evidence-based recommendations for overcoming these challenges.</p><p><strong>Results / key findings: </strong>The persistent failure to provide adequate pain relief stems from critical gaps in healthcare professionals' knowledge and attitudes, socio-political and economic barriers, cultural and spiritual beliefs surrounding pain, and limited access to appropriate care and resources.</p><p><strong>Conclusion & recommendations: </strong>Addressing these ethical breaches requires immediate action by health care professionals, advocacy, and systemic policy reform. Actionable recommendations are provided across practice and governance to transform pain management care so that no person, anywhere, ever should have to die in pain.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Evaluation of the NKASRP Scale in Turkish Clinical Nurses.","authors":"Aysun Özdemir, Şükriye İlkay Güner","doi":"10.1016/j.pmn.2026.08.016","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.08.016","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to methodologically evaluate the psychometric performance and contextual sensitivity of the Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP) across non-oncology general clinical settings according to clinical specialization.</p><p><strong>Materials and methods: </strong>This methodological study was conducted between February and August 2021. To ensure statistical homogeneity, the operating room group (n = 5) was excluded from the analysis, and the study was completed with 308 nurses from internal medicine, surgery, intensive care, oncology, and emergency departments. Anti-Image Correlation was used for structural validity, Item Difficulty (P) and Item Discrimination indices (D) for item analysis, and Cronbach's Alpha and KR-20 coefficients for reliability. Differences between units were analyzed using One-Way ANOVA and post-hoc tests.</p><p><strong>Findings: </strong>42.5% of the participants had 0-5 years of professional experience. The overall internal consistency coefficients of the scale were found to be far below acceptable limits (Cronbach's Alpha: .27; KR-20: .24). According to the item analysis results, more than 50% of the scale items (22 items) had discrimination indices (D) below .19 (very weak). Advanced tetrachoric correlation modeling revealed marked psychometric instability with an uninterpretable overall KMO value of 0.07. In particular, ANOVA results (F = 5.183, p = .002, ƞ² = .064) demonstrated significant differences in mean knowledge scores across clinical departments-with higher mean scores observed in oncology and intensive care units-reflecting unit-based score variations rather than demonstrated differences in unit-specific psychometric properties.</p><p><strong>Conclusion: </strong>The NKASRP scale demonstrated low internal consistency and substantial item heterogeneity within this general clinical sample in Türkiye. These findings highlight the contextual sensitivity of the instrument across diverse clinical settings and underscore the need to evaluate measurement properties carefully prior to routine deployment in heterogeneous nursing populations. The findings indicate that the sensitivity of the scale is highly vulnerable to sample heterogeneity. The development of new, simpler, and more discriminative measurement tools that are compatible with the diversity and cognitive realities of clinical practice emerges as a critical need.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Pain Assessment and Management Among Nursing Home Residents Living With Dementia.","authors":"Sari Luthfiyah, Minarti Minarti, Mohammed Ismath","doi":"10.1016/j.pmn.2026.09.006","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.09.006","url":null,"abstract":"","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Factors Associated With Subanesthetic-Dose Ketamine Infusion in the Postanesthesia Care Unit.","authors":"Ashley Thomas, Marilyn Bazinski, Benjamin Michaels, Korana Avdagic, Maria Yefimova, Thomas Hoffmann, Michele M Pelter","doi":"10.1016/j.pmn.2026.08.017","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.08.017","url":null,"abstract":"<p><p>A multi-modal approach to pain control, including subanesthetic-dose ketamine infusion (SDKI), may improve postoperative pain management, especially in patients with opioid tolerance. Identifying preoperative patient characteristics associated with receiving SDKI in the postanesthesia care unit (PACU) may help clinicians anticipate which patients could benefit from timely SDKI.</p><p><strong>Purpose: </strong>This study was designed to examine preoperative patient characteristics associated with SDKI in the PACU.</p><p><strong>Design: </strong>Retrospective cohort study of consecutive adults (≥18 years) undergoing scheduled surgery between January 1, 2020, and December 31, 2021, at a large academic medical center. Demographics, opioid use history, mental health diagnoses, and surgical service type were extracted from the electronic health record. A stepwise regression model was used to identify patient characteristics associated with SDKI in the PACU.</p><p><strong>Results: </strong>Among 6,419 patients, 90 (1.4%) received a SDKI in the PACU. Predictor variables in the final model included age (p = .031), White race (p = .014), history of psychoactive substance use (p < .001), prescribed morphine equivalent daily dose (MEDD) ≥60 mg (p = .0019) or ≥90 mg (p = .0018), and orthopedic/neurological surgery (p = .0079). Patients prescribed an MEDD ≥60 mg or ≥90 mg had nearly fourfold higher odds of receiving SDKI, whereas those with a history of mental and behavioral disorders due to psychoactive substance use had approximately threefold higher odds.</p><p><strong>Conclusion and clinical implications: </strong>Preoperative screening for these characteristics in patients undergoing scheduled surgery may help identify patients who could benefit from proactive SDKI therapy in the immediate postoperative period.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Distraction Techniques on Preschool Children's Pain and Physiological Indicators During Venipuncture: A Randomized Controlled Trial.","authors":"Zahra Tavakolnia, Mahshid Mirzaie Taklimi, Yasaman Yaghobi, Saman Maroufizadeh","doi":"10.1016/j.pmn.2026.09.020","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.09.020","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine and compare the effect of listening to music and watching cartoons on pain and physiological indicators resulting from venipuncture in hospitalized children at the Hefdah-Shahrivar Educational and Medical Center in Rasht, Iran.</p><p><strong>Design & methods: </strong>This clinical trial enrolled 114 hospitalized children aged 3-6 years over 3 months. The participants were allocated to three groups: music, cartoon, and control using a consecutive random sampling method and block randomization. Interventions were performed from 3 minutes prior to the procedure until its completion. Pain was assessed using the Oucher pain scale, and physiological indicators (HR and SpO₂) were measured using a pulse oximeter 3 minutes before, during, and after the procedure. Data analysis was performed using SPSS version 16, employing descriptive statistics and statistical tests, including ANCOVA and Bonferroni post hoc tests.</p><p><strong>Results: </strong>The children in the music and cartoon groups had a significantly lower mean pain score than the control group (p < .001), while no significant difference was observed between the two intervention groups (p > .05). Regarding mean heart rate, a significant difference was observed only at the end of venipuncture between the cartoon and control groups (p < .05), with no significant differences in other variables (p > .05). The mean percentage of blood oxygen saturation did not differ significantly between the groups (p > .05).</p><p><strong>Conclusion: </strong>Listening to music and watching cartoons were effective in reducing pain associated with venipuncture in children. Therefore, nurses can utilize these low-cost and low-risk nonpharmacological methods to alleviate pain resulting from invasive procedures.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Global Evaluation of Multimodal Nursing Led Pain Management Programs in the Peri-Operative Period.","authors":"Shanshan Li, Jia Yuan, Zhaohui Yang, Yan Bao","doi":"10.1016/j.pmn.2026.08.015","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.08.015","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To identify, evaluate, and synthesize the effects of non-pharmacological nursing interventions on postoperative pain relief in patients undergoing abdominal surgery, and to examine whether intervention timing and physiological and psychosocial components are associated with differences in pain outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Systematic review and meta-analysis of experimental and quasi-experimental studies conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;A comprehensive search was conducted in five electronic databases (Scopus, PubMed, MEDLINE, Embase, and Web of Science) from database inception to October 2025. The search strategy combined controlled vocabulary and free-text terms related to nursing interventions, postoperative pain, and abdominal surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Review/analysis methods: &lt;/strong&gt;Eligible studies included randomized controlled trials, controlled clinical trials, non-randomized controlled trials, and controlled before-and-after studies evaluating non-pharmacological nursing interventions for postoperative pain management in patients undergoing abdominal surgery. Study selection and data extraction were performed according to predefined eligibility criteria. Meta-analyses were conducted using pooled mean differences (MDs) with 95% confidence intervals (CIs). Subgroup analyses were performed according to the timing of intervention delivery and the physiological and psychosocial dimensions targeted by the interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 118 studies involving 14,570 patients were included. The studies evaluated 31 categories of nursing and non-pharmacological interventions. Overall, these interventions were associated with a significant reduction in postoperative pain intensity, with a pooled MD in visual analog scale (VAS) pain scores of -4.55 (95% CI: -5.20 to -3.89). Subgroup analysis indicated that interventions delivered across multiple perioperative phases (preoperative, intraoperative, and postoperative) were associated with a greater reduction in pain scores (MD: -5.45; 95% CI: -6.83 to -4.08) than interventions delivered during a single perioperative phase. Interventions addressing both physiological and psychosocial dimensions were also associated with a greater reduction in pain scores (MD: -5.00; 95% CI: -5.32 to -4.68) than interventions targeting physiological or psychosocial factors alone.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Non-pharmacological nursing interventions were associated with reduced postoperative pain among patients undergoing abdominal surgery. Interventions incorporating multiple perioperative phases and addressing both physiological and psychosocial dimensions were associated with larger reductions in pain scores. However, substantial heterogeneity across patient populations, surgical procedures, intervention characteristics","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing Responses to Digital Pain Reports After Ambulatory Surgery: A Scoping Review.","authors":"Roison Andro Narvaez, Ralph Antonio Peco, Marilane Ferrer, Joylyn Mejilla","doi":"10.1016/j.pmn.2026.09.014","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.09.014","url":null,"abstract":"<p><strong>Objectives: </strong>To map digital pain reporting during home recovery after ambulatory surgery and associated nursing responses.</p><p><strong>Design: </strong>Scoping review guided by Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.</p><p><strong>Data sources: </strong>PubMed, Embase, CINAHL, PsycINFO, Scopus, and Web of Science were searched from inception through June 30, 2026.</p><p><strong>Review/analysis methods: </strong>Studies were eligible when adults recovering at home after ambulatory surgery reported pain digitally and nurses had an identifiable role in assessment, advice, follow-up, referral, or escalation. Reporting processes, nursing actions, outcomes, and methodological limitations were descriptively mapped.</p><p><strong>Results: </strong>Thirteen reports were included. Systems included apps, portal questionnaires, automated texts, quick-response forms, and WeChat. Four overlapping response models were identified: patient-requested contact, rule-triggered callbacks, clinical-team surveillance, and consultative nursing escalation. Across models, pathway completeness comprised the reporting schedule, trigger, recipient, response interval, nursing assessment and authority, escalation, and closure or alternative access. Digital pathways often improved reach, completeness, satisfaction, or efficiency, but effects on pain, recovery, service use, and cost were inconsistent. Some increased nursing communication or limited responses to service hours.</p><p><strong>Conclusions: </strong>Digital pain reporting supported surveillance when responsibility, response time, and escalation were explicit, but reporting alone did not improve recovery or service use consistently.</p><p><strong>Nursing practice implications: </strong>Services should define report recipients, nursing-assessment triggers, response times, escalation authority, documentation, and alternatives for people unable or unwilling to use digital tools.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing Nurse Navigators to Improve Pain Management in the Community.","authors":"Haley Donovan, Elizabeth Feustel, Michael Coriasco, Jennifer C Anderson, Fionnuala S Brown, Ross J Bindler, Marian Wilson","doi":"10.1016/j.pmn.2026.08.004","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.08.004","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic pain among adults is a highly prevalent condition characterized by persistent gaps in care delivery, inequitable access to evidence-based interventions, and variable care continuity across clinical settings. Nurse Navigators are strategically positioned to help eliminate barriers by assisting in care coordination and person-centered resource maximization. A community-based nurse-led telehealth pilot program was implemented in the Northwestern United States as an extension of a state-funded evidence-based, online platform designed to promote nonpharmacologic pain management options and opioid risk reduction.</p><p><strong>Design: </strong>This initiative offered structured one-to-one virtual consultations and facilitated use of digital self-assessment and educational resources.</p><p><strong>Methods: </strong>A convenience sample of adults (≥18 years) with self-reported chronic pain of at least 3 months' duration was recruited via email listservs. Eligible participants completed an initial videoconference session with a Pain Nurse Navigator and a follow-up session 10-14 days later.</p><p><strong>Results: </strong>Ten adults (80% female; mean age 65) with chronic pain participated and completed the follow-up survey. Most either agreed or strongly agreed that they felt comfortable in the sessions with the Pain Nurse Navigator (100%) and were satisfied with the ease of participation (100%) and level of support (90%) provided by the Pain Nurse Navigator. The median Client Satisfaction Questionnaire-8 score was 26, indicating acceptable levels of satisfaction for the program.</p><p><strong>Conclusion: </strong>This pilot project established that a nurse-led pain navigation program can be delivered to adults living in a community setting, is acceptable to participants, and generated sufficient satisfaction scores to warrant further study.</p><p><strong>Clinical implications: </strong>The model may be adaptable in other settings pending outcome evaluation.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus Guidelines for Radiofrequency Ablation of Chronic Knee Pain in Rural Communities.","authors":"Eyeneys Valdivia Gonzalez, Shanice Fabio, Cheryl Martin, Eleanor Rawson, John Maye","doi":"10.1016/j.pmn.2026.08.008","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.08.008","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic Knee pain is one of the most reported types of pain in the United States and causes a significant issue in rural and underserved communities. Radiofrequency ablation (RFA) is a treatment that has shown significant improvement for up to 24 months for people suffering from chronic knee pain, but consensus guidelines for RFA in the management of chronic knee pain with emphasis on the unique aspects of rural health care have not been established.</p><p><strong>Design: </strong>This quality improvement initiative utilized a literature review, initial needs assessment survey, and input from an expert panel of pain management providers.</p><p><strong>Methods: </strong>A primary survey was distributed to an expert panel utilizing the Delphi method to acheive consensus guidelines for condition assessment, procedural details, and follow-up evaluation/recommendations.</p><p><strong>Results: </strong>This initiative found that while most items reached consensus, procedural details remained the most contested category throughout each round particularly regarding RFA modalities, which ultimately favored cooled RFA for its superior and longer-lasting pain relief.</p><p><strong>Conclusion: </strong>The initiative was able to establish consensus guidelines for RFA of the knee which will improve patient outcomes by establishing best practices for patient selection, procedural techniques, and follow-up care. This will lead to more predictable pain relief, reduced opioid dependence, and improve quality of life.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When the Number Falls Short: Nurses, Postoperative Pain Discordance, and Opioid Stewardship.","authors":"Osama Mohamed Elsayed Ramadan, Samah Ramadan Shaheen Ibrahim, Maha Suwailem Shuaib Alshammari, Ahmed Eid Mohamed Elmezayn, Ghada Elsaid Ali Elsayed, Sahar Ahmed Mohamed, Ibrahim Alasqah, Hamda Ahmed Mohamed Eldesoky","doi":"10.1016/j.pmn.2026.08.014","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.08.014","url":null,"abstract":"<p><strong>Purpose: </strong>To explore how surgical-ward nurses experience and interpret patient-nurse discordance in postoperative pain assessment and how this discordance shapes pain management and opioid stewardship in practice.</p><p><strong>Design: </strong>Qualitative study using Interpretive Description.</p><p><strong>Methods: </strong>Nineteen registered nurses providing direct postoperative care in adult surgical wards were purposively recruited from two hospitals in southern Saudi Arabia to maximize variation across sites, experience, roles, and specialties. Individual semi-structured interviews were audio-recorded, transcribed verbatim, and analyzed concurrently using Interpretive Description.</p><p><strong>Results: </strong>Four interpretive themes were identified: Reading pain beyond the number; negotiating credibility in a relational and cultural space; practicing caution under the shadow of opioids; and carrying discordance within organizational constraints. Discordance was described not as a simple mismatch between pain scores and clinical observation, but as an interpretive challenge shaped by trust, family dynamics, multilingual communication, workload, and hierarchical decision-making. Participants described it as influencing whether analgesia was administered, delayed, questioned, or escalated, and intensifying the tension between relieving suffering and avoiding opioid-related harm.</p><p><strong>Conclusions: </strong>Patient-nurse discordance in postoperative pain assessment is a clinically consequential phenomenon that extends beyond numeric pain scoring and was described as shaping analgesic decision-making and opioid stewardship in surgical wards. Nurses navigate this discordance through interpretive, relational, and organizational work not fully captured by standard pain assessment tools alone.</p><p><strong>Clinical implications: </strong>Postoperative pain management may be strengthened by approaches that support nurses' clinical judgement, communication across linguistic and cultural differences, structured team-based decision-making, and opioid stewardship practices responsive to uncertainty in pain assessment.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}