Exploring the relationship between pain intensity, self-management of pain and pain self-efficacy on post-operative pain on day 5 after cesarean section: A cross-sectional study in Mie prefecture in Japan.

Introduction: Pain self-management among women who begin child-rearing after a cesarean section (CS) has not been ascertained. This study aimed to explore the relationship among pain intensity, self-management, and self-efficacy on post-operative day (POD) 5 after CS in postpartum women.

Methods: A cross-sectional online survey was conducted on POD5 after CS. Participants were recruited through convenience sampling in Mie Prefecture, Japan, from August 2023 to April 2024. Pain was assessed using a numerical rating scale (NRS), both during activity and at rest, with higher scores indicating greater pain. Pain self-efficacy was assessed using the Japanese version of the Pain Self-Efficacy Questionnaire (PSEQ-J), and pain self-management was investigated. SPSS version 29.0 was used for data analysis, and p<0.05 was set as the significance level.

Results: Data from 124 participants (valid response rate: 73.8%) were analyzed. The median (IQR) of the NRS was 4.5 (3-6) during activity and 2.0 (1-4) at rest. There were significant differences according to method of oral analgesia during activity (p<0.049) and at rest (p<0.015). Multiple regression analysis revealed that NRS scores at maximum pain after CS significantly influenced pain on POD5. However, the number of oral analgesics and PSEQ-J scores were not influenced (during activity: R²=0.21, p<0.001, at rest: R²=0.12, p<0.001).

Conclusions: Pain intensity during activity on POD5 was moderate and required pain-management. Acute post-operative pain-management was related to pain intensity on POD5, suggesting the importance of early post-operative pain control. Future studies are needed to examine the association between pain self-efficacy and other psychological factors.