Generally from the previous studies, there were no association between patient satisfaction and postoperative pain severity, because most patients are satisfied with the pain management they receive even if they suffer from moderate to severe pain, but there is association between postoperative pain management and patient satisfaction (26-29).
This study showed that the overall proportion of patients who were satisfied with pain management services was 72.2 % [95%CI: 67.7-76.6]. This finding was low compared with other abroad studies (8, 9, 14, 26, 30-35).This could be due to good caring attitude of health care professional, high rate of preoperative pain education, presence of good communication, provides frequent education on pain-related issues for the ward nurses, especially focusing to the frequent measurement of pain assessment(11, 36, 37) and they used non pharmacology pain management methods but not in our study area (10).
But our finding was high compared with recent study, Jimma, Ethiopia, which showed that overall proportion of patients satisfaction, were 50%(38).This discrepancy could be post-operative nerve block was common method of pain management in our study area but not mentioned in that study.
We found that disease status has association with level of satisfaction, ASA1 patients were 3.5 times more likely to be satisfied compared with ASA3&ASA4 patients [AOR=3.55(1.20-10.55)] and also ASA2 patients were 3.7 times more likely to be satisfied compared with ASA3 and ASA4 patients [AOR= 3.72,95%CI=1.04-13.28]. A study conducted in Australia patients with ASA 3 and above were a significant factors for patients dissatisfaction in postoperative pain management survives in univariate odd ratio analysis. However after adjustment ,ASA status was no longer association with patients dissatisfaction (33)
Patients receiving a postoperative regional analgesic technique generally had lower pain scores and a higher level of satisfaction (6, 39-43). In the present study, 95.7% of patients were satisfied with post-operative nerve block which was 9 times more likely to be satisfied compared with patients without nerve block [AOR=9.14,95%CI=3.93-20.86]. This showed that our study had similar finding with other studies(6, 39, 40, 42).This is because of nerve block has superior postoperative analgesia, which may result in higher levels of patient satisfaction(40).
From 418 patients, 15 (3.6%) didn’t receive any post-operative analgesic and from this only 5(33.3%) patients were satisfied whereas 10(66.6%) patients were dissatisfied. When compared patients with post-operative analgesic and without analgesic, patients with analgesic 6 times more likely to be satisfied [AOR=6.1:95%CI=1.17-33.91].In the other studies also, patients who were receive postoperative a pain management service were very satisfied compared with non-treated patients(20, 44).
In the current study, 149 (35.6%) patients were feeling pain immediately after operation. From these group of patients were 1.8 times less satisfied when compared with who didn’t feel pain immediately after operation [AOR=1.86:95% CI=1.02-3.39].Several studies conclude that patients’ satisfaction with postoperative pain management was associated with the patients’ actual pain experience (9, 19, 27, 36, 45) and have similar finding with this study.
Another factor associated with patient satisfaction in post-operative pain management was using analgesic before request. Patients who received analgesics before request were 6.9 times more likely to be satisfied compared with hadn’t received analgesics before request or totally didn’t receive analgesic [AOR=6.90:95% CI=3.72-12.83]. This finding also line with the other study and could be the association between pain management and patient satisfaction (46).
In this study patients satisfaction in post-operative pain management has positive association with surgeon seniority. When level of residency increase, level of satisfaction increase. 55.6% of patients were satisfied with resident one, 63% were satisfied with resident two, 67.5% were satisfied with resident three, 69.9% were satisfied with resident four and 88.1% were satisfied with senior surgeons. Patients underwent operation by senior surgeons were more satisfied compared with resident one (88.1%vs55.6%),This could be explained by the accurate knowledge, skill and experiences of senior surgeons may attribute to less surgical manipulation, short duration of the procedure .However, this was not statistically significant [AOR= 1.28, 95%CI=0.15-10.72].
Limitation of the study: Dichotomized of likert data, leads to loss of information and the space between each choice cannot possible be equidistance. The study didn’t include patients discharged before 24 hours and post 24 hours level of satisfaction was not assessed.