Keywords
nurse-led interventions
multimodal pain management
non-pharmacological strategies
secondary health facilities
Nigeria
Abstract
Postoperative pain remains inadequately managed in many low-resource settings, contributing to delayed recovery and reduced patient satisfaction. Nurse-led multimodal and non-pharmacological pain management strategies have been proposed as effective, context-appropriate approaches to improving postoperative outcomes. This study examined the effect of nurse-led multimodal and non-pharmacological pain management interventions on postoperative pain outcomes in selected secondary health facilities in Cross River State, Nigeria. A quasi-experimental, non-randomised pre-test and post-test control group design was adopted. The study involved registered nurses working in postoperative care units of selected secondary health facilities. A sample of 280 nurses was determined using Yamane’s formula and selected through a multistage sampling technique. Data were collected using a validated structured questionnaire and observational checklist. Reliability testing yielded a Cronbach’s alpha coefficient of 0.82. The intervention comprised nurse-led training and supervised implementation of multimodal and non-pharmacological pain management strategies over four weeks. Data were analysed using SPSS version 25, with descriptive and inferential statistics applied. Statistical significance was set at p < 0.05. Findings showed a statistically significant improvement in postoperative pain outcomes following the intervention. Patients in the intervention group reported reduced pain intensity, improved functional recovery, and higher satisfaction with pain management compared with pre-intervention scores and the control group. Nurse-related outcomes, including pain assessment practices and utilisation of non-pharmacological interventions, also improved significantly. Nurse-led multimodal and non-pharmacological pain management interventions are effective in improving postoperative pain outcomes in secondary health facilities. Integrating structured nurse-led pain management programmes into routine postoperative care may enhance recovery and patient satisfaction, particularly in resource-constrained settings.
References
Adebayo, A. A., & Yusuf, O. T. (2024). Nurses’ knowledge and utilisation of non-pharmacological pain management strategies in tertiary hospitals in Lagos State, Nigeria. African Journal of Nursing and Midwifery, 26(1), 61–74.
Adebayo, A. A., & Yusuf, O. T. (2024). Patient-centred postoperative pain management practices and outcomes in Nigerian hospitals. African Journal of Nursing and Midwifery, 26(1), 45–58.
Akpojaro, O. J., Osagiede, E. E., Aigbokhan, E. E., & Imasogie, A. O. (2024). Knowledge and utilisation of pain assessment tools among nurses in tertiary hospitals in southern Nigeria. International Journal of Nursing Practice, 30(2), e13219. https://doi.org/10.1111/ijn.13219
Apfelbaum, J. L., Chen, C., Mehta, S. S., & Gan, T. J. (2003). Postoperative pain experience: Results from a national survey suggest postoperative pain continues to be undermanaged. Anesthesia & Analgesia, 97(2), 534–540. https://doi.org/10.1213/01.ANE.0000068822.10113.9E
Aziato, L., & Adejumo, O. (2014). Determinants of nurses’ knowledge gap on pain management in Ghana. Nurse Education in Practice, 14(2), 195–199. https://doi.org/10.1016/j.nepr.2013.08.004
Brown, E. A., & Okon, A. E. (2023). Pain assessment practices among nurses in secondary and tertiary health facilities in Cross River State, Nigeria. Journal of Nursing and Health Sciences, 12(3), 67–75.
Chou, R., Gordon, D. B., de Leon-Casasola, O. A., Rosenberg, J. M., Bickler, S., Brennan, T., & Wu, C. L. (2016). Management of postoperative pain: A clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists. The Journal of Pain, 17(2), 131–157. https://doi.org/10.1016/j.jpain.2015.12.008
Ehwarieme, T. A., Josiah, B. O., & Abiodun, A. A. (2023). Nurses’ knowledge and utilisation of postoperative pain assessment tools in selected hospitals in Benin City, Nigeria. Nigerian Journal of Nursing Sciences, 14(1), 23–31.
Eja, M. E., & Ukwayi, J. K. (2020). Nursing workload and postoperative care outcomes in secondary health facilities in Cross River State, Nigeria. International Journal of Caring Sciences, 13(3), 1685–1694.
Eja, M. E., & Ukwayi, J. K. (2020). Pain assessment and postoperative nursing care practices in tertiary hospitals in Cross River State, Nigeria. International Journal of Caring Sciences, 13(3), 1685–1694.
Eja, M. E., Ukwayi, J. K., & Ojong, F. E. (2021). Pain assessment and management practices among nurses in secondary health facilities in Cross River State, Nigeria. Global Journal of Health Science, 13(7), 89–98. https://doi.org/10.5539/gjhs.v13n7p89
Gan, T. J., Habib, A. S., Miller, T. E., White, W., & Apfelbaum, J. L. (2014). Incidence, patient satisfaction, and perceptions of postsurgical pain: Results from a US national survey. Current Medical Research and Opinion, 30(1), 149–160. https://doi.org/10.1185/03007995.2013.860019
Gelinas, C., Arbour, C., Michaud, C., Robar, L., & Côté, J. (2013). Patients and ICU nurses’ perspectives of non-pharmacological interventions for pain management. Nursing in Critical Care, 18(6), 307–318. https://doi.org/10.1111/nicc.12031
Ibrahim, A. O., Lawal, F. B., Adeyemi, A. O., & Sadiq, A. A. (2023). Effect of multimodal pain management on postoperative pain relief and patient satisfaction following abdominal surgery in South-West Nigeria. Nigerian Journal of Clinical Practice, 26(4), 512–519. https://doi.org/10.4103/njcp.njcp_324_22
Ikpe, E. E., Etim, J. J., & Udo, A. E. (2022). Postoperative pain experiences and patient satisfaction in selected hospitals in Cross River State, Nigeria. Nigerian Journal of Clinical Nursing, 11(2), 54–63.
International Journal of Research and Scientific Innovation (IJRSI). (2024). Resource constraints and postoperative pain management outcomes in Nigerian hospitals. International Journal of Research and Scientific Innovation, 11(4), 102–110.
International Journal of Research and Scientific Innovation (IJRSI). (2025). Effectiveness of multimodal pain management strategies following abdominal surgery in South-West Nigeria. International Journal of Research and Scientific Innovation, 12(1), 33–41.
Kehlet, H., & Dahl, J. B. (2003). The value of multimodal or balanced analgesia in postoperative pain treatment. Anesthesia & Analgesia, 77(5), 1048–1056. https://doi.org/10.1213/01.ANE.0000087217.28771.48
Kizza, I. B., Muliira, J. K., & Kohi, T. W. (2016). Nurses’ knowledge of postoperative pain management in low-resource settings. International Journal of Africa Nursing Sciences, 5, 1–7. https://doi.org/10.1016/j.ijans.2016.04.001
Kolcaba, K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(6), 1178–1184. https://doi.org/10.1111/j.1365-2648.1994.tb01202.x
McCaffery, M., & Pasero, C. (1999). Pain: Clinical manual (2nd ed.). Mosby.
McCaffery, M., & Pasero, C. (2011). Pain assessment and pharmacologic management. Mosby Elsevier.
Nigerian Journal of Surgery. (2020). Postoperative pain management and patient satisfaction in a tertiary hospital in Northern Nigeria. Nigerian Journal of Surgery, 26(1), 14–21. https://doi.org/10.4103/njs.NJS_42_19
Odejobi, O. A., & Adejumo, P. O. (2023). Effect of pain management training on nurses’ knowledge, attitude, and practices in Nigerian hospitals. African Journal of Nursing and Midwifery, 25(2), 89–101.
Odejobi, O. A., Maneewat, K., & Chittithavorn, C. (2019). Effects of a nurse-led pain management programme on postoperative pain and recovery outcomes among thoracic surgery patients. Nurse Media Journal of Nursing, 9(2), 85–96. https://doi.org/10.14710/nmjn.v9i2.23415
Ogboli-Nwasor, E., Makusidi, M., Yusufu, L., & Ewa, E. (2013). Pain management in Nigerian hospitals: A survey of physicians. Nigerian Journal of Clinical Practice, 16(3), 361–366. https://doi.org/10.4103/1119-3077.113461
Okafor, C. E., Nwankwo, O. C., & Iloh, G. U. (2023). Awareness and utilisation of non-pharmacological pain management techniques among nurses in Nigerian tertiary hospitals. African Journal of Medical and Health Sciences, 22(2), 91–99.
Rawal, N. (2016). Current issues in postoperative pain management. European Journal of Anaesthesiology, 33(3), 160–171. https://doi.org/10.1097/EJA.0000000000000366
Registered Nurses’ Association of Ontario. (2013). Assessment and management of pain (3rd ed.). RNAO.
Tick, H., Nielsen, A., Pelletier, K. R., Bonakdar, R., Simmons, S., Glick, R., & Zador, V. (2018). Evidence-based nonpharmacologic strategies for comprehensive pain care. Mayo Clinic Proceedings, 93(2), 245–258. https://doi.org/10.1016/j.mayocp.2017.11.008
Ukwayi, J. K., Eja, M. E., & Ojong, F. E. (2022). Nurse-led postoperative care protocols and recovery outcomes in secondary health facilities in Cross River State, Nigeria. Journal of Nursing Practice and Education, 6(1), 40–49.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2026 Author