Healthcare professionals' perceived challenges and benefits of digital patient-reported data for in-hospital postoperative pain monitoring: A qualitative study

BACKGROUND: Pain is a common consequence of surgery, with many patients experiencing moderate to severe postoperative pain. Although self-reported pain remains the gold standard for assessment, there are barriers to implementing current assessment methods in clinical practice. Promising results from digital solutions for pain management underscore their potential for more efficient and personalised treatment, yet more research is needed for clinical integration. A new risk assessment system for chronic postsurgical pain is being developed, based on patient-reported data and digital acute pain monitoring. Innovations that align with existing practices are more likely to lead to successful implementation in healthcare settings. OBJECTIVE: We aimed to explore healthcare professionals' perspectives on the use of digital solutions for postoperative pain assessment in the context of in-hospital clinical practice, as a first step in implementing digital patient-reported pain monitoring. DESIGN: A qualitative exploratory study was conducted. SETTING: This study was conducted in different hospital departments (post-anaesthesia care unit, general surgery wards, and orthopaedic wards) of two hospitals on Norway's west coast. METHODS: This study used semi-structured focus group interviews of healthcare professionals who worked with postoperative hospitalised patients. Seven focus group interviews were conducted with 39 healthcare professionals. The data were analysed inductively and in accordance with Braun and Clarke's six steps of Reflexive thematic analysis. RESULTS: Our analyses yielded two overarching themes: (1) Challenges associated with utilising digital pain intensity monitoring and (2) Perceived benefits of utilising digital pain measures in clinical practice. The three sub-themes, (1a) Pain assessment is an inseparable part of a complex care process, (1b) Subjective pain reports require contextual evaluation, and (1c) Variable patients and situational fits of digital self-reports, collectively reflected the perceived challenges of the usability and integration of digital pain intensity monitoring tools in the clinical practice of surgical care. The sub-themes, (2a) Preventing loss of control by mapping and (2b) Patient empowerment through enhanced communication, illustrated the potential benefits of digital pain monitoring in clinical practice. CONCLUSIONS: This study highlights the concern among healthcare professionals that digital systems reduce healthcare professionals' time with patients and undermine their clinical experience. Although digital pain monitoring might provide valuable information, clinical judgement remains essential due to the multifaceted nature of pain assessment. Involving stakeholders early in the implementation process provides valuable insights for tailoring digital solutions to the needs of healthcare professionals and patients.