Psychological experiences of unplanned interruption of patient-controlled intravenous analgesia in adult postoperative patients

This qualitative study aimed to explore the psychological experiences of adult postoperative patients who unplanned discontinued patient-controlled intravenous analgesia (PCIA), based on the stress and coping theory and the Activating event, Beliefs, Consequences emotion theory. The findings are intended to provide insights for developing individualized analgesia management and psychological interventions in clinical practice. Employing a purposive sampling strategy, adult patients who experienced unplanned PCIA interruption within 3 days after surgery at a tertiary hospital in Nanchong were recruited. Twenty participants were interviewed. Following 3 pilot interviews, semi-structured interviews were conducted with 16 participants until data saturation was reached; 4 additional interviews were then performed to reinforce the findings. Interview data were analyzed using Giorgi’s descriptive phenomenological method. Two main themes emerged: negative psychological experiences and sleep disturbances. The negative psychological experiences encompassed concerns about increased pain, adverse drug reactions, financial burden, and anxiety regarding the exacerbation of preexisting conditions. Scale-assisted assessments (Visual Analog Scale, Generalized Anxiety Disorder-7, and Insomnia Severity Index) indicated mild to moderate levels of pain, anxiety, and insomnia among some participants. This study is the first to systematically analyze the psychological mechanisms behind unplanned PCIA interruption using a dual-theoretical framework. Negative psychological experiences and sleep disturbances significantly contribute to patients’ decisions to discontinue PCIA prematurely. Clinical staff should prioritize dynamic assessment of patients’ psychological and sleep status. Implementing multidimensional intervention strategies – including optimized physiological analgesia, targeted cognitive education, and behavioral support – is crucial to reduce unplanned PCIA interruption, improve analgesia quality, and enhance postoperative recovery outcomes.