A descriptive study was conducted to identify the change patterns on the level of perceived distress during the early postoperative period with regard to state anxiety in patients using patient controlled analgesia.

One hundred women who underwent elective hysterectomy procedures or other gynecologic surgeries completed a series of questionnaires measuring state anxiety, and subjective distress assessed by visual analog scales at 8, 24, & 48 hours postoperatively. Data were analyzed with frequencies, percentages, means, ANOVA, Repeated Measures ANCOVA, and Scheffè post test utilizing SPSS WIN 11.0.

There was a gradual decrease in levels of total distress and pain over the three points in time after surgery regardless the levels of state anxiety. However, women with higher levels of anxiety their pain curve rose at 48 hours post-op. In addition, over the first two points in time, women in the higher anxiety group showed higher levels of distress than those in the lower anxiety group, but no such group differences were observed in the levels of pain, revealing higher pain levels only at 8 hours post-op in both groups.

Irrespective of effective pain management modality, most postoperatively experienced distress in gynecological patients was derived from anxiety and pain. These findings have implications for pain management, especially in patients with emotionally charged surgeries like hysterectomy.