Analysis of Current Pain Management in Total Knee Arthroplasty in 8 Tertiary Hospitals in China Based on the Theory of Planned Behavior

Purpose: To investigate the current status of perioperative pain management for patients undergoing total knee arthroplasty (TKA) among medical personnel and to identify influencing factors in eight tertiary hospitals in China, thereby providing evidence for optimizing TKA pain management protocols. Methods: Guided by the Theory of Planned Behavior, a cross-sectional survey was conducted among nurses and physicians involved in the care of TKA patients across multiple healthcare institutions. A validated questionnaire assessing perioperative pain management practices in TKA was administered between March and April 2024 to 333 healthcare professionals responsible for the diagnosis, treatment, and nursing care of TKA patients. Data were analyzed using univariate analysis and multiple stepwise linear regression to identify factors influencing current perioperative pain management practices. Results: The mean score for perioperative pain management behaviors among medical staff was 77.45 +/- 10.39, corresponding to a score rate of 86.0%. Self-evaluation emerged as a significant predictor of pain management behavior during the perioperative period of TKA. Additionally, age, experience in systematic training for TKA pain management, and professional category (operating room nurse, orthopedic nurse) were identified as influencing factors of current pain management practices. Conclusion: Medical professionals demonstrate a positive attitude toward perioperative pain management in TKA. However, discrepancies exist between their attitudes and actual practices. Variations in subjective norms were observed, and documentation of pain management requires standardization.