: Patients are often not actively involved in their acute pain management.: To understand the attitudes of patients, family caregivers and nurses to patient participation in pain management after their knee or hip joint replacement.: Q-methodological design.: 45 participants were recruited, included 15 patients, 15 caregivers and 15 nurses. Forty-nine statements were rank-ordered in a Q-sort table.: Four factors which explained 65% of the variance were identified from factor analysis. They are named "Endurers", "Supporters", "Worriers" ,and "Wabblers".: Each group have a significant knowledge deficit in pain management. Patients and caregivers were more likely to have a passive attitude and false cognition towards pain and analgesic drugs. Nurses often play a role as a supporter, however, it is hard for them to understand their important role in facilitating patient involvement in their pain management.

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