In Manitoba, over 1000 cardiac surgery procedures are performed annually. Despite multiple advancements in the delivery of analgesic medications, significant issues remain regarding the control of postoperative pain in cardiac surgery. Evidence links high intensity acute postoperative pain to the development of chronic pain. Chronic pain results in increased costs in the order of billions annually. Further, growing rates of opioid misuse and diversion are driving the desire to improve pain management in a more patient focused manner. Experts agree that clinically meaningful pain assessments are critical to guide pain management decisions. The current gold standard of pain reporting is patient self-report. Patient engagement in care is recognized as an essential aspect to improve outcomes. Clinicians often bring assumptions to pain assessment and may benefit from having improved understanding of the patient perspective of self-report. To address this gap in care, a scoping review was completed which examined factors influencing the patient role in adequate pain assessment and management. Opportunity for improvement was noted in the articulation of the perceived role of the surgical patient and specifically the cardiac patient with respect to pain assessment and management. To explore this perceived pain role, semi structured, digitally recorded interviews were conducted with six cardiac surgery patients six months post-surgery. Additional descriptive data was derived from a sociodemographic survey and measures of anxiety and depression. Data was informed through reflective journaling by the researcher and analyzed using open, axial and selective coding. Key insights regarding the lived experience were categorized thematically with three major themes and nine subthemes identified. The major theme of attitude toward pain assessment and management was comprised of the subthemes of expectations, prior experience and beliefs. The major theme of coping was comprised of the subthemes of mindfulness or distraction, social interaction and knowing yourself. The major theme of care and communication was comprised of the subthemes of pain assessment interaction, pain education and empathetic care communication. Understanding how patients view their role, and what influences the development and evolution of this role may provide insights to enable clinicians to target perioperative education, assessment determinations and treatment decisions.