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Neuwersch-Sommeregger S, Köstenberger M, Pipam W, Demschar S, Trummer B, Breschan C, Likar R. Pain in Austrian hospitals: evaluation of 1089 in-patients. Wien Med Wochenschr 2024; 174:69-78. [PMID: 36441358 DOI: 10.1007/s10354-022-00984-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 10/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite the existence of internationally consistent guidelines for the management of pain, efficient regional anesthesia techniques, safe pain medications, and organizational structures, e.g., acute pain services, various studies have shown that pain is still common among both surgical and non-surgical in-patients. OBJECTIVE The primary objective of this study was to evaluate, on a multi-center basis, the point pain prevalence of surgical and non-surgical in-patients. We further analyzed pain intensities, in-hospital pain triggers, pain-related impairments, pain assessments, patient information about pain, and patient satisfaction with pain therapy. This benchmark information should lead to better implementation of pain management strategies and thus improve health care quality. METHODS We surveyed all adult in-patients in three general hospitals in Austria (general hospital Klagenfurt am Wörthersee, general hospital Villach, general hospital Wolfsberg) on the index day with two standardized questionnaires for both surgical and non-surgical patients. RESULTS Overall, a pain prevalence of 40.0%, with no statistically significant difference between surgical and non-surgical patients, was shown. Higher pain prevalence in female patients, high pain prevalence in the age group 18-30 years, and highest pain prevalence in the age group over 90 years old was found. Overall pain intensity was relatively low, but unacceptable maximum pain within the preceding 24 h was shown. Different in-hospital pain triggers like patient's care and mobilization were found. Our survey has shown that pain has an impact on personal hygiene, mobilization, mood, sleep, and appetite. However, patients were very satisfied with their pain therapy. CONCLUSION Medical staff and nurses have to be sensitized to the urgent need to improve pain management strategies.
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Affiliation(s)
- Stefan Neuwersch-Sommeregger
- Center for Interdisciplinary Pain Therapy, Oncology and Palliative Care, Clinic Center Klagenfurt, Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, 9020, Klagenfurt am Wörthersee, Austria.
- Medical University of Graz, Graz, Austria.
| | - Markus Köstenberger
- Center for Interdisciplinary Pain Therapy, Oncology and Palliative Care, Clinic Center Klagenfurt, Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, 9020, Klagenfurt am Wörthersee, Austria
- Medical University of Graz, Graz, Austria
| | - Wolfgang Pipam
- Center for Interdisciplinary Pain Therapy, Oncology and Palliative Care, Clinic Center Klagenfurt, Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, 9020, Klagenfurt am Wörthersee, Austria
| | - Susanne Demschar
- Center for Interdisciplinary Pain Therapy, Oncology and Palliative Care, Clinic Center Klagenfurt, Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, 9020, Klagenfurt am Wörthersee, Austria
| | - Brigitte Trummer
- Center for Interdisciplinary Pain Therapy, Oncology and Palliative Care, Clinic Center Klagenfurt, Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, 9020, Klagenfurt am Wörthersee, Austria
| | - Christian Breschan
- Center for Interdisciplinary Pain Therapy, Oncology and Palliative Care, Clinic Center Klagenfurt, Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, 9020, Klagenfurt am Wörthersee, Austria
- Medical University of Graz, Graz, Austria
| | - Rudolf Likar
- Center for Interdisciplinary Pain Therapy, Oncology and Palliative Care, Clinic Center Klagenfurt, Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, 9020, Klagenfurt am Wörthersee, Austria
- Paracelsus Medical University, Salzburg, Austria
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Becerra-Bolaños Á, Armas-Domínguez A, Valencia L, Jiménez-Marrero P, López-Ruiz S, Rodríguez-Pérez A. Pain Prevalence and Satisfaction with Pain Management in Inpatients: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:3191. [PMID: 38132081 PMCID: PMC10743299 DOI: 10.3390/healthcare11243191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Pain in hospitalized adults is underestimated and undervalued. The aim of this study was to evaluate pain prevalence and satisfaction with the hospital's pain management among patients attending a tertiary university hospital. Predictor factors of pain were also studied. METHODS A prospective, cross-sectional study was carried out through a structured questionnaire given on one day to all hospitalized patients in a university hospital. Clinical data, such as personal history and analgesic treatment, were collected from medical records. Other variables related to pain (including intensity rated by the visual analogue scale as well as location and patient satisfaction measured by the numerical rating scale) were also obtained. RESULTS Of the 274 surveyed patients, pain prevalence was 52.9%, with an average intensity of 5.3 ± 2.8 according to VAS. The overall satisfaction was 87.2%, and 72.6% had already been prescribed at least one analgesic. Patients receiving analgesics showed higher pain intensity (VAS 3.6 ± 3.4) than those without treatment (VAS 1.1 ± 2.1) (p < 0.001). However, patients with treatment showed more satisfaction (NRS 7.8 ± 2 vs. 5.3 ± 1.4, p < 0.001). CONCLUSIONS The prevalence of pain in hospitalized patients was high, despite the fact that patient satisfaction was also very high.
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Affiliation(s)
- Ángel Becerra-Bolaños
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.R.-P.)
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
| | - Annette Armas-Domínguez
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
| | - Lucía Valencia
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.R.-P.)
| | - Pedro Jiménez-Marrero
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.R.-P.)
| | - Sergio López-Ruiz
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.R.-P.)
| | - Aurelio Rodríguez-Pérez
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.R.-P.)
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
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Zuazua-Rico D, Mosteiro-Diaz MP, Collado-Boira E, Del Carmen Casal-Angulo M, Cobo-Cuenca AI, Fernandez-Garrido J, Lavado-Garcia JM, Maestro-Gonzalez A. Knowledge about Pain in Spanish Nursing Students. Pain Manag Nurs 2022; 23:871-877. [PMID: 35491350 DOI: 10.1016/j.pmn.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND All nurses should receive training and education regarding pain as part of their pre-graduate stage, as its assessment and appropriate management when treating patients largely depends on them. With the right knowledge it is possible to reduce its high prevalence, as well as the serious consequences it can lead to. AIM To determine the level of knowledge and attitudes towards pain of final-year nursing students in Spain. METHODS Descriptive cross-sectional study using a convenience sample of five Spanish universities during the academic year 2020-2021. The Spanish version of the Knowledge and Attitudes Survey Regarding Pain (KASRP) was used. In addition, socio-demographic variables such as age, sex, relationship status, employment status, and the number of dependants were collected. The specific palliative or oncology subjects of each university was also assessed. RESULTS A total of 224 questionnaires were collected. One of the nursing universities obtained the best score in the KASRP (59.75%) which was significant (p = .001). This university was the only one that offers specific subjects in palliative or oncologic care. A training deficit in aspects related to pain assessment and pharmacologic concepts was detected. We found no relationship between the KASRP and the different sociodemographic variables. CONCLUSIONS Specific training in palliative care improves the students' knowledge regarding pain, although the results did not reach an acceptable minimum. The universities' training programs for Spanish students need to be adapted in order to achieve better results.
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Affiliation(s)
- David Zuazua-Rico
- Medicine department, Nursing Area. University of Oviedo, Spain; Hospital Universitario Central de Asturias. Oviedo, Spain
| | | | | | | | - Ana Isabel Cobo-Cuenca
- Faculty of Physiotherapy and Nursing. Group IMCU. University of Castilla-La Mancha. Toledo, Spain.
| | - Julio Fernandez-Garrido
- Faculty of Nursing and Podiatry. University of Valencia, Spain; Conselleria de Sanitat Universal i Salut Pública. Generalitat Valenciana, Spain
| | | | - Alba Maestro-Gonzalez
- Medicine department, Nursing Area. University of Oviedo, Spain; Hospital Universitario Central de Asturias. Oviedo, Spain
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Herzig SJ, Anderson TS, Jung Y, Ngo L, Kim DH, McCarthy EP. Relative risks of adverse events among older adults receiving opioids versus NSAIDs after hospital discharge: A nationwide cohort study. PLoS Med 2021; 18:e1003804. [PMID: 34570810 PMCID: PMC8504723 DOI: 10.1371/journal.pmed.1003804] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 10/11/2021] [Accepted: 09/09/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although analgesics are initiated on hospital discharge in millions of adults each year, studies quantifying the risks of opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) among older adults during this transition are limited. We sought to determine the incidence and risk of post-discharge adverse events among older adults with an opioid claim in the week after hospital discharge, compared to those with NSAID claims only. METHODS AND FINDINGS We performed a retrospective cohort study using a national sample of Medicare beneficiaries age 65 and older, hospitalized in United States hospitals in 2016. We excluded beneficiaries admitted from or discharged to a facility. We derived a propensity score that included over 100 factors potentially related to the choice of analgesic, including demographics, diagnoses, surgeries, and medication coadministrations. Using 3:1 propensity matching, beneficiaries with an opioid claim in the week after hospital discharge (with or without NSAID claims) were matched to beneficiaries with an NSAID claim only. Primary outcomes included death, healthcare utilization (emergency department [ED] visits and rehospitalization), and a composite of known adverse effects of opioids or NSAIDs (fall/fracture, delirium, nausea/vomiting, complications of slowed colonic motility, acute renal failure, and gastritis/duodenitis) within 30 days of discharge. After propensity matching, there were 13,385 beneficiaries in the opioid cohort and 4,677 in the NSAID cohort (mean age: 74 years, 57% female). Beneficiaries receiving opioids had a higher incidence of death (1.8% versus 1.1%; relative risk [RR] 1.7 [1.3 to 2.3], p < 0.001, number needed to harm [NNH] 125), healthcare utilization (19.0% versus 17.4%; RR 1.1 [1.02 to 1.2], p = 0.02, NNH 59), and any potential adverse effect (25.2% versus 21.3%; RR 1.2 [1.1 to 1.3], p < 0.001, NNH 26), compared to those with an NSAID claim only. Specifically, they had higher relative risk of fall/fracture (4.5% versus 3.4%; RR 1.3 [1.1 to 1.6], p = 0.002), nausea/vomiting (9.2% versus 7.3%; RR 1.3 [1.1 to 1.4], p < 0.001), and slowed colonic motility (8.0% versus 6.2%; RR 1.3 [1.1 to 1.4], p < 0.001). Risks of delirium, acute renal failure, and gastritis/duodenitis did not differ between groups. The main limitation of our study is the observational nature of the data and possibility of residual confounding. CONCLUSIONS Older adults filling an opioid prescription in the week after hospital discharge were at higher risk for mortality and other post-discharge adverse outcomes compared to those filling an NSAID prescription only.
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Affiliation(s)
- Shoshana J. Herzig
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Timothy S. Anderson
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Yoojin Jung
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Long Ngo
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Dae H. Kim
- Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, United States of America
| | - Ellen P. McCarthy
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, United States of America
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Saunders R, Crookes K, Atee M, Bulsara C, Bulsara MK, Etherton-Beer C, Ewens B, Gallagher O, Graham RM, Gullick K, Haydon S, Nguyen KH, O'Connell B, Seaman K, Hughes J. Prevalence of frailty and pain in hospitalised adult patients in an acute hospital: a protocol for a point prevalence observational study. BMJ Open 2021; 11:e046138. [PMID: 33757956 PMCID: PMC7993156 DOI: 10.1136/bmjopen-2020-046138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Frailty and pain are associated with adverse patient clinical outcomes and healthcare system costs. Frailty and pain can interact, such that symptoms of frailty can make pain assessment difficult and pain can exacerbate the progression of frailty. The prevalence of frailty and pain and their concurrence in hospital settings are not well understood, and patients with cognitive impairment are often excluded from pain prevalence studies due to difficulties assessing their pain. The aim of this study is to determine the prevalence of frailty and pain in adult inpatients, including those with cognitive impairment, in an acute care private metropolitan hospital in Western Australia. METHODS AND ANALYSIS A prospective, observational, single-day point prevalence, cross-sectional study of frailty and pain intensity of all inpatients (excluding day surgery and critical care units) will be undertaken. Frailty will be assessed using the modified Reported Edmonton Frail Scale. Current pain intensity will be assessed using the PainChek smart-device application enabling pain assessment in people unable to report pain due to cognitive impairment. Participants will also provide a numerical rating of the intensity of current pain and the worst pain experienced in the previous 24 hours. Demographic and clinical information will be collected from patient files. The overall response rate of the survey will be reported, as well as the percentage prevalence of frailty and of pain in the sample (separately for PainChek scores and numerical ratings). Additional statistical modelling will be conducted comparing frailty scores with pain scores, adjusting for covariates including age, gender, ward type and reason for admission. ETHICS AND DISSEMINATION Ethical approval has been granted by Ramsay Health Care Human Research Ethics Committee WA/SA (reference: 2038) and Edith Cowan University Human Research Ethics Committee (reference: 2020-02008-SAUNDERS). Findings will be widely disseminated through conference presentations, peer-reviewed publications and social media. TRIAL REGISTRATION NUMBER ACTRN12620000904976.
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Affiliation(s)
- Rosemary Saunders
- Centre for Research in Aged Care, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Kate Crookes
- Centre for Research in Aged Care, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Mustafa Atee
- School of Pharmacy and Biomedical Sciences, Curtin University, Bentley, Western Australia, Australia
- The Dementia Centre, St Leonards, New South Wales, Australia
| | - Caroline Bulsara
- School of Nursing and Midwifery, University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Max K Bulsara
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Christopher Etherton-Beer
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
- WA Centre for Health & Ageing, University of Western Australia, Crawley, Western Australia, Australia
| | - Beverley Ewens
- Centre for Research in Aged Care, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Olivia Gallagher
- Centre for Research in Aged Care, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Renee M Graham
- Centre for Research in Aged Care, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Karen Gullick
- Clinical Services, Hollywood Private Hospital, Nedlands, Western Australia, Australia
| | - Sue Haydon
- Clinical Services, Hollywood Private Hospital, Nedlands 6009, Western Australia, Australia
| | - Kim-Huong Nguyen
- Faculty of Medicine and Biomedical Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Bev O'Connell
- Centre for Research in Aged Care, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Karla Seaman
- Centre for Research in Aged Care, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Jeff Hughes
- School of Pharmacy and Biomedical Sciences, Curtin University, Bentley, Western Australia, Australia
- PainChek Ltd, Bentley, Western Australia, Australia
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Burden M, Keniston A, Wallace MA, Busse JW, Casademont J, Chadaga SR, Chandrasekaran S, Cicardi M, Cunningham JM, Filella D, Hoody D, Hilden D, Hsieh MJ, Lee YS, Melley DD, Munoa A, Perego F, Shu CC, Sohn CH, Spence J, Thurman L, Towns CR, You J, Zocchi L, Albert RK. Opioid Utilization and Perception of Pain Control in Hospitalized Patients: A Cross-Sectional Study of 11 Sites in 8 Countries. J Hosp Med 2019; 14:737-745. [PMID: 31339840 DOI: 10.12788/jhm.3256] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hospitalized patients are frequently treated with opioids for pain control, and receipt of opioids at hospital discharge may increase the risk of future chronic opioid use. OBJECTIVE To compare inpatient analgesic prescribing patterns and patients' perception of pain control in the United States and non-US hospitals. DESIGN Cross-sectional observational study. SETTING Four hospitals in the US and seven in seven other countries. PARTICIPANTS Medical inpatients reporting pain. MEASUREMENTS Opioid analgesics dispensed during the first 24-36 hours of hospitalization and at discharge; assessments and beliefs about pain. RESULTS We acquired completed surveys for 981 patients, 503 of 719 patients in the US and 478 of 590 patients in other countries. After adjusting for confounding factors, we found that more US patients were given opioids during their hospitalization compared with patients in other countries, regardless of whether they did or did not report taking opioids prior to admission (92% vs 70% and 71% vs 41%, respectively; P < .05), and similar trends were seen for opioids prescribed at discharge. Patient satisfaction, beliefs, and expectations about pain control differed between patients in the US and other sites. LIMITATIONS Limited number of sites and patients/country. CONCLUSIONS In the hospitals we sampled, our data suggest that physicians in the US may prescribe opioids more frequently during patients' hospitalizations and at discharge than their colleagues in other countries, and patients have different beliefs and expectations about pain control. Efforts to curb the opioid epidemic likely need to include addressing inpatient analgesic prescribing practices and patients' expectations regarding pain control.
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Affiliation(s)
- Marisha Burden
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Angela Keniston
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado
- Denver Health, Denver, Colorado
| | - Mary Anderson Wallace
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Jason W Busse
- Department of Anesthesia, Department of Health, Evidence and Impact; Michael G Degroote Institute for Pain Research and Care; Michael G Degroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ontario, Canada
| | - Jordi Casademont
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - Marco Cicardi
- Istituti Clinici Scientifici Maugeri; University of Milan, Italy
| | - John M Cunningham
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado
- Denver Health, Denver, Colorado
| | - David Filella
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | | - Yoon-Seon Lee
- Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Centre, Seoul, South Korea
| | - Daniel D Melley
- Imperial College, Chelsea and Westminster Hospital, London, United Kingdom
| | - Anna Munoa
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado
- Denver Health, Denver, Colorado
| | | | | | - Chang Hwan Sohn
- Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Centre, Seoul, South Korea
| | - Jeffrey Spence
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado
- Denver Health, Denver, Colorado
| | - Lindsay Thurman
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Cindy R Towns
- Wellington Hospital, Newtown, Wellington, New Zealand
- University of Otago, Wellington New Zealand
| | - John You
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Luca Zocchi
- Angelo Bellini Hospital (Somma Lombardo), Internal Medicine and Cardiac Rehab. Lombardia, Italy
| | - Richard K Albert
- Department of Medicine, University of Colorado School of Medicine., Aurora, Colorado
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Das SK, Dhar SS, Panigrahi A. Prevalence of Pain and Its Characteristics in Hospitalized Patients in an Indian Teaching Hospital. Pain Manag Nurs 2019; 21:299-303. [PMID: 31303530 DOI: 10.1016/j.pmn.2019.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 04/22/2019] [Accepted: 06/04/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pain has a great impact on the physical and mental condition of hospitalized patients, reduces quality of life, and increases economic burden. AIMS The study aimed to determine pain prevalence, its characteristics, analgesic treatment, and associated factors for severity and chronicity of pain in hospitalized patients. METHODS A cross-sectional study was carried out including 847 eligible adult in-patients, aged ≥18 years, admitted to the All India Institute of Medical Sciences, Bhubaneswar, India, from June to August 2018. Pain severity was evaluated by visual analog scale (VAS) at the time of interview and after 1 week/completion of pain treatment. RESULTS The prevalence of pain during the 24 hours preceding the interview was 70.6%. The duration of pain was ≥4 weeks in 162 (27.1%) patients and severe (VAS ≥ 7) in 144 (24.1%) patients. The mean VAS score was 6.27 ± 1.97 at the time of interview and 3.31 ± 1.89 after 1 week/completion of pain treatment (p < .001). Use of opioid analgesics (adjusted odds ratio [aOR]: 3.18; confidence interval [CI]: 2.23-4.55) was significantly related to pain severity, whereas patients ≥60 years (aOR: 1.64; CI: 0.99-2.70), patients in a nonsurgical ward (aOR: 1.78; CI: 1.21-2.60), and patients using opioid analgesics (aOR: 2.63; CI: 1.73-3.98) had prolonged pain, defined as ≥4 weeks. CONCLUSION Pain prevalence and intensity in this Indian hospital were high and pain treatment was adequate in many cases. Timely assessment and appropriate management of pain in hospitalized patients is needed to prevent further pain and its complications in these patients.
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Affiliation(s)
- Saroj Kumar Das
- Department of Radiotherapy, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sovan Sarang Dhar
- Department of Radiotherapy, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Ansuman Panigrahi
- Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India.
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Dissemination and Implementation of Patient-centered Indicators of Pain Care Quality and Outcomes. Med Care 2019; 57:159-166. [PMID: 30570589 DOI: 10.1097/mlr.0000000000001042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous approaches to measuring and improving nursing-sensitive, patient-centered metrics of pain quality and outcomes in hospitalized patients have been limited. METHODS In this translational research study, we disseminated and implemented pain quality indicators in 1611 medical and/or surgical, step-down, rehabilitation, critical access, and obstetrical (postpartum) units from 326 US hospitals participating in the National Database of Nursing Quality Indicators. Eligible patients were English-speaking adults in pain. Trained nurses collected patients' perceptions via structured interview including 9 pain quality indicators, demographic, and clinical variables; these patient experience data were merged with unit and hospital level data. Analyses included geographic mapping; summary statistics and 3-level mixed effects modeling. RESULTS Hospitals in 45 states and District of Columbia participated. Of 22,293 screened patients, 15,012 were eligible; 82% verbally consented and participated. Pain prevalence was 72%. Participants were 59.4% female; ages ranged from 19 to 90+ (median: 59 y); 27.3% were nonwhite and 6.5% were Hispanic. Pain intensity on average over the past 24 hours was 6.03 (SD=2.45) on a 0-10 scale. 28.5% of patients were in severe pain frequently or constantly. Race (nonwhite), younger age, being female and nonsurgical were associated (P<0.001) with greater pain. Care quality indicators ranking lowest related to discussion of analgesic side effects and use of nonpharmacologic approaches. CONCLUSIONS Unrelieved pain remains a high-volume problem. Individual factors and unit type were significantly associated with pain outcomes. Hospitals can employ these quality indicators to direct continuous quality improvement targeting pain care quality.
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Impact of pain in overweight to morbidly obese women: preliminary findings of a cross-sectional study. Physiotherapy 2018; 104:417-423. [DOI: 10.1016/j.physio.2018.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 05/04/2018] [Indexed: 12/16/2022]
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10
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Herzig SJ, Calcaterra SL, Mosher HJ, Ronan MV, Groningen NV, Shek L, Loffredo A, Keller M, Jena AB, Nuckols TK. Safe Opioid Prescribing for Acute Noncancer Pain in Hospitalized Adults: A Systematic Review of Existing Guidelines. J Hosp Med 2018; 13:256-262. [PMID: 29624188 PMCID: PMC6278929 DOI: 10.12788/jhm.2979] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/05/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Pain is common among hospitalized patients. Inpatient prescribing of opioids is not without risk. Acute pain management guidelines could inform safe prescribing of opioids in the hospital and limit associated unintended consequences. PURPOSE To evaluate the quality and content of existing guidelines for acute, noncancer pain management. DATA SOURCES The National Guideline Clearinghouse, MEDLINE via PubMed, websites of relevant specialty societies and other organizations, and selected international search engines. STUDY SELECTION Guidelines published between January 2010 and August 2017 addressing acute, noncancer pain management among adults were considered. Guidelines that focused on chronic pain, specific diseases, and the nonhospital setting were excluded. DATA EXTRACTION Quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. DATA SYNTHESIS Four guidelines met the selection criteria. Most recommendations were based on expert consensus. The guidelines recommended restricting opioids to severe pain or pain that has not responded to nonopioid therapy, using the lowest effective dose of short-acting opioids for the shortest duration possible, and co-prescribing opioids with nonopioid analgesics. The guidelines generally recommended checking the prescription drug monitoring program when prescribing opioids, developing goals for patient recovery, and educating patients regarding the risks and side effects of opioid therapy. Additional recommendations included using an opioid dose conversion guide, avoidance of co-administration of parenteral and oral opioids, and using caution when co-prescribing opioids with other central nervous system depressants. CONCLUSIONS Guidelines, based largely on expert opinion, recommend judicious prescribing of opioids for severe, acute pain. Future work should assess the implications of these recommendations on hospital-based pain management.
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Affiliation(s)
- Shoshana J Herzig
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
- Harvard Medical School, Boston, Massachusetts, USA
| | - Susan L Calcaterra
- Department of Medicine, Denver Health Medical Center, Denver, Colorado, USA
- Department of Medicine, Division of General Internal Medicine, University of Colorado, Aurora, Colorado, USA
| | - Hilary J Mosher
- The Comprehensive Access and Delivery Research and Evaluation Center at the Iowa City Veterans Affairs Healthcare System, Iowa City, Iowa, USA
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Matthew V Ronan
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Internal Medicine, West Roxbury Medical Center, Veterans Health Administration Boston Healthcare System, West Roxbury, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Nicole Van Groningen
- Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Lili Shek
- Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Anthony Loffredo
- Department of Emergency Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Michelle Keller
- Division of Health Services Research, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Anupam B Jena
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Teryl K Nuckols
- Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
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11
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Pain in hospitalized patients in a third-level health care institution. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2018. [DOI: 10.1097/cj9.0000000000000004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Jeon N, Sorokina M, Henriksen C, Staley B, Lipori GP, Winterstein AG. Measurement of selected preventable adverse drug events in electronic health records: Toward developing a complexity score. Am J Health Syst Pharm 2017; 74:1865-1877. [PMID: 29118045 DOI: 10.2146/ajhp160911] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The defining of a select number of high-priority preventable adverse drug events (pADEs) for measurement in the electronic health record (EHR) and the estimation of pADE incidences in two tertiary care facilities are described. METHODS This study was part of a larger effort aimed at developing an automated electronic health record (EHR)-based complexity-score (C-score) that ranks hospitalized patients according to their risk for pADEs for clinical intervention. We developed measures for 16 high-priority pADEs often deemed preventable using discrete clinical and administrative EHR data. For each pADE we specified inclusion and exclusion criteria that were used to define risk populations for each specific pADE. The incidence of each type of pADE was then measured during a designated follow-up period considering all adult admissions to 2 large academic tertiary care hospitals, who were eligible for the pADE-specific risk populations during any of their first 5 hospital days. RESULTS Utilizing the data from 83,787 admissions who were at risk for at least one pADE during at least one of their first five hospital days, we found that 27,193 admissions (32.5%) developed at least one pADE. Uncontrolled postsurgical pain, uncontrolled pneumonia, and drug-associated hypotension had the highest incidences with the following number of days with pADE per number of patients at risk: 13,484 of 19,640; 527 of 1,530; and 13,394 of 43,630, while drug-associated falls (446 of 75,036), drug-associated acute mental status changes (262 of 66,875) and venous thromboembolism (214 of 74,283) had the lowest incidence rates. CONCLUSION EHR-based definitions of clinically important pADEs were developed, and the incidence of the pADEs was estimated. These definitions will be advanced for the creation of prediction models to develop a C-score for identifying patients at risk for pADEs to prioritize pharmacist intervention.
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Affiliation(s)
- Nakyung Jeon
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL
| | - Magarita Sorokina
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL
| | - Carl Henriksen
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL
| | - Ben Staley
- Department of Pharmacy Service, UF Health Shands Hospital, Gainesville, FL
| | | | - Almut G Winterstein
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, and Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, FL
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13
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Dequeker S, Van Lancker A, Van Hecke A. Hospitalized patients’ vs. nurses’ assessments of pain intensity and barriers to pain management. J Adv Nurs 2017; 74:160-171. [DOI: 10.1111/jan.13395] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Sara Dequeker
- Department of Public Health; Faculty of Medicine and Health Sciences; University Center for Nursing and Midwifery; Ghent University; Ghent Belgium
| | - Aurélie Van Lancker
- Department of Public Health; Faculty of Medicine and Health Sciences; University Center for Nursing and Midwifery; Ghent University; Ghent Belgium
| | - Ann Van Hecke
- Department of Public Health; Faculty of Medicine and Health Sciences; University Center for Nursing and Midwifery; Ghent University; Ghent Belgium
- Ghent University Hospital; Ghent Belgium
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14
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Pain Intensity in Hospitalized Adults: A Multilevel Analysis of Barriers and Facilitators of Pain Management. Nurs Res 2017; 65:290-300. [PMID: 27362515 DOI: 10.1097/nnr.0000000000000160] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite an enhanced interest and evolution in pain management, prevalence remains high. Interventions to optimize pain-related care can only be effective if barriers are identified and accounted for. AIM To assess pain intensity and examine its association with patient- (including health literacy defined in this study as "requiring help to read health information"), nurse-, and system-related (including social capital defined as "the importance of network and norms at work") barriers/facilitators to pain management. METHODS A two-center, cross-sectional study was performed between October 2012 and April 2013. The study included patients and nurses of 39 noncritical wards of two hospitals in Belgium. Patients who were 18 years of age or older and without impaired cognition or consciousness were eligible to take part. All nurses working in the included ward were invited to participate. Pain intensity and patient-related barriers were collected by a structured and standardized questionnaire, completed in dialogue with the patient. Nurses completed the questionnaire on the nurse- and system-related barriers and the social capital scale. Multilevel analysis was used to analyze the data because of the hierarchical structure of the data. RESULTS The average pain of all patients across all wards on a 0-10 scale was 2.2 (SD = 3.6). The multilevel analysis indicates that pain intensity can be explained by variables at patient and ward levels. A significant independent association was found between higher pain intensity and younger age, receiving pain medication, the conviction of patients that pain medication does not improve pain, inadequate health literacy in patients, nurses without advanced education, and nurse's concerns about side effects. Social capital did not emerge as predictor of pain intensity. DISCUSSION Patient and nurse level factors should be taken into account in hospitals when setting up strategies to improve pain management.
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15
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Ortiz MM, Carr E, Dikareva A. An Integrative Review of the Literature on Pain Management Barriers: Implications for the Canadian Clinical Context. Can J Nurs Res 2017; 46:65-93. [PMID: 29509486 DOI: 10.1177/084456211404600305] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Despite decades of pain research, substandard pain management continues to be distressingly prevalent across health-care settings. This integrative literature review analyzes and synthesizes barriers to effective pain management and identifies areas for future investigation in a Canadian context. Three sets of key barriers were identified through thematic analysis of 24 original research studies published in the period 2003-13: patient, professional, and organizational. These barriers rarely occurred in isolation, with many studies reporting examples in all three categories. This suggests that interventions need to reflect the multifactorial nature of pain management. Reframing pain education as a public health initiative could lead to sustainable improvement, as could the strengthening of partnerships between patients and health-care providers. There are tremendous opportunities for the advanced practice nurse to take a lead in pain management. The delivery of high-quality care that encompasses effective pain management strategies must be a priority for nursing. Research approaches, such as pragmatic mixed methods, that offer contextual understanding of how pain is managed are suggested.
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Affiliation(s)
- Mia Maris Ortiz
- BSN student in the Faculty of Nursing, University of Calgary, Alberta, Canada
| | - Eloise Carr
- Faculty of Nursing, and Associate Dean, Faculty of Graduate Studies, University of Calgary
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16
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Andersson V, Bergman S, Henoch I, Ene KW, Otterström-Rydberg E, Simonsson H, Ahlberg K. Pain and pain management in hospitalized patients before and after an intervention. Scand J Pain 2017; 15:22-29. [DOI: 10.1016/j.sjpain.2016.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/11/2016] [Accepted: 11/13/2016] [Indexed: 11/30/2022]
Abstract
Abstract
Background and aim
Studies have shown that pain is common among hospitalized patients and that there is a lack of compliance with pain management guidelines. Improving pain management does not only involve developing new drugs or technology; even more important is an effective organisation that utilises existing expertise. The aim of this study was to investigate whether pain in hospitalized patients can be reduced by implementing evidence-based pain management guidelines, providing education for staff and an organisation that includes pain responsibility nurses.
Methods
A cross-sectional study was carried out between 2009 and 2010 at two hospitals in southwest Sweden, comprising a baseline survey followed by an intervention. The study involved 306 patients, who answered questions about pain intensity at rest and while moving, disturbed sleep due to pain and whether they had used a pain rating scale while in hospital. Medical records were scrutinised for analgesic prescriptions. An intervention then took place, involving implementation of evidence-based guidelines, staff education and the introduction of pain responsibility nurses. A follow-up survey was carried out in 2012, in which 293 patients answered the same questions and their medical records were also reviewed. The baseline results were then compared with those of the follow-up survey.
Results
When compared with the baseline survey, the follow-up survey revealed significant differences in the use of validated pain rating instruments as well as the prescription of more appropriate analgesics. Prescription of paracetamol increased significantly in the follow-up survey; 56% of the patients were prescribed paracetamol on a regular basis, compared with 42% at baseline. There was also a significant increase in the use of strong opioids, from 38% at baseline to 55% at follow-up. Prescriptions of weak opioids decreased from 16% at baseline to 4% at follow-up. No significant differences were observed in patient pain levels in the follow-up survey. At baseline, 29% of the patients reported moderate to severe pain at rest (NRS 4–10) and at follow-up that figure was 24% (NRS 4–10). In both surveys, 41% reported moderate to severe pain (NRS 5–10) during movement. Thirty-nine percent reported disturbed sleep at night at both baseline and follow-up.
Conclusions
This study demonstrates that evidence-based guidelines made accessible to all staff as a pocket size booklet and on the intranet, in combination with staff education, pain responsibility nurses who informed other staff on their own wards, improved the prescription of analgesics in the hospitals studied. In order to achieve a noticeable effect for patients, i.e., reduced pain levels, an intervention containing more components than those employed in the present study is required.
Implications
Nurses and physicians need greater knowledge about the importance of pain rating. A vital part of pain management at hospitals is continuous evaluation of treatment outcomes to prevent severe pain and disturbed sleep. The complexity of pain and pain management requires commitment, time and knowledge on the part of healthcare staff. Multi-professional pain teams that support ward staff in pain management are necessary in order to reduce suffering and unnecessary pain in hospitalized patients.
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Affiliation(s)
- Viveka Andersson
- The Sahlgrenska Academy , University of Gothenburg , Institute of Health and Care Sciences , Box 457, 405 30 Gothenborg , Gothenburg , Sweden
- Department of Medicine , Hallands Hospital Varberg , Träslövsvägen 68, 432 37 , Varberg , Sweden
| | - Stefan Bergman
- Primary Health Care Unit, Department of Public Health and Community Medicine , Institute of Medicine, The Sahlgrenska Academy , University of Gothenburg , Box 457, 405 30 , Gothenborg , Sweden
- Spenshult Research and Development Centre , Bäckagårdsvägen 47, 302 74 , Halmstad , Sweden
| | - Ingela Henoch
- The Sahlgrenska Academy , University of Gothenburg , Institute of Health and Care Sciences , Box 457, 405 30 Gothenborg , Gothenburg , Sweden
- Angered Local Hospital , Halmtorget 1, 424 65 , Gothenburg , Sweden
| | - Kerstin Wickström Ene
- Department of Research, Development and Education , Hallands Hospital , Varberg , Träslövsvägen 68, 432 37 Varberg , Sweden
| | - Eva Otterström-Rydberg
- Department of Anesthesia and Intensive Care , Hallands Hospital , Varberg , Träslövsvägen 68, 432 37 Varberg , Sweden
| | - Hanna Simonsson
- Department of Surgery , Hallands Hospital , Halmstad , Lasarettsvägen, 302 33 Halmstad , Sweden
| | - Karin Ahlberg
- The Sahlgrenska Academy , University of Gothenburg , Institute of Health and Care Sciences , Box 457, 405 30 Gothenborg , Gothenburg , Sweden
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17
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Abstract
BACKGROUND In a survey of all adult inpatients at the Wilhelminen Hospital in Vienna and the Klagenfurt Clinic on Lake Wörthersee, data on pain prevalence, the most frequent sites of pain, pain intensity, pain type, effect of pain on patients, pain evaluation on the various wards, pain precipitating factors, and patient satisfaction were collected. MATERIALS AND METHODS All inpatients > 18 years were questioned using a questionnaire developed by the investigators at the Department for Anesthesia, Intensive Care, and Pain Medicine at the Wilhelminen Hospital. RESULTS A pain prevalence of 45.7% was found at the Wilhelminen Hospital and of 40.8% at the Klagenfurt Clinic. Women reported pain significantly more often than men. No significant difference was found between surgical and conservative treatment wards in terms of pain prevalence. Patients on conservative treatment wards reported significantly higher current pain intensity than those in surgical departments. The most common areas of pain were joints and bones. A score >3 in the ID pain questionnaire was reached by 8.8% (Wilhelminen Hospital) and 4.0% (Klagenfurt Clinic) of participants. Pain influenced mood, mobility, and nighttime sleep, and was intensified by the daily clinical routine. CONCLUSION Overall, it was demonstrated that the majority of patients at both hospitals were satisfied with the pain management. However, pain management in conservative treatment disciplines must not be neglected. More intense current pain, a worse quality of life, and a trend toward lower patient satisfaction indicate that analgesic treatment in nonsurgical disciplines should be optimized.
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18
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Ludvigsen ES, Flaeten ØØ, Gay CL, TarAngen M, Granheim TI, Lerdal A. Pain and concomitant symptoms in medical and elective surgical inpatients: a point prevalence survey. J Clin Nurs 2016; 25:3229-3240. [DOI: 10.1111/jocn.13346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Caryl L Gay
- Department of Family Health Care Nursing; School of Nursing; University of California; San Francisco CA USA
- Department
of Patient Safety and Research; Lovisenberg Diakonale Hospital; Oslo Norway
| | - Magnus TarAngen
- Surgical Department; Lovisenberg Diakonale Hospital; Oslo Norway
| | | | - Anners Lerdal
- Department
of Patient Safety and Research; Lovisenberg Diakonale Hospital; Oslo Norway
- Department of Nursing Science; Faculty of Medicine; Institute of Health and Society; University of Oslo; Oslo Norway
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19
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Gregory J, McGowan L. An examination of the prevalence of acute pain for hospitalised adult patients: a systematic review. J Clin Nurs 2016; 25:583-98. [DOI: 10.1111/jocn.13094] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Julie Gregory
- School of Nursing, Midwifery and Social Work; University of Manchester; Manchester UK
| | - Linda McGowan
- Faculty of Medicine & Health; School of Healthcare; University of Leeds; Leeds UK
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20
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[Psychosomatic aspects of chronic pelvic pain syndrome. Psychometric results from the pilot phase of an interdisciplinary outpatient clinic]. Schmerz 2015; 28:311-8. [PMID: 24728530 DOI: 10.1007/s00482-014-1422-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Chronic pelvic pain syndrome (CPPS) presents as a multicausal disorder. Complex interactions of psychological factors with somatic dysfunctions are crucial to the development and maintenance of CPPS. AIM This study characterized the patient cohort from a psychosomatic perspective. MATERIAL AND METHODS Subjects with CPPS were recruited from an interdisciplinary CPP outpatient clinic. Sociodemographic data, symptoms (National Institutes of Health Chronic Prostatitis Symptom Index, NIH-CPSI) and pain-related factors (Short Form of the McGill Pain Questionnaire, SF-MPQ) as well as depressive symptoms (Patient Health Questionnaire 9, PHQ-9), anxiety [Generalized Anxiety Disorder 7-item (GAD-7) Scale], the severity of somatic symptoms (PHQ-15) and quality of life (Short Form-12, SF-12) were measured. Additional socioeconomic data were obtained. RESULTS A total of 50 men and women with a mean disease duration of 5.8 years were included in the study. The disease-related symptom severity and healthcare utilization were high. All psychometric scales showed significantly lower values compared with the general population. A high symptom burden was associated with high psychopathological findings and reduced quality of life. CONCLUSION The psychopathological comorbidities in subjects with CPPS require specific evidence-based diagnostic and treatment methods to reduce psychopathology and improve quality of life.
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21
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Bellido-Vallejo JC, Rodríguez-Torres MC, López-Medina IM, Pancorbo-Hidalgo PL. Psychometric Testing of the Spanish Version of the Pain Level Outcome Scale in Hospitalized Patients With Acute Pain. Int J Nurs Knowl 2015; 27:10-6. [PMID: 25612148 DOI: 10.1111/2047-3095.12070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE This study aims to evaluate the psychometric properties and sensitivity to change of the Spanish version of the Pain Level Outcome Scale. METHODS This article applied observational longitudinal validation study with patients suffering from acute pain at three hospitals. FINDINGS The study included 73 patients. Inter-rater agreement was kappa = .88 and internal consistency α = .93. Principal components analysis yielded four components that explained 81.86% of the variance; the correlation with the Numerical Pain Intensity Scale was r = -.81. CONCLUSIONS The version with 17 indicators shows good psychometric properties and adequate sensitivity to change. A Spanish version of the Pain Level Outcome Scale with 17 indicators is proposed as a structured multidimensional instrument to help nurses choose the most appropriate indicators for assessing patients' pain.
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22
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Favre C, Dériaz O, Hanon R, Luthi F. Care related pain in rehabilitation after orthopedic trauma: An exploratory study with qualitative data. Ann Phys Rehabil Med 2014; 58:132-8. [PMID: 25818069 DOI: 10.1016/j.rehab.2014.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 08/07/2014] [Accepted: 08/07/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Care related pain (CRP) is generally under-estimated and rarely studied in rehabilitation as well as in general medecine. Beliefs about pain influence psychological distress, adjustment to pain and physical disability. In this sense, perceptions of CRP could limit recovery. This exploratory study aims to understand patients' and caregivers' subjective perceptions and beliefs about CRP. PATIENTS AND METHODS Questionnaires about CRP were submitted to members of the interdisciplinary team of a rehabilitation hospital and to patients with musculoskeletal complaints (cross-sectional design). Twenty patients were also individually interviewed (qualitative data). Four topics were addressed: frequency of CRP, situations and procedures causing CRP, beliefs about CRP and means used to deal with CRP. RESULTS Seventy-five caregivers and 50 patients replied to the questionnaire. CRP is a very common experience in rehabilitation and it is recognized by both groups. Generally, the situations causing CRP reflect the specificity of rehabilitation (mobilization…) and are similarly perceived by patients and caregivers, with patients considering them as more painful. Beliefs about CRP are clearly different from those usually associated with pain. Both groups point out the utilitarian and the inevitable character of CRP. They differ on that, that patients had a more positive view about CRP. They associate it more often with progress and see it as acceptable at least until a certain limit. They are also able to perceive the richness of means used by physiotherapists to help them coping with CRP. CONCLUSION Our data may suggest new keys to motivate patient to be active in rehabilitation for example in choosing carefully arguments or words which may fit theirs' beliefs about CRP, or in using various means to manage CRP. Promoting the use of relational competences with chronic pain patients and of a patient-centred approach may also be a concern in training caregivers.
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Affiliation(s)
- C Favre
- Service de psychosomatique, clinique romande de réadaptation Suvacare, avenue Grand-Champsec 90, 1950 Sion, Switzerland.
| | - O Dériaz
- Institut de recherche en réadaptation-réinsertion, avenue Grand-Champsec 90, 1950 Sion, Switzerland
| | - R Hanon
- Service de physiothérapie, clinique romande de réadaptation Suvacare, avenue Grand-Champsec 90, 1950 Sion, Switzerland
| | - F Luthi
- Service de réadaptation de l'appareil locomoteur, clinique romande de réadaptation Suvacare, avenue Grand-Champsec 90, 1950 Sion, Switzerland; Département de l'appareil locomoteur, service de rhumatologie, centre hospitalier universitaire Vaudois (CHUV), avenue Pierre-Decker 4, 1005 Lausanne, Switzerland
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23
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Jabusch KM, Lewthwaite BJ, Mandzuk LL, Schnell-Hoehn KN, Wheeler BJ. The pain experience of inpatients in a teaching hospital: revisiting a strategic priority. Pain Manag Nurs 2014; 16:69-76. [PMID: 25439113 DOI: 10.1016/j.pmn.2014.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 05/21/2014] [Accepted: 05/27/2014] [Indexed: 11/28/2022]
Abstract
For hospital executives and clinicians to improve pain management, organizations must examine the current pain experience of in-patients beyond simply measuring patient satisfaction. The aim of this study was to quantify the prevalence of pain among adult in-patients and the degree of interference pain had on daily activities. A descriptive, cross-sectional study was undertaken in a 530 bed tertiary care, teaching hospital in central Canada. A convenience sample (N = 88) of adult medical-surgical patients completed the Short Form-Brief Pain Inventory survey. Pain prevalence was 70.4%. The mean pain severity score was 3.76 (standard deviation, SD = 2.88) and mean pain interference score on daily activities was 4.56 (SD = 3.93). The most frequently identified site of pain was the lower extremities (n = 15, 28%). Women had higher mean scores on pain "right now" compared to men (p < 0.05). The sample majority (n = 81) indicated hospital staff asked about the presence of pain. Seventy-nine percent (n = 57) reported hospital staff "always" did everything they could to help manage pain. Eighty-four percent (n = 61) selected "always" or "usually" to describe their ability to be involved in deciding pain treatments. The mean pain relief score from treatments was 61% (SD = 34.79). Significant positive correlations were found between pain intensity ratings and pain interference on all daily activities (p < 0.001). Pain prevalence remains high with a significant relationship between pain and activities of daily living. The study provides baseline data to direct future initiatives at improving pain management.
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Affiliation(s)
| | | | - Lynda L Mandzuk
- Rehabilitation and Geriatrics Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | | | - Barbara J Wheeler
- Woman & Child Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada
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24
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Echevarria Moreno M, Ortega Garcia JL, Herrera Silva J, Galvez Mateo R, Torres Morera LM, de la Torre Liebanas R. [Prevalence of pain in Andalusian public hospitals]. ACTA ACUST UNITED AC 2014; 61:549-56. [PMID: 24742791 DOI: 10.1016/j.redar.2014.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the prevalence of pain in medical and surgical patients admitted to reference hospitals in Andalusia, as well as their features and the most population groups most affected. MATERIAL AND METHODS A cross-sectional, multicenter epidemiological study was conducted simultaneously on the population admitted to 5 hospitals. Using a structured questionnaire the demographics, hospital area, presence of pain at the time of the interview, and pre- and post-variables related to the intensity of pain and its treatment at 24h were investigated. All patients over 18 years old were included, except those patients with difficulty in understanding the questionnaire, and psychiatric and obstetric patients. Pain intensity was assessed by simple verbal scale. RESULTS Of the 1,236 patients included, 54.2% were male, with 51.1% of patients aged 65 years, and 69.17% were admitted to medical areas. Pain was observed in 52.9% of patients admitted to the surgical area compared to 29.4% in the medical area. Of the 19.4% who reported having had pain in the last 24h prior to the questionnaire, 57.7% of them were surgical patients and 32% were medical, P<.005), and of the 42.2% who had pain at the time of study, 52.7% were female. The incidence of pain on movement was higher than that observed at rest. The mean resting pain was 1.8 and 1.4 for the surgical and medical patients, respectively (P<.01). The mean pain on movement was 2.2 and 1.6 for the surgical and medical patients, respectively (P<.01). More than one quarter (25.8%) of surgical patients and 16.5% of medical patients had difficulty sleeping (P<.005). Some 12.8% of all patients had no analgesic regimen, and 66.2% and 85.6% of surgical and medical patients, respectively, did not request analgesics (P<.005). The main drugs were prescribed paracetamol analgesic and metamizole, and in 54.4% of patients. CONCLUSIONS We believe that the presence of pain in patients admitted to our study population is high and it is essential to encourage an improvement in the pain management of both acute and chronic pain processes.
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Affiliation(s)
- M Echevarria Moreno
- Servicio de Anestesiología y Reanimación, Hospital de Valme, Sevilla, España.
| | - J L Ortega Garcia
- Servicio de Anestesiología y Reanimación, Hospital Puerto Real, Cádiz, España
| | - J Herrera Silva
- Servicio de Anestesiología y Reanimación, Hospital de Valme, Sevilla, España
| | - R Galvez Mateo
- Servicio de Anestesiología y Reanimación, Hospital Virgen de la Nieves, Granada, España
| | - L M Torres Morera
- Servicio de Anestesiología y Reanimación, Hospital Puerta del Mar, Cádiz, España
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The Relationship Between Pain and Comorbid Health Conditions in People with Chronic Obstructive Pulmonary Disease. Cardiopulm Phys Ther J 2014. [DOI: 10.1097/01823246-201403000-00007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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HajGhanbari B, Garland SJ, Road JD, Reid WD. Pain and physical performance in people with COPD. Respir Med 2013; 107:1692-9. [DOI: 10.1016/j.rmed.2013.06.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
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Azevedo LF, Costa-Pereira A, Mendonça L, Dias CC, Castro-Lopes JM. Epidemiology of chronic pain: a population-based nationwide study on its prevalence, characteristics and associated disability in Portugal. THE JOURNAL OF PAIN 2013; 13:773-83. [PMID: 22858343 DOI: 10.1016/j.jpain.2012.05.012] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 04/30/2012] [Accepted: 05/17/2012] [Indexed: 11/24/2022]
Abstract
UNLABELLED A cross-sectional nationwide epidemiological study was performed in a random sample of the Portuguese adult population, aiming to describe the prevalence and impact of chronic pain (CP). The 5,094 participants were selected by random digit dialing, between January 2007 and March 2008, and estimates were adequately weighted for the population. Prevalence of CP was 36.7% (95% confidence interval [CI] [35.3-38.2]), based on the definition of the International Association for the Study of Pain. Recurrent or continuous pain was present in 85% of those with CP, and moderate-to-severe intensity and disability were present in 68 and 35%, respectively. Highest CP prevalence was observed among the elderly, retired, unemployed, and less educated. Highest disability was found in relation with family/home responsibilities, recreational activities, occupation/work, and sleep/rest; 13% reported a diagnosis of depression and 49% reported interference in their job. The main factors associated with disability were sex, pain intensity, and depression or depressive symptoms. CP is highly prevalent, causes high personal and social burden, and affects particularly the most vulnerable subgroups. Portugal, depending on CP definition, could be placed in the lower prevalence group in Europe. Improvement in pain intensity management and special attention to affective components of CP are recommended. PERSPECTIVE In this cross-sectional nationwide epidemiological study, we showed that chronic pain is a significant problem that is present in 37% of the Portuguese adult general population, is associated with high personal, family, and social burden, and affects in particular the most vulnerable subgroups of the population.
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Affiliation(s)
- Luís Filipe Azevedo
- Department of Health Information and Decision Sciences (CIDES), Faculty of Medicine, University of Porto, Portugal.
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Peña A, Estrada CA, Soniat D, Taylor B, Burton M. Nominal group technique: a brainstorming tool for identifying areas to improve pain management in hospitalized patients. J Hosp Med 2012; 7:416-20. [PMID: 22190453 DOI: 10.1002/jhm.1900] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 10/19/2011] [Accepted: 11/15/2011] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. OBJECTIVE To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. DESIGN Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). SETTING One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. PARTICIPANTS Nurses, resident physicians, patient care technicians, and unit clerks. MEASUREMENTS Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" RESULTS Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. CONCLUSIONS Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers.
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Affiliation(s)
- Adolfo Peña
- Saint Joseph Hospital, Section of Hospital Medicine, London, Kentucky, USA
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HajGhanbari B, Holsti L, Road JD, Darlene Reid W. Pain in people with chronic obstructive pulmonary disease (COPD). Respir Med 2012; 106:998-1005. [PMID: 22531146 DOI: 10.1016/j.rmed.2012.03.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 03/06/2012] [Accepted: 03/07/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The prevalence and characteristics of pain are not known in COPD patients. The purposes of this study were to determine if pain is more common in COPD patients than in healthy people and if it was related to self-reported physical activity, health related quality of life (HRQoL) and comorbidities. METHODS Participants returned a mailed survey package that contained: 1) McGill Pain Questionnaire (MPQ) and Brief Pain Inventory (BPI) to evaluate pain severity and how pain interferes with activities; 2) Tampa Scale for Kinesiophobia (TSK) to evaluate fear of movement related to pain; 3) Short Form-36 (SF-36), to measure HRQoL; 4) Community Health Activities Model Program for Seniors (CHAMPS) to evaluate physical activity; 5) a form to list medications and comorbidities. RESULTS Forty-seven COPD patients and 47 age- and gender-matched healthy people responded. People with COPD demonstrated more pain (MPQ and BPI, p = 0.000), a greater pain-related interference in their lives (BPI, p = 0.000), a higher pain-related fear of movement, and lower frequency and energy expenditure of physical activities (CHAMPS, p = 0.000) than healthy people (TSK, p < 0.001). Pain severity (MPQ and BPI) was indirectly correlated to the Physical Component Score of the SF-36. COPD patients identified pain in the neck and trunk 3.1 times more often than healthy people. The number of comorbidities was the most consistent independent correlate of pain in COPD patients. CONCLUSIONS COPD patients demonstrate more pain which interferes with activities more so than healthy people of similar age. Pain is also negatively associated with HRQoL in COPD.
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Affiliation(s)
- Bahareh HajGhanbari
- Department of Physical Therapy, Muscle Biophysics Laboratory, Vancouver Coastal Health Research Institute, University of British Columbia, Canada V6T 1Z3.
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Wadensten B, Fröjd C, Swenne CL, Gordh T, Gunningberg L. Why is pain still not being assessed adequately? Results of a pain prevalence study in a university hospital in Sweden. J Clin Nurs 2011; 20:624-34. [PMID: 21320191 DOI: 10.1111/j.1365-2702.2010.03482.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to investigate the prevalence of pain and pain assessment among inpatients in a university hospital. BACKGROUND Pain management could be considered an indicator of quality of care. Few studies report on prevalence measures including all inpatients. DESIGN Quantitative and explorative. METHOD Survey. RESULTS Of the inpatients at the hospital who answered the survey, 494 (65%) reported having experienced pain during the preceding 24 hours. Of the patients who reported having experienced pain during the preceding 24 hours, 81% rated their pain >3 and 42.1% rated their pain >7. Of the patients who reported having experienced pain during the preceding 24 hours, 38.7% had been asked to self-assess their pain using a Numeric Rating Scale (NRS); 29.6% of the patients were completely satisfied, and 11.5% were not at all satisfied with their participation in pain management. CONCLUSIONS The result showed that too many patients are still suffering from pain and that the NRS is not used to the extent it should be. Efforts to overcome under-implementation of pain assessment are required, particularly on wards where pain is not obvious, e.g., wards that do not deal with surgery patients. Work to improve pain management must be carried out through collaboration across professional groups. RELEVANCE TO CLINICAL PRACTICE Using a pain assessment tool such as the NRS could help patients express their pain and improve communication between nurses and patients in relation to pain as well as allow patients to participate in their own care. Carrying out prevalence pain measures similar to those used here could be helpful in performing quality improvement work in the area of pain management.
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Affiliation(s)
- Barbro Wadensten
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
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Beck SL, Towsley GL, Pett MA, Berry PH, Smith EL, Brant JM, Guo JW. Initial Psychometric Properties of the Pain Care Quality Survey (PainCQ). THE JOURNAL OF PAIN 2010; 11:1311-9. [DOI: 10.1016/j.jpain.2010.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Revised: 01/21/2010] [Accepted: 03/09/2010] [Indexed: 10/19/2022]
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Gunnarsdottir S, Ward SE, Serlin RC. A population based study of the prevalence of pain in Iceland. Scand J Pain 2010; 1:151-157. [DOI: 10.1016/j.sjpain.2010.05.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 05/05/2010] [Indexed: 10/19/2022]
Abstract
Abstract
Prevalence estimates of pain differ depending on how it is defined and measured and on the populations studied. It has been estimated that on a given day, as many as 30–44% of the general population experience some kind of pain. Information about the prevalence of pain in Iceland is not available. The aims of this study were to evaluate the prevalence of pain of various origins among the general population of Iceland, to test hypotheses regarding relationships between pain, quality of life (QOL) and demographic variables, to evaluate participants’ beliefs about causes of their pain, and to evaluate how those who experience pain manage it. A random sample of 1286 adults was drawn from a national registry holding information about all citizens of Iceland. Data were collected with a postal-survey. Pain was evaluated with the Brief Pain Inventory (BPI), with instructions modified to evaluate pain in the past week as opposed to the past 24 h. Of 1286 invited, 599 (46.6%) participated, of which, 232 had experienced pain in the past week (40.3%). Participants had a mean (SD) age of 44.94 (17.12) years and 56% were women. Those who had pain perceived their health to be worse than those who had not [B = −0.91, SE = 0.15, Wald = 38.75, p = 0.00], but did not differ on other variables. Of 232 individuals reporting pain, 183 (79.6%) or 30.6% of the total sample had experienced pain for more than three months. On a scale from 0 “no pain” to 10 “pain as bad as I can imagine” the mean (SD) pain severity score (composite of four pain severity scores) for the 232 participants reporting pain was 3.21 (1.73) and pain interference with life activities 2.59 (1.98), also on a 0–10 scale. Pain severity predicted pain interference [B = 0.71; F = 126.14; df = 1,206; p = 0.00], which mediated the effects of pain severity on mood and QOL. Between Pain Interference with Life and Positive Affect [B = −0.06; F = 4.53; df = 1,196; p = 0.04], between Pain Interference and Negative Affect [B = 0.15; F = 23.21; df = 1,196; p = 0.00], and between Pain Interference and Global Quality of Life [B = −0.18; F = 29.11; df = 1,196; p = 0.00]. Most frequent causes for pain were strain injuries (n = 79), resulting from work or sports activity, arthritis (n = 39), mechanical problems (e.g. due to birth defects, curvature, slipped discs, etc.) (n = 37), various diseases (n = 31) and accidents (n = 30). Nineteen participants did not know what caused their pain. Treatments for pain varied, but most had used medications alone (n = 76) or in combination with other treatments (n = 61). The prevalence of pain in the general population of Icelandic adults is similar to what has been reported. Estimates of chronic pain are towards the higher end when compared to data from other European counties, yet comparable to countries such as Norway. This raises questions about possible explanations to be looked for in genetics or cultural point of view. This population based study provides valuable information about the prevalence of pain in Iceland and also supports findings previously reported about pain in the neighboring countries.
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Affiliation(s)
- Sigridur Gunnarsdottir
- Landsptali National University Hospital of Iceland, Faculty of Nursing , Eiriksgata 34, 101 Reykjavik , Iceland
- National Hospital , Reykjavik , Iceland
| | - Sandra E. Ward
- University of Wisconsin Madison, School of Nursing , Wisconsin , United States
| | - Ronald C. Serlin
- University of Wisconsin Madison , Department of Educational Psychology , Wisconsin , United States
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Pain Prevalence Study in a Large Canadian Teaching Hospital. Round 2: Lessons Learned? Pain Manag Nurs 2010; 11:45-55. [DOI: 10.1016/j.pmn.2009.01.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Revised: 01/19/2009] [Accepted: 01/26/2009] [Indexed: 11/15/2022]
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Nurses' Knowledge, Attitudes, and Practice Patterns Regarding Titration of Opioid Infusions at the End of Life. J Hosp Palliat Nurs 2010. [DOI: 10.1097/njh.0b013e3181cf791c] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bibliography. PROGRESS IN PALLIATIVE CARE 2008. [DOI: 10.1179/096992608x346198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Sawyer J, Haslam L, Robinson S, Daines P, Stilos K. Pain Prevalence Study in a Large Canadian Teaching Hospital. Pain Manag Nurs 2008; 9:104-12. [DOI: 10.1016/j.pmn.2008.02.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Revised: 01/08/2008] [Accepted: 02/04/2008] [Indexed: 10/21/2022]
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