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Türker Ö, Şanlı D. Surgical Patients' Evaluation of Pain Management Quality and Surgical Nurses' Pain-Related Knowledge and Attitudes. Pain Manag Nurs 2024:S1524-9042(24)00110-3. [PMID: 38600012 DOI: 10.1016/j.pmn.2024.03.012] [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: 09/04/2023] [Revised: 03/01/2024] [Accepted: 03/12/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE The present study was aimed at investigating the quality of pain management evaluated by inpatients in surgical clinics, and pain-related knowledge and attitudes of nurses working in surgical clinics, surgical units, or emergency services. METHODS The study was conducted as a descriptive and cross-sectional study. The study data were collected from inpatients in surgical clinics (N = 306), and from nurses working in surgical clinics, surgical units, or emergency services (N = 57) between January 2020 and September 2020. The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) and Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP) were the tools used for data collection. RESULTS The mean scores the participants obtained from the severity of worst pain, pain relief, and satisfaction with pain treatment components of the APS-POQ-R were 6.14 ± 2.59, 59.28 ± 22.26, and 8.99 ± 1.62, respectively. There were significant differences between many components of the APS-POQ-R in terms of such variables as age, sex, undergoing previous surgery, presence of pain before surgery, surgery performed, and type of anesthesia (p < .05). The mean score the participants obtained from the NKASRP was 15.35 ± 3.87. CONCLUSIONS It was concluded that the patients' pain was relieved moderately, that they were very highly satisfied with pain treatment, and that the nurses' pain-related knowledge and attitude levels were below the moderate level. CLINICAL IMPLICATIONS Nurses should support patients whose in-bed activities were prevented due to pain, involve them in pain treatment decisions, advise them about pain treatment options, and encourage them to use nonpharmacological methods.
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Affiliation(s)
- Özge Türker
- Izmir Alsancak Nevvar Salih Isgoren State Hospital, Konak, Izmir, Türkiye
| | - Deniz Şanlı
- Izmir Katip Celebi University, Faculty of Health Sciences, Nursing Department, Department of Surgical Nursing, Izmir, Türkiye.
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Lovasi O, Gaál P, Frank K, Lám J. Acute Pain Services and pain-related patient-reported outcomes in Hungarian hospitals. Perioper Med (Lond) 2024; 13:18. [PMID: 38475942 DOI: 10.1186/s13741-024-00373-z] [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: 05/03/2022] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Postoperative pain management is an important part of surgical care, where Acute Pain Service offers added value in terms of patient outcomes and costs. The technology, however, has hardly been adopted in Hungary, with only two hospitals operating Acute Pain Service and whose performance has not been evaluated yet. This research compared pain management outcomes of surgical, orthopedic, and traumatology patients in Hungarian hospitals with and without Acute Pain Service. METHODS We recruited 348 patients, 120 in the APS group and 228 in the control group, whose experience was surveyed with an adapted version of the American Pain Society Patient Outcome Questionnaire. The questionnaire covered pain intensity, pain interference with physical and emotional functions, side effects, patient satisfaction, information received, and participation in treatment decisions. The differences were analyzed by Fisher's exact test and Mann-Whitney U test. RESULTS The APS group showed better results with lower pain intensity scores regarding worst postoperative pain (χ2 = 18.919, p = 0.0043). They reported less pain interference with activities in bed (χ2 = 21.978, p = 0.0006) and out of bed (χ2 = 14.341, p = 0.0129). Furthermore, patients in the APS group experienced fewer pain-management-related side effects, like nausea (χ2 = 15.240, p = 0.0101), drowsiness (χ2 = 26.965, p = 0.0001), and dizziness (χ2 = 13.980, p = 0.0124). However, patient information (χ2 = 3.480, p = 0.0945) and patient satisfaction (χ2 = 5.781, p = 0.2127) did not differ significantly between the two groups. CONCLUSIONS Our findings confirm earlier international evidence on the benefits of Acute Pain Service in postoperative pain management and support the wider adoption of the technology in Hungarian hospitals. Nevertheless, close attention should be paid to patient information and involvement as better outcomes alone do not necessarily increase patient satisfaction.
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Affiliation(s)
- Orsolya Lovasi
- School of PhD Studies, Semmelweis University, Üllői Út 26, 1085, Budapest, Hungary.
| | - Péter Gaál
- Health Services Management Training Center, Semmelweis University, Budapest, Hungary
- Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Targu Mures, Romania
| | - Krisztián Frank
- Szekszárd District Office of the Government Office of Tolna County, Szekszárd, Hungary
| | - Judit Lám
- Health Services Management Training Center, Semmelweis University, Budapest, Hungary
- NEVES Society for Patient Safety, Budapest, Hungary
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Erden S, Güler S, Tura İ, Başibüyük İF, Arslan UE. Evaluating patient outcomes in postoperative pain management according to the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R). Appl Nurs Res 2023; 73:151734. [PMID: 37722782 DOI: 10.1016/j.apnr.2023.151734] [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: 04/03/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND In the first 24 h after surgery, it is necessary to evaluate the patient responses to pain, analgesia and patient satisfaction to prevent complications related to the pain management process. AIM To evaluate patients' outcomes (pain qualities, side effects of the pain management, pain treatment satisfaction, non-pharmacological pain treatment methods, predictors of pain management satisfaction and percentage of pain relief) according to the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) in the first 24 h. DESIGN Cross-sectional study. METHODS The study sample was comprised of 700 patients, who were surgically treated at the surgical clinics of a university hospital and completed the first postoperative 24 h. The data was collected through the "Patient Information Form" and the "Turkish version of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)". RESULTS The medians of the lowest and the worst postoperative pain severity level were 3.0 and 7.0, respectively. Patients experienced severe pain in 60 % of the first postoperative 24 h and reported that 70 % of their pain eventually decreased. A positive and significant correlation was found between pain interference, pain-affected mood/emotions, the severity of pain-related side effects, the least and worst pain severity levels and severe pain, and the percentage of time experienced with severe pain. CONCLUSIONS Most of the patients experienced severe pain, which restricted their daily life activities and led to negative emotions. Acute postoperative pain may negatively affect patient outcomes and delay postoperative recovery during the early period. Therefore, pain should be managed in the early period to prevent physical and psychological side effects.
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Affiliation(s)
- Sevilay Erden
- Cukurova University, Faculty of Health Sciences, Department of Surgical Nursing, Adana, Türkiye (RN, PhD).
| | - Sevil Güler
- Gazi University, Faculty of Nursing, Department of Surgical Nursing, Ankara, Türkiye (RN, PhD).
| | - İlknur Tura
- Cukurova University, Faculty of Health Sciences, Department of Surgical Nursing, Adana, Türkiye (RN, MsN)
| | | | - Umut Ece Arslan
- Hacettepe University, Public Health Institute, Public Health Department, Ankara, Türkiye (RN, PhD)
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Walton LL, Duff E, Arora RC, McMillan DE. Surgery patients’ perspectives of their role in postoperative pain: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2023. [DOI: 10.1016/j.ijnsa.2023.100124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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Chaw SH, Lo YL, Lee JY, Wong JW, Zakaria WAW, Ruslan SR, Tan WK, Shariffuddin II. Evaluate construct validity of the Revised American Pain Society Patient Outcome Questionnaire in gynecological postoperative patients using confirmatory factor analysis. BMC Anesthesiol 2021; 21:20. [PMID: 33451283 PMCID: PMC7809867 DOI: 10.1186/s12871-020-01229-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
Background The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) evaluates the patient-reported quality of pain management in adults. A validated APS-POQ-R is pivotal to guide effective pain management with better patient satisfaction. Previous studies revealed that subscales of “patients’ perception of pain management” were unstable cross-culturally. This study aims to evaluate the construct validity of the APS-POQ-R in gynecological postoperative patients with a multi-cultural background using confirmatory factor analysis to allow comparisons among different a priori models at the latent factor level. Methods Patients aged 18 years old or above and who were scheduled for gynecology surgery were selected. Three different models with a combination of latent factors were based on a priori hypotheses from previous studies. The root-mean-squared error of approximation, comparative fit index, Tucker-Lewis Index, Chi-squared test, and change in Chi-squared statistic given a change in degrees of freedom between models were used to assess the model fit to the present data. Results A total of 302 patients completed the questionnaire. The five-factor model which was based on Gordon’s study has an acceptable fit for the data and was superior when compared to the one-factor baseline model. Although the four-factor model, which originated from Botti’s study, also demonstrates a good model fit, the “perception of care” construct was excluded in this model. The “perception of care” construct is conceptually important as patient-centered care has become the focus of quality improvement of pain service. Conclusions The APS-POQ-R is easy to administer and is useful for quality evaluation in postoperative pain management. The present study demonstrates that a five-factor structure of the APS-POQ-R is the best fitting model in our patient sample. The results of this study provide further evidence to support the use of APS-POQ-R as a measurement tool for pain management evaluation in acute postoperative patients with a multi-cultural background.
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Affiliation(s)
- Sook Hui Chaw
- Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yoke Lin Lo
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, No 126 Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, Malaysia.
| | - Jia Yin Lee
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, No 126 Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Jia Wing Wong
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, No 126 Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Wan Aizat Wan Zakaria
- Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shairil Rahayu Ruslan
- Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wei Keang Tan
- Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Hughes JA, Jones L, Potter J, Wong A, Brown NJ, Chu K. An initial psychometric evaluation of the APS-POQ-R in acute pain presenting to the emergency department. Australas Emerg Care 2021; 24:287-295. [PMID: 33451967 DOI: 10.1016/j.auec.2020.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/18/2020] [Accepted: 12/06/2020] [Indexed: 12/29/2022]
Abstract
AIM The purpose of this study was to examine the psychometric properties of a modified version of the American Pain Societies - Patient Outcome Questionnaire - Revised edition in adult patients presenting with acute pain to the emergency department. BACKGROUND There is a lack of validation and use of patient-reported outcome measures of pain care in the adult emergency setting. DESIGN Prospective psychometric evaluation. METHODS Adult patients who had presented with acute pain were invited to participate in the study after their emergency department care. The Questionnaire was administered by one of the investigators. Exploratory factor analysis (principal axis factoring) was used to explore items mapping to constructs. The number of constructs with an Eigenvalue closest to 1 was considered the correct fit for the data. Assessment of the analysis was conducted using the Kaiser-Meier-Olkin test of sampling adequacy, and the fit was assessed using Bartlett's test of sphericity. RESULTS The Questionnaire demonstrated construct validity in these patients. Exploratory factor analysis demonstrated five constructs. The tool demonstrated discriminatory ability based on patient urgency, and subscale measurement was associated with patient satisfaction with care CONCLUSIONS: The Questionnaire has demonstrable construct validity in adult patients presenting with acute pain to the ED.
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Affiliation(s)
- James A Hughes
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia; School of Nursing, Queensland University of Technology, Brisbane, Australia.
| | - Lee Jones
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | | | - Alixandra Wong
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Nathan J Brown
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Kevin Chu
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
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Khaw D, Bucknall T, Considine J, Duke M, Hutchinson A, Redley B, de Steiger R, Botti M. Six-year trends in postoperative prescribing and use of multimodal analgesics following total hip and knee arthroplasty: A single-site observational study of pain management. Eur J Pain 2020; 25:107-121. [PMID: 32969139 DOI: 10.1002/ejp.1652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/12/2020] [Accepted: 08/18/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Guidelines for acute postoperative pain management recommend administering analgesics in multimodal combination to facilitate synergistic benefit, reduce opioid requirements and decrease side-effects. However, limited observational research has examined the extent to which multimodal analgesics are prescribed and administered postoperatively following joint replacement. METHODS In this longitudinal study, we used three-point prevalence surveys to observe the 6-year trends in prescribing and use of multimodal analgesics on the orthopaedic wards of a single Australian private hospital. We collected baseline postoperative data from total hip and knee arthroplasty patients in May/June 2010 (Time 1, n = 86), and follow-up data at 1 year (Time 2, n = 199) and 5 years (Time 3, n = 188). During the follow-up, data on prescribing practices were presented to anaesthetists. RESULTS We found a statistically significant increase in the prescribing (p < 0.001) and use (p < 0.001) of multimodal analgesics over time. The use of multimodal analgesics was associated with lower rest pain (p = 0.027) and clinically significant reduction in interference with activities (p < 0.001) and sleep (p < 0.001). However, dynamic pain was high and rescue opioids were likely under-administered at all time points. Furthermore, while patients reported high levels of side-effects, use of adjuvant medications was low. CONCLUSIONS We observed significant practice change in inpatient analgesic prescribing in favour of multimodal analgesia, in keeping with contemporary recommendations. Surveys, however, appeared to identify a clinical gap in the bedside assessment and management of breakthrough pain and medication side-effects, requiring additional targeted interventions. SIGNIFICANCE Evaluation of 6-year trends in a large Australian metropolitan private hospital indicated substantial growth in postoperative multimodal analgesic prescribing. In the context of growing global awareness concerning multimodal analgesia, findings suggested diffusion of best-evidence prescribing into clinical practice. Findings indicated the effects of postoperative multimodal analgesia in real-world conditions outside of experimental trials. Postoperative multimodal analgesia in the clinical setting was only associated with a modest reduction in rest pain, but substantially reduced interference from pain on activities and sleep.
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Affiliation(s)
- Damien Khaw
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.,Centre for Quality and Patient Safety Research-Epworth HealthCare Partnership, Melbourne, VIC, Australia
| | - Tracey Bucknall
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.,Centre for Quality and Patient Safety Research Alfred Health Partnership, Melbourne, VIC, Australia
| | - Julie Considine
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.,Centre for Quality and Patient Safety Research-Eastern Health Partnership, Melbourne, VIC, Australia
| | - Maxine Duke
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia
| | - Ana Hutchinson
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.,Centre for Quality and Patient Safety Research-Epworth HealthCare Partnership, Melbourne, VIC, Australia
| | - Bernice Redley
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.,Centre for Quality and Patient Safety Research-Monash Health Partnership, Melbourne, VIC, Australia
| | - Richard de Steiger
- Department of Surgery, Epworth Healthcare, University of Melbourne, Melbourne, VIC, Australia
| | - Mari Botti
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.,Centre for Quality and Patient Safety Research-Epworth HealthCare Partnership, Melbourne, VIC, Australia
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Analgesic Outcomes in a Danish Acute Care Hospital Following Electronic Prescribing and Analgesic Self-Administration. Pain Manag Nurs 2020; 21:345-353. [PMID: 32063502 DOI: 10.1016/j.pmn.2019.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/10/2019] [Accepted: 12/07/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Despite the long-term consequences of poorly controlled postoperative pain, inadequate pain control remains a problem. AIMS To improve the quality of postoperative pain management, the study site, an acute care hospital in Denmark, introduced electronic prescribing with standard order-sets, and allowed patients to self-administer analgesia. This study aimed to describe analgesic prescribing, prescriptions for multimodal analgesia, analgesic administration, and patients' pain experience, in this context. DESIGN Point-prevalence survey. SETTINGS One Danish regional hospital. PARTICIPANTS Consecutive sample of 286 surgical inpatients comprising 65 orthopaedic, 41 gynaecological, 57 urology and 123 gastrointestinal patients. METHODS We evaluated the quality of postoperative pain management on four postoperative surgical wards using: (1) the Revised American Pain Society Patient Outcome Questionnaire; and (2) patient chart audit. RESULTS Overall, 89.2% of patients were prescribed a fixed analgesic and 71.7% were prescribed fixed analgesics in multimodal combination. Patterns of multimodal prescribing and administration varied significantly across surgical groups. Patients received 87.7% of available fixed prescriptions and 22.5% of available analgesics prescribed 'as needed'. However, patients' worst pain intensity was high (mean = 5.8/10, SD = 2) and 73.4% reported moderate-to-severe worst pain during the previous 24-hours. Patients who self-administered medications used significantly more fixed-schedule paracetamol (p = .018), non-steroidal anti-inflammatory drugs (p = .001), weak (p = .035) and strong (p < .001) opioids. CONCLUSIONS The availability of multimodal analgesia was high following the introduction of electronic prescribing. However, gaps remain in the administration of both fixed and 'as needed' analgesics for postoperative patients. Findings suggested that allowing patients to self-administer analgesia may increase compliance with fixed schedule prescriptions.
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Pain Management and Its Possible Implementation Research in North Ethiopia: A before and after Study. Adv Med 2020; 2020:5317352. [PMID: 32566691 PMCID: PMC7288047 DOI: 10.1155/2020/5317352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/22/2020] [Accepted: 05/02/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Though there is an effective intervention, pain after surgical intervention is undermanaged worldwide. A systematic implementation is required to increase the utilization of available evidence-based intervention to manage the inevitable pain after surgery. The aim of this research project is to develop a scalable model for managing pain after cesarean section by implementing the World Health Organization's (WHO) pain management guidelines through a combination of implementation research and quality improvement methods. METHODS We implemented the World Health Organization (WHO) pain management guidelines using effective implementation strategies. First, we conducted a formative qualitative exploration to identify enablers and obstacles. In addition, we took base-line assessment on pain management implementation process and outcome using a checklist prepared from the guideline and an adapted American Pain Outcome assessment tool version 2010, respectively. Then, we integrated the guidelines into the existing practice by using collaborative iterative learning strategy. We analyzed the data by Statistical Packages for Social Sciences (SPSS) version 21. We compared the before and after data using chi-squared and Fischer's exact test. A change in any measurement was considered as significant at p value 0.05. RESULT We collected data from 106 mothers before and 110 mothers after intervention implementation. We successfully integrated pain as a fifth vital sign in more than 87% (p value <0.001) of patient, and fidelity was approximately 59% (p value <0.001). In addition, we significantly improved pain outcome measures after the implementation of the intervention. Conclusion and Recommendations. A systematic approach to implement pain management guidelines was successful. We recommend the ward sustain these gains and that hospital, the region, and the nation to replicate the success.
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Meissner W, Zaslansky R. A survey of postoperative pain treatments and unmet needs. Best Pract Res Clin Anaesthesiol 2019; 33:269-286. [PMID: 31785713 DOI: 10.1016/j.bpa.2019.10.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022]
Abstract
More than 300 million patients undergo surgery worldwide each year. Pain associated with these procedures is associated with short- and long-term negative sequelae for patients, healthcare providers, and healthcare systems. The following chapter is a review of the reality of postoperative pain management in everyday clinical routine based on survey- and registry-derived data with a focus on care in adults. Between 30% and up to 80% of patients report moderate to severe pain in the days after surgery. Structures, processes, and outcomes vary widely between hospitals and indicate gaps between evidence-based findings and practice. Pain assessment is not effectively implemented in many hospitals and should consider cultural differences. Few data exist on the situation of pain management in low- and middle-income countries, indicating lack of resources and available medication in many of these areas. Certain types of surgery as well as demographic and clinical factors are associated with increased risk of severe postoperative pain.
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Affiliation(s)
- Winfried Meissner
- Dept of Anesthesiology and Intensive Care, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany.
| | - Ruth Zaslansky
- Dept of Anesthesiology and Intensive Care, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany
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Siu E, Quick JS, Xu X, Correll DJ. Evaluation of the Determinants of Satisfaction With Postoperative Pain Control After Thoracoscopic Surgery. Anesth Analg 2019; 128:555-562. [DOI: 10.1213/ane.0000000000003756] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Schultz H, Skræp U, Schultz Larsen T, Rekvad LE, Littau-Larsen J, Schmidt SF, Möller S, Qvist N. Psychometric evaluation of the Danish version of a modified Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-D) for patients hospitalized with acute abdominal pain. Scand J Pain 2019; 19:117-130. [PMID: 30352045 DOI: 10.1515/sjpain-2018-0106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/27/2018] [Indexed: 01/10/2023]
Abstract
Background and aims This paper forms part of a study evaluating the effect of patient-controlled oral analgesia for patients admitted to hospital with acute abdominal pain. Pain is a subjective experience, and a multifaceted evaluation tool concerning patient-reported outcome measures is needed to monitor, evaluate, and guide health care professionals in the quality of pain management. The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) is a validated multifaceted evaluation tool for measuring patient-reported pain experiences to evaluate different pain management interventions. The aim of this study was to evaluate the psychometric properties of a modified Danish version of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-D) used during and after hospitalization for patients with acute abdominal pain. Methods The APS-POQ-R was translated into Danish and two slightly different questionnaires were formed. Questionnaire one had 39 items and the six subscales pain severity (pain), perception of care (satisfaction), pain interference with function (activity) and emotions (emotion), side effects of treatment (safety), and patient-related barriers to pain management. The questionnaire focused on time during hospital stay and was to be completed at discharge. Questionnaire two included 25 items and the five subscales pain, satisfaction, activity, emotion, and safety and focused on time at home and was to be completed daily 1 week after discharge. The questionnaires were tested on 156 patients with acute abdominal pain. Internal consistency reliability and construct validity was examined. Results In both questionnaires, the results of correlations and tests for internal consistency reliability showed a Cronbach's alpha of >0.7 for the pain, activity, and emotion subscales, but the value was ≥0.69 for the satisfaction subscale. In questionnaire one, Cronbach's alpha was ≤0.64 for the safety subscale, but this was 0.73 when the item "itching" was deleted. In questionnaire two, Cronbach's alpha was ≤0.51 for the safety subscale. For the patient-barrier subscale in questionnaire one, Cronbach's alpha was ≤0.62 for any combination of the items in the subscale. The results of the construct validity and factor analysis showed a five-factor structure in questionnaire one and a three-factor structure in questionnaire two. In questionnaire one, items from the pain, activity, emotion, and safety subscales, except for the items "least pain" and "itching," loaded on factor one. In questionnaire two, all items from the pain, activity, and emotion subscales loaded on factor one. Conclusions The modified APS-POQ-R-D demonstrated adequate psychometric properties for the five subscales pain severity (pain), perception of care (satisfaction), pain interference with function (activity) and emotions (emotion), side effects of treatment (safety), but not for the patient-barrier subscale for patients hospitalized with acute abdominal pain. Consequently, the APS-POQ-R-D may be used without the patient-barrier subscale. Implications The clinical implications of this study may help clinicians with investigating how acute patients manage pain during and after hospital admission.
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Affiliation(s)
- Helen Schultz
- Surgical Department, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense C, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN - Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark, Phone: (+45) 2240 1513
| | - Ulla Skræp
- Surgical Department, Odense University Hospital, Svendborg, Denmark
| | | | | | | | | | - Sören Möller
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN - Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Niels Qvist
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Surgical Department, Odense University Hospital, Odense, Denmark
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Chaw S, Lo Y, Shariffuddin II, Wong J, Lee J, Leong DW, Ng KW, Chan L. Evaluation of the quality of acute pain management in a pediatric surgical setting: Validation of a parent proxy modified version of the revised American Pain Society Patient Outcome Questionnaire. Paediatr Anaesth 2019; 29:68-76. [PMID: 30381868 DOI: 10.1111/pan.13528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 10/07/2018] [Accepted: 10/10/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Effective pain management involves a cycle of continual pain assessment, good pain control strategies, and assessment of a standard quality improvement measures. A validated questionnaire that focuses on the quality of postoperative pain management in pediatric surgical patients and parental satisfaction on pain treatment is lacking. We, therefore, modified the revised American Pain Society Patient Outcome Questionnaire to evaluate the quality of postoperative pain management in a pediatric surgical setting. The primary aim of this study was to validate the modified version of revised American Pain Society Patient Outcome Questionnaire. METHODS Parents whose children aged below 12 years and were scheduled for elective surgery in a teaching hospital, were approached to participate in this survey. The reliability of the modified version of revised American Pain Society Patient Outcome Questionnaire was evaluated using Cronbach's alpha test, while the construct validity was assessed with a principal component analysis using a varimax rotation. The parental satisfaction with pain treatment received was measured. RESULTS A total of 108 parents completed the questionnaire. The internal consistency of the questionnaire shows a Cronbach's alpha of 0.798. Principal component analysis revealed a four-factor structure of the 12 items which explained 69.7% of the total variance. The factors are "Interference of sleep and activity," "Pain severity and drowsiness," "Perception of care," and "Adverse effects," respectively. Our study showed that this questionnaire is a valid and reliable measure for "Interference of sleep and activity" and "Pain severity and drowsiness" factors, but not for "Perception of care" and "Adverse effects." The results for "Perception of care" and "Adverse effects," therefore, should be reported as individual items instead of total score. The parental satisfaction with pain treatment given was good (median 8.0; IQR 3.0). CONCLUSION The modified version of revised American Pain Society Patient Outcome Questionnaire is a feasible and easy instrument to administer. The questionnaire can be used to obtain feedback from parents about the outcomes and experiences of pain management and is helpful in continuous quality evaluation and improvement in the postoperative care in a pediatric setting.
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Affiliation(s)
- SookHui Chaw
- Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - YokeLin Lo
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Ina I Shariffuddin
- Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - JiaWing Wong
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - JiaYin Lee
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - David WeiJie Leong
- Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kevin WeiShan Ng
- Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Lucy Chan
- Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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O'Donnell KF. Preoperative Pain Management Education: An Evidence-Based Practice Project. J Perianesth Nurs 2018; 33:956-963. [PMID: 30449444 DOI: 10.1016/j.jopan.2017.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 11/01/2017] [Accepted: 11/04/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this evidence-based practice project was to evaluate the effectiveness of a preoperative pain management patient education intervention on improving patients' pain management outcomes. DESIGN The project was conducted in an outpatient general surgery service at a teaching institution for patients undergoing same-day surgery. Intervention patients received one-on-one education on postoperative pain management including how to take medications, managing medication side effects, using nonpharmacologic methods, and reporting inadequate postoperative pain control. Comparison patients received general education from multiple health care providers, and this information may not have been consistent. METHODS Intervention patients received education at the first preoperative clinic visit. Patients in the intervention and comparison groups completed the Revised American Pain Society Patient Outcome Questionnaire during their first postoperative clinic visit. Results were analyzed by the Mann-Whitney U test/Wilcoxon rank sum test. FINDINGS A 12-month project (N = 99) showed statistically significant results (P = .020 and P = .001, respectively) in questions about side effects and whether the patient was encouraged to use nonpharmacologic methods to reduce pain. The intervention group reported the effects of pain on mood (P = .067) and use of nonpharmacologic methods (P = .052); however, these results were not statistically significant. CONCLUSIONS More intervention patients than comparison patients reported medication side effects and were encouraged to use nonpharmacologic methods for reducing postoperative pain. Intervention patients also reported the effects of pain on mood and the use of nonpharmacologic methods more frequently than comparison patients. Preoperative pain management education may increase patients' knowledge in key areas of postoperative pain management to prevent negative outcomes.
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15
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Zaslansky R, Meissner W, Chapman CR. Pain after orthopaedic surgery: differences in patient reported outcomes in the United States vs internationally. An observational study from the PAIN OUT dataset. Br J Anaesth 2018; 120:790-797. [PMID: 29576119 DOI: 10.1016/j.bja.2017.11.109] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 11/06/2017] [Accepted: 11/17/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND A previous PAIN OUT study found that American orthopaedic-surgical patients rated 'worst pain' higher than did similar European patients. This study aims to confirm these findings in a larger, international patient sample, explore whether risk factors for greater postoperative pain exist disproportionately in the American population, and confirm the findings for one procedure. METHODS Surveyors collected patient reported outcomes (PROs) and perioperative pain management practices using PAIN OUT methodology. Most PROs used 11-point numerical rating scales (0=null, 10=worst possible). Risk factors included: female gender, younger age, high BMI, chronic pain, and opioid use before surgery. Initial analysis used a mixed patient cohort. A secondary analysis used only patients undergoing total knee replacement (TKR). Inference was based primarily on effect size using Cohen's d. RESULTS 13,770 patients in 13 European and non-European countries (international ) and 564 patients from the United States (US) contributed data on the 1st postoperative day. Three of 11 PROs differed between the cohorts: 'worst pain' {US 7.5 (2.5) vs international 5.6 (2.8); d=0.66 [confidence interval (CI) 0.58-0.75]}; proportion 'receiving information about treatment options' [US 0.86 vs international 0.66; d=0.53 (CI 0.39-0.66)]; reporting adverse effects and their severity [US 0.87 vs international 0.73; d=0.52 (CI 0.38-0.66)]. Risk factors did not differ between the two cohorts. PROs and management patterns in TKR patients were similar to the mixed cohort. CONCLUSIONS Three PROs differed between international and US patients, with higher 'worst pain' for US patients. Neither risk factors, nor patient mix accounted for the observed differences for 'worst pain'. CLINICAL TRIAL REGISTRATION NCT 02083835.
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Affiliation(s)
- R Zaslansky
- Department of Anaesthesiology and Intensive Care, University Hospital Jena, Jena, Germany.
| | - W Meissner
- Department of Anaesthesiology and Intensive Care, University Hospital Jena, Jena, Germany
| | - C R Chapman
- Pain Research Centre, Department of Anaesthesiology, University of Utah, Salt Lake City, UT, USA
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McNeill J, Sherwood G. Development of the Spanish Language Houston Pain Outcome Instrument for Spanish Speakers. HISPANIC HEALTH CARE INTERNATIONAL 2017; 15:173-179. [PMID: 29164932 DOI: 10.1177/1540415317741499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To address reported disparities in pain management among Hispanic patients, this article reports the psychometrics of the newly developed Spanish language Houston Pain Outcome Instrument (HPOI) with postoperative Hispanic patients. METHODS Findings from qualitative interviews conducted with 35 self-identified Hispanics in Phase 1 of the overall project were used to generate items for a new Spanish language instrument, Cuestionario de Houston Sobre el Dolor (HPOI). The second phase tested the psychometric properties with 95 self-identified Hispanic postoperative inpatients in three Texas hospitals. RESULTS HPOI subscale reliabilities ranged from .63 to .91, with similar reliabilities for Spanish and English versions. Concurrent validity was demonstrated by moderate significant correlations with similar items on the Brief Pain Inventory. Participants reported moderate and severe worst pain in the last 24 hours; 38% were undertreated for pain according to the Pain Management Index; and 75% reported nonpharmacologic strategies including family support, prayer, and position change as highly effective in managing pain. CONCLUSIONS The HPOI is a reliable instrument for addressing disparities in pain management for the rapidly growing Hispanic population in the United States. Subscales for interference with mood and physical function and patient-reported nonpharmacologic strategies facilitate a more comprehensive assessment of the pain experience.
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Affiliation(s)
| | - Gwen Sherwood
- 2 University of North Carolina at Chapel Hill, NC, USA
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17
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The effectiveness of the Pain Resource Nurse Program to improve pain management in the hospital setting: A cluster randomized controlled trial. Int J Nurs Stud 2017; 75:83-90. [DOI: 10.1016/j.ijnurstu.2017.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 07/09/2017] [Accepted: 07/12/2017] [Indexed: 02/07/2023]
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18
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Fang H, Liang J, Hong Z, Sugiyama K, Nozaki T, Kobayashi S, Sameshima T, Namba H, Asakawa T. Psychometric evaluation of the Chinese version of the revised American Pain Society Patient Outcome Questionnaire concerning pain management in Chinese orthopedic patients. PLoS One 2017; 12:e0178268. [PMID: 28542551 PMCID: PMC5444797 DOI: 10.1371/journal.pone.0178268] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 05/08/2017] [Indexed: 12/16/2022] Open
Abstract
The present study tested the clinical efficiency (item grouping, internal consistency of the subscales, construct validity, and clinical feasibility) of a widely used pain assessment system, the Mandarin version of the American Pain Society Patient Outcome Questionnaire (APS-POQ-R-C), in Chinese patients. We also attempted to investigate the current quality of pain management provided in orthopedic inpatient units in China and provide baseline data. First, we investigated the test–retest reliability of APS-POQ-R-C. In total, 236 orthopedic patients were evaluated. Our results showed that APS-POQ-R-C has satisfactory internal consistency and construct validity, although some items are not appropriate for orthopedic patients. Test–retest reliability outcomes indicated that APS-POQ-R-C is a satisfactory battery with acceptable validity and reliability, and is therefore recommended for pain management in future studies.
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Affiliation(s)
- Huan Fang
- Department of Pharmacy, Jinshan Hospital of Fudan University, Shanghai, China
- * E-mail: (TA); (HF)
| | - Jingjuan Liang
- Department of Orthopedics, Huashan Hospital of Fudan University, Shanghai, China
| | - Zhen Hong
- Department of Neurology, Huashan Hospital of Fudan University, Shanghai, China
| | - Kenji Sugiyama
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takao Nozaki
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Susumu Kobayashi
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tetsuro Sameshima
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hiroki Namba
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tetsuya Asakawa
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
- * E-mail: (TA); (HF)
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Wang H, Sherwood GD, Gong Z, Ren L, Liu H. Reliability and Validity of the Chinese Version of the Revised American Pain Society Patient Outcome Questionnaire in Postoperative Patients. Pain Manag Nurs 2017; 18:110-120. [PMID: 28259638 DOI: 10.1016/j.pmn.2017.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 11/30/2022]
Abstract
The American Pain Society Patient Outcome Questionnaire and the subsequent revised version are the most frequently reported measures of the quality of pain management. However, the reliability and validity of the revised questionnaire have not been reported in Chinese patients. This study sought to evaluate the psychometric properties of the Chinese version of the revised questionnaire in postoperative patients in China. The study was a descriptive, cross-sectional psychometric study. The revised questionnaire was translated into Chinese according to international guidelines and then administered to participants. The patients' present, average, and worst pain intensity were evaluated in face-to-face interviews. The Pain Management Index was calculated according to the worst pain intensity and the classification of analgesic drugs used by the patients. The continuous items in the revised questionnaire demonstrated excellent construct validity and acceptable internal consistency reliability (0.732). Cronbach's alpha coefficients for the following subscales were acceptable: pain severity and sleep interference (0.773), activity interference (0.812), affective (0.824), and adverse effects (0.636); the exception was for the perception of pain care subscale (0.492). Patients with different anticipated pain management outcomes were differentiated as expected. Satisfaction could be predicted (31.3% of the variance) using subscales and items in the questionnaire. Although our evidence supports the psychometric properties of the Chinese version of the revised questionnaire when tested with postoperative patients, further study is needed, especially on the subscale perception of pain care.
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Affiliation(s)
- Hui Wang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Gwen D Sherwood
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Zhiyi Gong
- Department of Anesthesia, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Liying Ren
- Operation Room, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Huaping Liu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Ingadottir B, Blondal K, Jaarsma T, Thylen I. Perceptions about traditional and novel methods to learn about postoperative pain management: a qualitative study. J Adv Nurs 2016; 72:2672-2683. [DOI: 10.1111/jan.13021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Brynja Ingadottir
- Divison of Nursing; Department of Social and Welfare Studies; Faculty of Medicine and Health Sciences; Linköping University; Sweden
- Landspitali - The National University Hospital of Iceland; Surgical Services and Faculty of Nursing; School of Health Sciences; University of Iceland; Reykjavik Iceland
| | - Katrin Blondal
- Landspitali - The National University Hospital of Iceland; Surgical Services and Faculty of Nursing; School of Health Sciences; University of Iceland; Reykjavik Iceland
| | - Tiny Jaarsma
- Divison of Nursing; Department of Social and Welfare Studies; Faculty of Medicine and Health Sciences; Linköping University; Sweden
| | - Ingela Thylen
- Department of Cardiology and Department of Medical and Health Sciences; Linköping University; Sweden
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21
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Zoëga S, Ward SE, Sigurdsson GH, Aspelund T, Sveinsdottir H, Gunnarsdottir S. Quality Pain Management Practices in a University Hospital. Pain Manag Nurs 2015; 16:198-210. [DOI: 10.1016/j.pmn.2014.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 06/18/2014] [Accepted: 06/18/2014] [Indexed: 12/19/2022]
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22
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Botti M, Khaw D, Jørgensen EB, Rasmussen B, Hunter S, Redley B. Cross-cultural examination of the structure of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R). THE JOURNAL OF PAIN 2015; 16:727-40. [PMID: 25998207 DOI: 10.1016/j.jpain.2015.03.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 02/18/2015] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED This study investigated the cross-cultural factor stability and internal consistency of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R), a measure of the quality of postoperative pain management used internationally. We conducted exploratory factor analysis (EFA) of APS-POQ-R data from 2 point prevalence studies comprising 268 and 311 surveys of Danish and Australian medical-surgical patients, respectively. Parallel analysis indicated 4- and 3-factor solutions for Danish and Australian patients, respectively, which accounted for 58.1% and 52.9% of variance. Internal consistency was unsatisfactory among both Danish (Cronbach α = .54) and Australian (Cronbach α = .63) cohorts. There was a high degree of between-group similarity in item-factor loadings of variables coded as "pain experience," but not "pain management." This finding reflected cross-cultural differences in ratings of treatment satisfaction. For Danish patients, satisfaction was associated with the degree of pain severity and activity interference, whereas for Australian patients, satisfaction was associated with their perceived ability to participate in treatment. To facilitate further cross-cultural comparison, we compared our findings with past research conducted in the United States and Iceland. EFA supported the construct validity of the APS-POQ-R as a measure of "pain experience" but indicated that items measuring "pain management" may vary cross-culturally. Findings highlighted the need for further validation of the APS-POQ-R internationally. PERSPECTIVE This study revealed the APS-POQ-R as a valid measure of postoperative pain experience for Danish and Australian patients. Measures of patients' perception of pain management were not robust to group differences in treatment expectations and demonstrated cross-cultural instability. Results highlighted the difficulties in establishing stable cross-cultural, cross-population subscales for the APS-POQ-R.
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Affiliation(s)
- Mari Botti
- Epworth/Deakin Centre for Clinical Nursing Research, Melbourne, Victoria, Australia
| | - Damien Khaw
- Epworth/Deakin Centre for Clinical Nursing Research, Melbourne, Victoria, Australia.
| | - Emmy Brandt Jørgensen
- Department of Nursing Research, VIA University College, Holstebro, Denmark; Hospitalsenheden Vest, Region Midtjylland, Denmark
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, Melbourne, Victoria, Australia
| | - Susan Hunter
- School of Nursing and Midwifery, Deakin University, Melbourne, Victoria, Australia
| | - Bernice Redley
- Epworth/Deakin Centre for Clinical Nursing Research, Melbourne, Victoria, Australia
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Zaslansky R, Rothaug J, Chapman C, Bäckström R, Brill S, Fletcher D, Fodor L, Gordon D, Komann M, Konrad C, Leykin Y, Pogatski-Zahn E, Puig M, Rawal N, Ullrich K, Volk T, Meissner W. PAIN OUT: The making of an international acute pain registry. Eur J Pain 2014; 19:490-502. [DOI: 10.1002/ejp.571] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2014] [Indexed: 11/10/2022]
Affiliation(s)
- R. Zaslansky
- Department of Anesthesiology & Intensive Care; Friedrich-Schiller University Hospital; Jena Germany
| | - J. Rothaug
- Department of Anesthesiology & Intensive Care; Friedrich-Schiller University Hospital; Jena Germany
| | - C.R. Chapman
- Pain Research Center; Department of Anesthesiology; University of Utah; Salt Lake City USA
| | - R. Bäckström
- Department of Anesthesiology & Intensive Care; University Hospital Örebro; Sweden
| | - S. Brill
- Department of Anesthesiology & Intensive Care; Sourasky Medical Center; Tel-Aviv Israel
| | - D. Fletcher
- Department of Anesthesiology & Intensive Care; Raymond Poincaré Hospital; Garches France
| | - L. Fodor
- Plastic and Reconstructive Surgery; Cluj University Hospital; Romania
| | - D.B. Gordon
- Department of Anesthesiology & Intensive Care; University of Washington Harborview Medical Center; Seattle USA
| | - M. Komann
- Department of Anesthesiology & Intensive Care; Friedrich-Schiller University Hospital; Jena Germany
| | - C. Konrad
- Department of Anesthesiology & Intensive Care; Kantonsspital; Lucerne Switzerland
| | - Y. Leykin
- Department of Anesthesiology & Intensive Care; Santa Maria Degli Angeli; University of Trieste and Udine; Italy
| | - E. Pogatski-Zahn
- Department of Anesthesiology & Intensive Care; University Hospital Muenster; Germany
| | - M.M. Puig
- Department of Anesthesiology & Intensive Care; IMIM-Hospital del Mar-Universitat Autònoma de Barcelona; Spain
| | - N. Rawal
- Department of Anesthesiology & Intensive Care; University Hospital Örebro; Sweden
| | - K. Ullrich
- Department of Anesthesiology & Intensive Care; Queen Mary and Westfield College; University of London; UK
| | - T. Volk
- Department of Anesthesiology & Intensive Care; Saarland University Hospital; Homburg Germany
| | - W. Meissner
- Department of Anesthesiology & Intensive Care; Friedrich-Schiller University Hospital; Jena Germany
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Zoëga S, Sveinsdottir H, Sigurdsson GH, Aspelund T, Ward SE, Gunnarsdottir S. Quality pain management in the hospital setting from the patient's perspective. Pain Pract 2014; 15:236-46. [PMID: 24433333 DOI: 10.1111/papr.12166] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 11/02/2013] [Indexed: 01/24/2023]
Abstract
BACKGROUND Pain management is a crucial issue for patients, and patients' perception of care is an important quality outcome criterion for health care institutions. Pain remains a common problem in hospitals, with subsequent deleterious effects on well-being. OBJECTIVES To assess the epidemiology of pain (frequency, severity, and interference), patient participation in pain treatment decisions, and patient satisfaction with care in a hospital setting. METHODS A point-prevalence study was conducted. Data were collected with the American Pain Society Patient Outcome Questionnaire (Icelandic version). Participants (n = 308) were ≥ 18 years old, alert, and hospitalized for ≥ 24 hours. RESULTS The response rate was 73%. The mean age of participants was 67.5 (SD = 17.4; range 18 to 100) years, and 49% were men. Pain prevalence in the past 24 hours was 83%, mean worst pain severity was 4.6 (SD = 3.1), and 35% experienced severe pain (≥ 7 on 0 to 10 scale). Moderate to severe interference with activities and sleep was experienced by 36% and 29% of patients respectively. Patient participation in decision making was weakly associated with spending less time in severe pain and better pain relief. Patient satisfaction was related to spending less time in severe pain, better pain relief, and lower pain severity (P < 0.05). CONCLUSIONS Pain was both prevalent and severe in the hospital, but patient participation in decision making was related to better outcomes. Optimal pain management, with emphasis on patient participation in decision making, should be encouraged in an effort to improve the quality of care in hospitals.
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Affiliation(s)
- Sigridur Zoëga
- Surgical Services, Landspítali - The National University Hospital of Iceland, Reykjavik, Iceland; Faculty of Nursing, University of Iceland, Reykjavik, Iceland
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