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Althagafi SM, Hughes JA. Identifying the relationship between patient-reported outcomes and treatment with opiates in the adult emergency department - A cross-sectional study. Int Emerg Nurs 2022; 62:101152. [PMID: 35245729 DOI: 10.1016/j.ienj.2022.101152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/09/2022] [Accepted: 01/31/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Suhair M Althagafi
- School of Nursing, Queensland University of Technology, Brisbane, Australia; College of Nursing, Umm AlQura University, Makkah, Saudi Arabia
| | - James A Hughes
- School of Nursing, Queensland University of Technology, Brisbane, Australia.
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Brady B, Andary T, Pang SM, Dennis S, Liamputtong P, Boland R, Tcharkhedian E, Jennings M, Pavlovic N, Zind M, Middleton P, Chipchase L. A Mixed-Methods Investigation into Patients' Decisions to Attend an Emergency Department for Chronic Pain. PAIN MEDICINE (MALDEN, MASS.) 2021; 22:2191-2206. [PMID: 33739379 PMCID: PMC8500722 DOI: 10.1093/pm/pnab081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study explored factors that underpin decisions to seek emergency department (ED) care for chronic noncancer pain in patients identifying as culturally and linguistically diverse (CALD) or Australian born. DESIGN AND METHODS This mixed-methods study was underpinned by the Behavioral Model of Health Services Use conceptual framework. Consenting consecutive patients attending the ED for a chronic pain condition were recruited to a CALD (n = 45) or Australian-born (n = 45) cohort. Statistical comparisons compared the demographic, pain, health literacy, and episode of care profiles of both cohorts. Twenty-three CALD and 16 Australian-born participants consented to an audio-recorded semi-structured interview (n = 24) or focus group (n = 5 focus groups) conducted in their preferred language. Interviews were translated and transcribed into English for analysis using applied thematic analysis, guided by the conceptual framework. Data were triangulated to investigate the patterns of ED utilization and contributing factors for both cohorts. RESULTS ED attendance was a product of escalating distress, influenced by the degree to which participants' perceived needs outweighed their capacity to manage their pain. This interaction was amplified by the presence of predisposing factors, including constrained social positions, trauma exposure, and biomedical health beliefs. Importantly, experiences varied between the two cohorts with higher degrees of pain catastrophizing, lower health literacy, and greater social challenges present for the CALD cohort. CONCLUSION This study highlights the role contextual factors play in amplifying pain-related distress for CALD and Australian-born patients with chronic pain. The findings support a need for health care providers to recognize features of higher vulnerability and consider streamlining access to available support services.
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Affiliation(s)
- Bernadette Brady
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
- Liverpool Hospital, Liverpool, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Toni Andary
- Fairfield Hospital, Fairfield, NSW, Australia
| | - Sheng Min Pang
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Sarah Dennis
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Pranee Liamputtong
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute, Western Sydney University, NSW, Australia
| | - Robert Boland
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Fairfield Hospital, Fairfield, NSW, Australia
| | | | - Matthew Jennings
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
- Liverpool Hospital, Liverpool, NSW, Australia
| | | | - Marguerite Zind
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Paul Middleton
- Liverpool Hospital, Liverpool, NSW, Australia
- South Western Emergency Research Institute (SWERI), The Ingham Institute, Liverpool, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
- Discipline of Emergency Medicine, University of Sydney, Sydney, Australia
- The MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Sydney, Australia
| | - Lucy Chipchase
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
- College of Nursing and Health Sciences, Flinders University, South Australia, Australia
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Taylor DM, Valentine S, Majer J, Grant N. Discordance between patient-reported and actual emergency department pain management. Emerg Med Australas 2021; 33:517-523. [PMID: 33225600 DOI: 10.1111/1742-6723.13690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/17/2020] [Accepted: 10/25/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine patient knowledge of the nature of their pain management in the ED. METHODS This was a planned sub-study of data collected during a randomised, controlled trial of the nature of the informed consent process in a single ED. Patients aged ≥18 years, with a triage pain score of ≥4, were enrolled. Forty-eight hours post-ED discharge, patients were asked if they had declined analgesia or if a range of pain management options had been administered. The primary outcome was discordance between the patient report and the ED report (proportion of cases where these reports differed). RESULTS Outcome data were collected on 655 patients. There was significant discordance for all variables examined (P < 0.001). Discordance for patients declining analgesia was lowest at 8.9% (95% confidence interval [CI] 6.8-11.4). Discordance for administration of pain management 'other' than analgesia was highest at 32.6% (95% CI 29.0-36.4). Discordance for the administration of oral analgesia or 'any' analgesia was 17.1% (95% CI 14.3-20.3) and 14.4% (95% CI 11.8-17.3), respectively. For both of these outcomes, patients with chest pain and lower triage pain scores were more likely to report discordant responses. With the exception of 'other' pain management, smaller proportions of patients incorrectly reported not receiving management than incorrectly reporting that they did receive it. CONCLUSION Patients are often unaware of the nature of their pain management. They are most often unaware of management other than analgesia. Patients with chest pain and lower triage pain scores had the least knowledge of their pain management.
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Affiliation(s)
- David McD Taylor
- Department of Emergency Medicine, Austin Hospital, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
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Abidova A, da Silva PA, Moreira S. Predictors of Patient Satisfaction and the Perceived Quality of Healthcare in an Emergency Department in Portugal. West J Emerg Med 2020; 21:391-403. [PMID: 31999247 PMCID: PMC7081842 DOI: 10.5811/westjem.2019.9.44667] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The predictors of patient satisfaction in emergency medicine (EM) have been widely studied and discussed in the scientific literature; the results vary depending on the specific EM attributes, cultural aspects, researchers' preferences, and approaches. However, it is not clear whether the same predictors of patient satisfaction can contribute to a better-perceived quality of healthcare or whether patients' perceptions form a different attitude toward satisfaction and perceived quality of healthcare. The goal of this study was to identify the key predictors of patient satisfaction and perceived quality of healthcare in the framework of an emergency department (ED). METHODS We conducted a retrospective study of patients seen at an ED between January -December 2016. Data collection took place in the public hospital in Lisbon, Portugal, between May - November 2017. The total sample size included 382 patients. The sample distribution had a 5% margin of error and a 95% confidence interval. Data for this research, using a questionnaire, was collected by mail or e-mail according to the respondent's preference. RESULTS A detailed analysis showed that three out of the 18 predictors had a statistically significant relationship with satisfaction: overall satisfaction with doctors, with a positive correlation (r = 0.14, p ≤ 0.01); qualitative perceived waiting time for triage, with a positive correlation (r = 0.08, p ≤ 0.05); and meeting expectations, with a positive correlation (r = 0.53, p ≤ 0.01). Furthermore, a detailed analysis showed that only two out of the 18 predictors had a statistically significant relationship with the perceived quality of healthcare (PQHC): overall satisfaction with doctors, with a positive correlation (r = 0.43, p ≤ 0.01) and meeting expectations, with a positive correlation (r = 0.26, p ≤ 0.01). CONCLUSION The main predictors of satisfaction and perceived quality of healthcare were overall satisfaction with doctors and meeting expectations. We should note that "meeting expectations" plays the most important role in terms of satisfaction; however, in terms of PQHC the predictor "overall satisfaction with doctors" plays the most important role due to its stronger correlation. In addition, the qualitative perceived waiting time for triage could be considered as another predictor, influencing satisfaction only, thus emphasizing similarities and differences between satisfaction and the PQHC in an ED context.
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Affiliation(s)
- Alina Abidova
- NOVA University of Lisbon, National School of Public Health, Lisbon, Portugal
| | | | - Sérgio Moreira
- University of Lisbon, Faculty of Psychology, Lisbon, Portugal
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