Pain and Pain Management in a Hong Kong Emergency Department

Wong, MT; Ip, Margaret; Graham, Colin A.

doi:10.1177/102490791101800606

Cited by 6 publications

(13 citation statements)

References 37 publications

(48 reference statements)

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“…The prevalence identified using this method in this population (55.22%, 95%CI 54.24%, 56.20%) compares well with previously reported prevalence using similar methods (56.0% - 61.2%) (1, 8, 9) and with pain prevalence identified in a similar population (59.0%) (20). Variations seen in the prevalence reported may be linked to the methods used, including the inclusiveness of this sample, the lack of reliance on self-report (20) and variations in case-mix seen between studies conducted in Hong Kong (9) and the United States (1). In New Zealand figures that most closely replicate the Australian population (8), there is a significant overlap of the confidence intervals – indicating no statistical differences between the New Zealand prevalence and reported here.…”

Section: Discussionsupporting

confidence: 87%

“…Commonly reported figures range from 49% to 78% (3,4). Some variation is explained by methodology, with retrospective data yielding a lower prevalence (1,3,(5)(6)(7)(8)(9) than directly asking patients upon presentation (4,(10)(11)(12)(13). However, pain prevalence studies lack consistency, and many methods require significant resource allocation for small sample sizes that may not generalise to target populations.…”

Section: Introductionmentioning

confidence: 99%

“…Table 1 outlines 16 pain prevalence studies in the ED from eight countries using three distinct approaches over the last 24 years. Retrospective chart review (RCR) was used in most studies to identify specific words, phrases, assessments, diagnoses, or treatments documented in routine care that indicated that the patient had presented in pain (1,3,(5)(6)(7)(8)(9)18). Prospective self-report (PSR) of pain on arrival was used in five of the identified studies (4,(10)(11)(12)(13), usually conducted by a dedicated researcher located in the ED during defined periods.…”

Section: Introductionmentioning

confidence: 99%

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Identifying patients presenting in pain to the adult emergency department: A binary classification task and description of prevalence

Hughes

Douglas

Jones

et al. 2022

Preprint

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BackgroundAccurate, reliable and efficient measures of pain-related presentations are essential to evaluate and improve pain care in the ED. Estimates of pain prevalence on arrival to the emergency department (ED) vary depending on the methods used. Artificial intelligence (AI) approaches are likely to be the future for identifying patients in pain from electronic health records (EHR). However, we need a robust method to identify these patients before this can occur. This study aims to identify patients presenting in pain to the ED using binary classification and to describe the population, treatment and outcomes.MethodsThis study employs a cross-sectional design using retrospective data routinely collected in the EHR at a single ED. A random sample of 10 000 patients was selected for inclusion over three years. Triage nursing assessment underwent binary classification by three expert clinicians. The prevalence of pain on arrival is the primary outcome. Patients with pain were compared to those without pain on arrival regarding demographics, treatment and outcomes.ResultsThe prevalence of pain on arrival was 55.2% (95%CI 54.2% - 56.2%). Patients who presented in pain differed from those without pain in terms of age, country of birth, socioeconomic status, mode of arrival, urgency and discharge destination. The median time to first analgesic medication was 65min (IQR 38 – 114 min), and 45.6% (95% CI 44.3% - 46.9%) of patients arriving in pain received analgesic medication.ConclusionsThe prevalence of pain on arrival compares well with previously reported figures using similar methods. Differences in the cohort presenting in pain compared to the population may represent differences in the prevalence or be an extension of previous bias seen in the documentation of pain. This work has set a rigorous methodology for identifying patients presenting with pain from the EHR. It will form the basis for future applications of AI to identify patients presenting in pain to the ED.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Identifying patients presenting in pain to the adult emergency department: A binary classification task and description of prevalence

Hughes

Douglas

Jones

et al. 2022

Preprint

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“…Patients under the age of 18 years, those who were court/law-enforced (i.e., prisoners), or suffer a primary mental health or substance abuse history (n ¼ 5) were excluded. Reoccurring patients (n ¼ 8) were excluded from the sampling list to minimize the effects of previous analgesic treatments (Wong, Ip, & Graham, 2011). The result was a total sample size was 15.…”

Section: Methods and Proceduresmentioning

confidence: 99%

Factors Influencing Patients’ Experiences of Pain Management in the Emergency Department

et al. 2019

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Background Despite management of acute pain, concerns regarding pain are still prevalent in the emergency department (ED). Purpose This study aimed to explore the factors influencing patients’ pain management in a Jordanian ED. Method Fifteen semistructured interviews (N = 15) with purposively selected patients in the ED. Results The thematic analysis uncovered two related themes. The first theme described the stage of “being on ED bed” which encapsulates two subthemes: “bad pain means, bad diagnosis” and “smiley faces versus grumpy faces.” The second theme referred to as “being discharged” including two subthemes, namely, “praying for not paying” and “being grateful to God.” The lack of money to pay for pain management was equally as stressful as pain itself. Patients’ narratives suggest that nursing pain management is a critical time, extending beyond medical management to encompass communication and spirituality. Conclusions The factors influencing the patients’ experience of pain management extend beyond addressing the source of the pain. Consequently, effective communication coupled with respecting patients’ spirituality and socioeconomic concerns is essential to pain management. To enhance patients’ experience of pain management, the ED system should shift toward a patient-centric model.

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“…During recent protests in Hong Kong authorities banned the use of masks, hoods, and even face painting in public assemblies. Invoking a colonial‐era regulation (Wong, 2011), the authorities claimed that the prohibition would help “to stop violence and restore calm to society as soon as possible” (Berlinger & Regan, 2019). According to section 3.1 of the ordinance (Cap.…”

Section: Contextual Integritymentioning

confidence: 99%

Protesting without a face: Privacy in public demonstrations

Parmo

2022

Constellations

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Regimes of all stripes feel deep discomfort at being exposed to citizen scrutiny. While the democratic environment makes direct persecution of critics difficult although not impossible, governments seek more surreptitious ways to control and stifle criticism. Citizens, for their part, seek to keep open the communicative channels of expression. Thus, faced with forms of control of public discourse they devise new forms of communication or design mechanisms to either circumvent or frustrate these more surreptitious forms of control (Brunton & Nissenbaum, 2015, p. 1).Protests are, precisely, in this situation. Through their intense regulation, states have sought ways to contour the once disruptive character of public appearances to the point of transforming them in some cases-as protests have not been deprived of all their political significance-into allegorical events (King, 2013). Protests, some have claimed, have been institutionalized in terms of their form, and of where and at what the time of day they can take place (McCarthy & McPhail, 1998). Since legal doctrine, in general, is satisfied that these regulations are neutral in their content, it loses sight of other less obvious forms of control. One of these has been the mass surveillance of streets, either through cameras installed on them or those worn by police officers, as a means of threatening those who protest with the possibility of being identified. How has the citizenry responded? By resorting to elements, such as masks, hoods, and balaclavas, or more recently umbrellas, to avoid identification and to safeguard their right to protest by fending off this threat (Kwok, 2021, p. 6).States, however, have increasingly criminalized this citizen strategy. Whereas antimask legislation is far from being new-criminalization in some places is possible thanks to statutes passed as far back as the 1840s (Doherty, 2020, p. 276)-there is a renewed trend toward their use. What is more troubling is that experience shows that regimes come in all forms and shapes when it comes to criminally banning the use of masks in protests. I briefly mention just a few examples in section 2.The right to protest is regularly built upon a cluster of foundational rights, most notably freedom of expression and of assembly-without them, there can be no right to protest. This work proposes to include the right to privacy in the cluster of constitutional rights and freedoms that lie at the foundation of the right to protest. 1 The matters discussed in this work expand that cluster in a twofold sense. First, because they oblige us to consider situations that normally would go unnoticed or at least are not necessarily related to protection of the right to protest. Second, because their consideration would strengthen the constitutional protection of protests. Therefore, it is not just that general

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Pain and Pain Management in a Hong Kong Emergency Department

Cited by 6 publications

References 37 publications

Identifying patients presenting in pain to the adult emergency department: A binary classification task and description of prevalence

Identifying patients presenting in pain to the adult emergency department: A binary classification task and description of prevalence

Factors Influencing Patients’ Experiences of Pain Management in the Emergency Department

Protesting without a face: Privacy in public demonstrations

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