The patient vs. caregiver perception of acute pain in the emergency department

Guru, Veena; Dubinsky, Isser

doi:10.1016/s0736-4679(99)00153-5

Cited by 172 publications

(143 citation statements)

References 20 publications

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“…30,31 Among ED patients with pain, nearly three-quarters present with moderate or severe pain. 32,33 Unrelieved acute pain in older adults is associated with poorer clinical outcomes. [34][35][36] For example, continued hip fracture pain is associated with longer hospital stays, missed or shortened physical therapy sessions, and delays in ambulation 37 and a ninefold increase in the risk of delirium.…”

Section: Resultsmentioning

confidence: 99%

Quality Indicators for Geriatric Emergency Care

Terrell

Hustey²,

Hwang³

et al. 2009

Academic Emergency Medicine

163

120

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Objectives: Emergency departments (EDs), similar to other health care environments, are concerned with improving the quality of patient care. Older patients comprise a large, growing, and particularly vulnerable subset of ED users. The project objective was to develop ED-specific quality indicators for older patients to help practitioners identify quality gaps and focus quality improvement efforts.

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Section: Resultsmentioning

confidence: 99%

Quality Indicators for Geriatric Emergency Care

Terrell

Hustey²,

Hwang³

et al. 2009

Academic Emergency Medicine

163

120

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“…5 In 2000, Guru and Dubinsky reported that 75% of patients arrived at the ED in moderate to severe pain and that 61% were discharged with pain of this intensity. 12 And in the US in 1998, Stahmer and colleagues reported mean pain intensity levels of 7.0 and 4.5 (on an 11-point numerical scale) …”

Section: Discussionmentioning

confidence: 99%

Survey of pain etiology, management practices and patient satisfaction in two urban emergency departments

Todd

Sloan

Chen

et al. 2002

CJEM

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Objective:The underuse of analgesics, or "oligoanalgesia," is common in emergency departments (EDs). To improve care we must understand our patients' pain experiences as well as our clinical practice patterns. To this end, we examined pain etiology, pain management practices and patient satisfaction in 2 urban EDs. Methods: We conducted a cross-sectional study using structured interviews and chart reviews for patients with pain who presented to either of 2 university-affiliated EDs. We assessed pain etiologies, patient pain experiences, pain management practices, and patient satisfaction with pain management. Results:The 525 study subjects reported high pain intensity levels on presentation, with a median rating of 8 on a 10-point numerical rating scale (NRS). At discharge, pain severity had decreased to a median rating of 4; however, 48% of patients were discharged from the ED in moderate to severe pain (NRS 5-10). Subjects reported spending 57% of their ED stay in moderate to severe pain. Analgesics were administered to only 50% of patients. The mean time to analgesic administration was almost 2 hours. Despite high levels of reported pain at discharge and low rates of analgesic administration, subjects reported high satisfaction with pain management. Conclusions: In the 2 EDs studied, we found high levels of pain severity for our patients, as well as low levels of analgesic use. When used, analgesic administration was often delayed. Despite these findings, patient satisfaction remained high. Despite recent efforts to improve pain management practice; oligoanalgesia remains a problem for our specialty. RÉSUMÉObjectif : La sous-utilisation des analgésiques ou «oligoanalgésie» est courante au département d'urgence (DU). Pour améliorer les soins, nous devons comprendre le niveau de douleur ressentie par nos patients ainsi que nos habitudes de pratique clinique. À cette fin, nous avons examiné l'é-tiologie de la douleur, les pratiques de prise en charge de la douleur et le degré de satisfaction des patients dans deux DU en milieu urbain. Méthodes : Nous avons mené une enquête transversale à l'aide d'entrevues structurées et de revue de dossiers pour des patients en douleur reçus à l'un ou l'autre de deux DU affiliés à une université. Nous avons évalué l'étiologie de la douleur, le niveau de douleur ressentie par les patients, les pratiques de prise en charge de la douleur et la satisfaction des patients face à cette prise en charge.

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“…[12] Previous studies show that nurses have tendency to underestimate their patients' pain. [8,11,[16][17][18][19][20][21][22][23][24][25] Underestimation of pain may result with inadequate nursing care and treatment, certain physical and psychological problems and also brings greater annual economic costs. [6,19,26,27] There are many reasons behind the underestimation of pain by nurses.…”

Section: ıNtroductionmentioning

confidence: 99%

“…Data Collecting Form is prepared by the researchers in accordance with the literature [8,11,[16][17][18][19][20][21][22][23][24][25] and includes questions related to demographic characteristics, past hospital experiences, pain beliefs and attitudes.…”

Section: Data Collectingmentioning

confidence: 99%

Pain Levels of Orthopedic Surgery Patients and Pain Perceptions of Their Relatives and Nurses

Yildirim¹

2015

Agri

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ÖzetAmaç: Bu tanımlayıcı araştırma, ortopedik cerrahi hastalarında ağrının hasta yakını ile hemşire tarafından algılanışının incelenmesi amacıyla gerçekleştirildi. Gereç ve Yöntem: Araştırmanın örneklemini ortopedi kliniğinde yatan 150 hasta, hastaların yanındaki 150 hasta yakını ve hastanın bakımından sorumlu 50 hemşire oluşturdu. Her hemşire araştırmaya yalnızca üç kere katıldı. Ağrı düzeyi, Görsel Analog Skala ile değerlendirildi. Hasta yakını ve hemşirenin, hastanın ağrı skalasını görmemesi sağlandı. Verilerin değerlendiril-mesinde; yüzdelik, ortalama, standart sapma, Mann-Whitney-U, Eşleştirilmiş Örneklem t-Testi, Lineer Regresyon ve Spearman Korelasyon Analizi kullanıldı. Bulgular: Hemşirelerin puan ortalamasının, hastaların puan ortalamasından istatistiksel olarak anlamlı düzeyde düşük olduğu (t=9.136, p<0.001); hasta yakını ile hastanın verdikleri puanlar arasında istatistiksel olarak anlamlı bir fark olmadığı saptandı. Regresyon analizinde; hasta yakınlarının, hastanın verdiği ağrı puanının yaklaşık %40'ını verirken, hemşirelerin %60 kadarını tahmin edebildiği saptandı. Sonuç: Hemşirelerin; ağrının hastadaki fiziksel ve emosyonel yansımalarını yorumlayabilmeleri için, ağrının fizyolojisi hakkın-da bilgilendirilmelerinin yanı sıra empatik becerilerinin geliştirilmesine yönelik eğitimlerin planlanması gereklidir. Bununla birlikte hastayla çokça vakit geçiren hasta yakınının da; cerrahi girişim sonrası hastanın gösterebileceği ağrı davranışları konusunda bilgilendirilmesi önerilmektedir.Anahtar sözcükler: Hemşire; ortopedik cerrahi; ağrı şiddeti; ağrı algısı; hasta yakını. SummaryObjectives: This descriptive study investigated pain levels of orthopedic surgery patients, and how this pain is perceived by their relatives and nurses. Methods: The study was carried out with 150 patients, 150 relatives and 50 nurses to determine pain intensity levels of orthopedic surgery patients and perceptions of this among their relatives and nurses. Intensity of pain was measured on a 0 to 10 visual analogue scale. Relatives and nurses were not allowed to see the patient's pain intensity score, and each nurse was allowed to participate in pain measurement three times. The data were analyzed by descriptive statistics, the Mann Whitney-U test, Paired Sample t-Test, Linear Regression and Spearman Correlation Analysis. results: The pain intensity scores given by nurses (t=9.136, p<0.001) were significantly lower than patients' own scores. There was no significant difference between relatives' and patients' pain scores. In the regression analysis, pain intensity scores given by relatives were approximately 40% lower than those given by patients, while nurses' scores were approximately 60% lower. conclusion: Education on pain management and the physical and emotional reactions of patients to pain should be provided for nurses working in surgical clinics. Meanwhile, as those who spend most time with the patient, relatives should be informed about possible pain behaviors in the postoperative period in order to prepare them for the...

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The patient vs. caregiver perception of acute pain in the emergency department

Cited by 172 publications

References 20 publications

Quality Indicators for Geriatric Emergency Care

Quality Indicators for Geriatric Emergency Care

Survey of pain etiology, management practices and patient satisfaction in two urban emergency departments

Pain Levels of Orthopedic Surgery Patients and Pain Perceptions of Their Relatives and Nurses

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