Quality Pain Management in the Hospital Setting from the Patient's Perspective

• Published in: Pain practice Vol. 15; no. 3; pp. 236 - 246
• Main Authors: Zoëga, Sigridur, Sveinsdottir, Herdis, Sigurdsson, Gisli H., Aspelund, Thor, Ward, Sandra E., Gunnarsdottir, Sigridur
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-03-2015
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Decision Making; Female; hospital; Hospitalization; Humans; Iceland - epidemiology; Icelandic version; Male; Middle Aged; outcomes; pain; Pain - epidemiology; Pain Management - standards; Pain Measurement; pain, patient participation; patient outcome questionnaire; Patient Participation; Patient Satisfaction; Prevalence; Quality of Health Care; quality pain management; Surveys and Questionnaires; Young Adult; Iceland; Icelandic version; pain, patient participation; quality pain management; hospital; outcomes; patient outcome questionnaire
• ISSN: 1530-7085; 1533-2500
• DOI: 10.1111/papr.12166

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.