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Bousché G, Koutris M, Su N, Verhoeff MC, Lobbezoo F. Predictors of patients' satisfaction after temporomandibular disorder treatment in a referral clinic. J Oral Rehabil 2024; 51:266-277. [PMID: 37727979 DOI: 10.1111/joor.13600] [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: 03/15/2023] [Revised: 04/26/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Evaluating patients' satisfaction after received care for temporomandibular disorders (TMD) pain provides oral health care professionals with knowledge and tools to improve their clinical procedures. However, knowledge on patient characteristics that determine satisfaction with the received care for TMD pain is lacking. OBJECTIVE To identify potential baseline predictors for patients' satisfaction regarding the management of TMD pain upon treatment completion in a referral clinic. METHODS Eligible patients, viz., individuals of ≥16 years of age, with a TMD-pain diagnosis according the diagnostic criteria for TMD (DC/TMD), and who were treated in a referral clinic, were included. As part of their standard care, a set of diagnostic questionnaires was filled in (e.g. TMD-pain screener, graded chronic pain scale (GCPS), etc.). After completion of the received care, patients filled in a custom-made questionnaire based on patient reported experience measures (PREMs) to quantify their satisfaction with their treatment results and received care. To identify potential predictors associated with patients' satisfaction, univariate and multivariate linear regression analyses were used. RESULTS Twenty-seven patients (mean 39.6, SD 15.0) were included in this study. Overall, the patients were satisfied with the treatment results and the received care. Depressive feelings were negatively associated with satisfaction of treatment results (p = .01) and positively associated with satisfaction of received care (p = .01), while pain intensity was negatively associated with satisfaction of the received care. CONCLUSION Depressive feelings are a significant negative predictor of patients' satisfaction with the treatment result for TMD pain, while average pain intensity is a significant negative predictor of patients' satisfaction with the received care.
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Affiliation(s)
- G Bousché
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M Koutris
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - N Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M C Verhoeff
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - F Lobbezoo
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Saleki M, Khabbass M, Bretherton B, Baranidharan G. Exploring Patient Satisfaction and Other Outcome Measures With Pain Relief in Spinal Cord Stimulation: A Single-Site, Cohort Audit. Cureus 2023; 15:e51339. [PMID: 38288220 PMCID: PMC10824466 DOI: 10.7759/cureus.51339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 01/31/2024] Open
Abstract
Context Spinal cord stimulation (SCS) is an approved treatment for chronic pain of neuropathic origin. Initial research suggests a close relationship between pain relief and patient satisfaction with SCS. Objectives To see whether similar patterns were observed in our center and to identify areas of improvement, this single-site, cohort audit explored the association between pain relief and satisfaction as well as specific factors that influence satisfaction at follow-up in patients with fully implanted SCS. Methods Age, gender, pain condition, SCS system, average pain (numerical rating scale, NRS), and worst pain (NRS) scores at baseline and the most recent follow-up visit were collected. Percentage change in average pain was calculated, and the patients were allocated to one of three pain improvement groups: <30%, 30%-50%, or >50%. A telephone survey explored patient outcomes including patient satisfaction, sleep, fatigue, quality of life (QoL), walking ability, and medication use. Chi-square tests of independence were performed. Results The final sample comprised 87 patients (<30%: n = 26; 30%-50%: n = 29; >50%: n = 32). The pain improvement group was significantly associated with satisfaction (p = 0.010): all patients in the >50% improvement group reported being either very satisfied or somewhat satisfied with SCS. The pain improvement group was also significantly associated with change in sleep (p < 0.001), fatigue (p = 0.001), QoL (p = 0.003), and opioid consumption (p = 0.010). Improvements were most frequently reported in the >50% improvement group. Conclusion Findings point to an association between pain relief and patient satisfaction with SCS. Other factors, including sleep, fatigue, QoL, and opioid consumption, may influence this association and deserve further exploration.
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Raad M, López WOC, Sharafshah A, Assefi M, Lewandrowski KU. Personalized Medicine in Cancer Pain Management. J Pers Med 2023; 13:1201. [PMID: 37623452 PMCID: PMC10455778 DOI: 10.3390/jpm13081201] [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: 07/04/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Previous studies have documented pain as an important concern for quality of life (QoL) and one of the most challenging manifestations for cancer patients. Thus, cancer pain management (CPM) plays a key role in treating pain related to cancer. The aim of this systematic review was to investigate CPM, with an emphasis on personalized medicine, and introduce new pharmacogenomics-based procedures for detecting and treating cancer pain patients. METHODS This study systematically reviewed PubMed from 1990 to 2023 using keywords such as cancer, pain, and personalized medicine. A total of 597 publications were found, and after multiple filtering processes, 75 papers were included. In silico analyses were performed using the GeneCards, STRING-MODEL, miRTargetLink2, and PharmGKB databases. RESULTS The results reveal that recent reports have mainly focused on personalized medicine strategies for CPM, and pharmacogenomics-based data are rapidly being introduced. The literature review of the 75 highly relevant publications, combined with the bioinformatics results, identified a list of 57 evidence-based genes as the primary gene list for further personalized medicine approaches. The most frequently mentioned genes were CYP2D6, COMT, and OPRM1. Moreover, among the 127 variants identified through both the literature review and data mining in the PharmGKB database, 21 variants remain as potential candidates for whole-exome sequencing (WES) analysis. Interestingly, hsa-miR-34a-5p and hsa-miR-146a-5p were suggested as putative circulating biomarkers for cancer pain prognosis and diagnosis. CONCLUSIONS In conclusion, this study highlights personalized medicine as the most promising strategy in CPM, utilizing pharmacogenomics-based approaches to alleviate cancer pain.
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Affiliation(s)
- Mohammad Raad
- Department of Molecular, Cellular and Biomedical Sciences, University of New Hampshire, Durham, NH 03824, USA
| | - William Omar Contreras López
- Neurosurgeon Clinica Foscal Internacional, Bucaramanga 680006, Colombia;
- Neurosurgeon Clinica Portoazul, Caribe, La Merced, Asunción, Centro, Barranquilla 680006, Colombia
| | - Alireza Sharafshah
- Cellular and Molecular Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht 41937-1311, Iran;
| | - Marjan Assefi
- University of North Carolina, Greensboro, NC 27412, USA;
| | - Kai-Uwe Lewandrowski
- Center for Advanced Spine Care of Southern Arizona, Tucson, AZ 85712, USA;
- Department of Orthopaedics, Fundación Universitaria Sanitas, Bogotá 111321, Colombia
- Department of Orthopedics, Hospital Universitário Gaffre e Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-004, Brazil
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Guadie YG, Kibret AK, Adem KS, Yalew ES. Patient's satisfaction in physiotherapy outpatient departments of Amhara regional comprehensive specialized hospitals, Ethiopia. BMC Health Serv Res 2022; 22:1011. [PMID: 35941683 PMCID: PMC9361663 DOI: 10.1186/s12913-022-08338-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Satisfaction is basically the state of being gratified and act of fulfilling one's need or desires. Nowadays, evidence-based practice concept is prevailing and there has been a growing interest in the measurement of patient satisfaction in healthcare research. Patient satisfaction surveys provide several benefits for healthcare professionals. Assessing patient’s satisfaction with physiotherapy service could generate knowledge that can utilized for improving or maintaining quality service. Although a wide coverage and high emphasis givens to patient satisfaction studies in developed counties, there are few research’s done in Africa. This study aimed to assess satisfaction in physiotherapy service and identify predictors that affect satisfaction among patient treated in physiotherapy outpatient department. Objectives To assess satisfaction in physiotherapy service and identify associated factors among patients in physiotherapy outpatient department in Amhara regional state comprehensive specialized hospitals. Method Institution based cross-sectional study was conducted among physiotherapy outpatients from April to June 2021, at three selected Comprehensive specialized hospitals. Data were collected by interviewing participants using semi-structured questionnaire. Patient satisfaction was determined by using Medrisk tool. Data were analyzed by using descriptive statistics and bivariate and multivariable logistic regression method were used to identify predictor factors. Result A total of 409 participants with a response rate of 95% were included in this study. The overall satisfaction among physiotherapy outpatient attendee was 50.1% with 95% CI (46.2–55.7). Pain level (AOR = 5.59 95%CI (2.58–12.1), longitudinal continuity of care (AOR = 3.02 95%CI (1.46–6.62) and self-rated health improvement (AOR = 3.76, 95% CI (1.78–7.94) were significantly associated factors. Conclusion The overall satisfaction in this study were found to be low in Amhara regional state comprehensive specialized hospitals. pain level, self-rated health improvement and longitudinal continuity of care were significantly associated factors.
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Affiliation(s)
- Yisak Girma Guadie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, University of Gondar, P.O. Box: 196, Gondar, Ethiopia.
| | - Alemu Kassaw Kibret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, University of Gondar, P.O. Box: 196, Gondar, Ethiopia
| | - Kedir Sany Adem
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, University of Gondar, P.O. Box: 196, Gondar, Ethiopia
| | - Ermias Solomon Yalew
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, University of Gondar, P.O. Box: 196, Gondar, Ethiopia
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Patient satisfaction with post-operative pain management and associated factors among surgical patients at Tikur Anbessa Specialized Hospital: Cross-sectional study. Ann Med Surg (Lond) 2022; 79:104087. [PMID: 35860062 PMCID: PMC9289483 DOI: 10.1016/j.amsu.2022.104087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Objective Method Result Conclusion Patient satisfaction with postoperative pain management was suboptimal. ASA status, pain, analgesic techniques & management were significantly associated. Patient satisfaction also associated with empathy, patient education, & communication.
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Hawari RJ, McCabe CT, Dougherty AL, Eskridge SL, Watrous JR, Sazon J, Galarneau MR. Transport time after combat-related injury and patient-reported outcomes among US service members. BMJ Mil Health 2021; 169:e34-e38. [PMID: 33483453 DOI: 10.1136/bmjmilitary-2020-001542] [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: 05/22/2020] [Revised: 12/21/2020] [Accepted: 12/27/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The 'golden hour' is a universal paradigm that suggests trauma patients have lower morbidity and mortality when provided with medical care within 1 hour after injury. The objective of this study was to examine whether transport time from point of injury to a military treatment facility (MTF) in-theatre was associated with patient-reported outcomes, such as post-traumatic stress disorder (PTSD), depression and quality of life (QOL), among US service members with combat-related injury. METHODS Participants were injured between March 2003 and March 2016 and completed standardised assessments of PTSD, depression and QOL for theWounded Warrior Recovery Project (WWRP) between January 2013 and November 2017. Multivariable regressions were used to assess the relationship between transport time (≤1 hour or >1 hour from injury to MTF) and positive screens for PTSD and depression, and QOL, respectively.Overall, 45.6% of participants (n=879) arrived at an MTF within 1 hour postinjury. About 8 years passed between when participants were injured on deployment and when they completed their first WWRP assessment. Approximately 48% of participants screened positive for PTSD and 51.3% for depression, with a mean QOL score of 0.513 (SD=0.150). After adjusting for covariates, transport time was not significantly associated with PTSD (OR 1.04, 95% CI 0.79 to 1.38; p=0.77), depression (OR 0.92, 95% CI 0.69 to 1.21; p=0.55) or QOL (β=0.009; p=0.38). CONCLUSION Transport time was not associated with patient-reported outcomes among US service members with combat-related injury. These findings are important as we seek to understand how combat casualties may be affected by extended medical evacuation or transport times anticipated in future expeditionary operations.
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Affiliation(s)
- Raneem J Hawari
- Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, California, USA.,Leidos Inc, San Diego, California, USA
| | - C T McCabe
- Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, California, USA .,Leidos Inc, San Diego, California, USA
| | - A L Dougherty
- Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, California, USA.,Leidos Inc, San Diego, California, USA
| | - S L Eskridge
- Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, California, USA.,Leidos Inc, San Diego, California, USA
| | - J R Watrous
- Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, California, USA.,Leidos Inc, San Diego, California, USA
| | - J Sazon
- Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, California, USA.,Axiom, San Diego, California, USA
| | - M R Galarneau
- Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, California, USA
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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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Hodapp JW, Ali S, Drendel AL. Bringing It All Together: A Review of the Challenges in Measuring Children's Satisfaction as a Key Component of Acute Pain Management. CHILDREN-BASEL 2020; 7:children7110243. [PMID: 33233508 PMCID: PMC7699486 DOI: 10.3390/children7110243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 01/14/2023]
Abstract
In 2008, the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (PedIMMPACT) published a consensus statement that recognized the dearth of research surrounding the topic of children’s satisfaction with acute pain management. This review of published literature will summarize what is known about the topic of children’s satisfaction with pain management, identify current gaps in the knowledge, and provide direction for future research in this critical area. Including children in the decision-making process as soon as they are developmentally able is a concept that is the fundamental basis for seeking assent and more active roles within healthcare decisions for children. It is the responsibility of adults to provide them with increasing opportunities for self-evaluation and more independent management of their healthcare, encouraging the development of children into adults. As clinicians and researchers, it is our prerogative to support the maturation of children by building effective methods to communicate their satisfaction with acute pain treatment and healthcare. Children’s satisfaction with acute pain management is not well studied and further research is needed for the development of inclusive, developmentally appropriate measures of satisfaction for our pediatric patients.
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Affiliation(s)
- Joseph W. Hodapp
- Department of Anesthesiology, Stanford University, Pal Alto, CA 94305, USA;
| | - Samina Ali
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Amy L. Drendel
- Department of Pediatrics, Section of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI 53201, USA
- Correspondence: ; Tel.: +414-266-6672
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Gordon DB, Stewart JA, Dahl JL, Ward S, Pellino T, Backonja M, Broad JE. Institutionalizing Pain Management. ACTA ACUST UNITED AC 2020. [DOI: 10.1080/10564950.1999.12098188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Debra B. Gordon
- Debra B. Gordon, RN, MS, is Senior linical Nurse Specialist, University of Wisconsin Hospital & Clinics
| | - James A. Stewart
- James A. Stewart, MD, FACP, is Professor, Department of Medicine, University of Wisconsin Medical School and Comprehensive Cancer Center, University of Wisconsin Hospital & Clinics
| | - June L. Dahl
- June L. Dahl, PhD, is Professor, Department of Pharmacology, University of Wisconsin Medical School
| | - Sandra Ward
- Sandra Ward, RN, PhD, is Associate Professor, University of Wisconsin School of Nursing
| | - Theresa Pellino
- Theresa Pellino, RN, PhD, is Senior Clinical Nurse Specialist, Nursing Research, University of Wisconsin Hospital & Clinics
| | - Miroslav Backonja
- Miroslav Backonja, MD, is Associate Professor, Department of Neurology, University of Wisconsin Medical School
| | - Judith E. Broad
- Judith E. Broad, RN, PhD, is Senior Vice President of Nursing, University of Wisconsin Hospital & Clinics, Madison, WI
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Assessment of Patient's Satisfaction and Associated Factors regarding Postoperative Pain Management at the University of Gondar Compressive Specialized Hospital, Northwest Ethiopia. Pain Res Manag 2020; 2020:8834807. [PMID: 33273994 PMCID: PMC7676941 DOI: 10.1155/2020/8834807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/19/2020] [Accepted: 10/29/2020] [Indexed: 11/17/2022]
Abstract
Objective We aimed to assess the level of patient's satisfaction and associated factors regarding postoperative pain management. Methods An institution-based cross-sectional study was conducted from April to May 2018 at the University of Gondar, and comprehensive specialized hospital data were collected through semistructured questionnaire and chart review. Level of satisfaction was measured using five-point Likert scale. Statistical analysis was done using SPSS software version 23. Both bivariable and multivariable logistic regression analyses were done. Variables of P value ≤0.2 in the bivariable analysis were a candidate for multivariable logistic regression. A P value ≤0.05 was considered as significantly associated with patient's level of satisfaction at 95% CI. Results A total of 418 patients were included in this study with a response rate of 98.58%. The overall proportion of patients who were satisfied with pain management services was 72.2% (95% CI: 67.7-76.6). ASA1 (AOR = 3.55: 95% CI = 1.20-10.55) and ASA2 patients (AOR = 3.72: 95% CI = 1.04-13.28), absence of postoperative pain (AOR = 1.86: 95% CI = 1.02-3.39), peripheral nerve block done (AOR = 9.14: 95% CI = 3.93 20.86), received analgesic before request (AOR = 6.90: 95% CI = 3.72-12.83), and received systemic analgesics (AOR = 6.10: 95% CI = 1.17-33.91) were significantly associated with the level of satisfaction. Conclusion The level of patient satisfaction with postoperative pain management was considerably low. Hence, it is vital to implement time-interval pain assessment method during the first 24 hours of postoperative period and treat accordingly based on the WHO pain ladder. Moreover, we suggested that all patients who underwent major surgery should receive peripheral nerve block as part of multimodal analgesia to decrease the incidence and severity of post op pain.
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The effect of adjuvant oral application of honey in the management of postoperative pain after tonsillectomy in adults: A pilot study. PLoS One 2020; 15:e0228481. [PMID: 32040956 PMCID: PMC7010464 DOI: 10.1371/journal.pone.0228481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/15/2020] [Indexed: 12/02/2022] Open
Abstract
Objective To analyze the effect of adjuvant oral application of honey for treating postoperative pain after tonsillectomy. Design Single centre prospective cohort study. Setting Two cohorts of patients after tonsillectomy. Participants 56 patients treated with honey 8 times per day (honey group), 18 patients treated without honey (control group); baseline analgesia were non-steroidal anti-inflammatory drugs (NSAID) or coxibs; opioids were used as pro re nata (PRN) medication; mean age 34.4 ± 13.4 years; 36% women. Main outcome measures On first to fifth postoperative day, patients rated their pain using the validated questionnaire of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including a numeric rating scale (NRS, 0–10) for determination of patient's pain. QUIPS allows standardized assessment of patients' characteristics andpain-associated patient-reported outcomes (PROs). The influence of preoperative and postoperative parameters on patients' postoperative pain were estimated by univariate and multivariate statistical analysis. Results Average pain in activity in the control group was greater than 4 (NRS 4.4 ± 2.4) during the first five postoperative days, with a renewed increase in pain intensity on the fifth day (4.3 ± 2.5). In the honey group, the pain in activity decreased without any further pain increase and was only higher than 4 on the first three postoperative days (4.3 ± 2.1, all p>0.05). However; neither minimal nor maximal pain were significantly different between both groups on the first postoperative day (p = 0.217, p = 0.980). Over the five postoperative days, the minimal and maximal pain in the honey group decreased continuously and faster than in the control group. With regard to pain-related impairments on the first day, the honey group reported less pain-related sleep disturbance (p = 0.026), as well as significantly fewer episodes of postoperative oral bleeding (p = 0.028) than the control group. Patients without honey consumption had on the first and fifth postoperative day a higher risk of increased minimal pain (OR = -2.424, CI = -4.075 –-0.385). Gender was an independent factor for compliance of honey consumption on the second postoperative day (p = 0.037). Men had a lower probability for compliance of honey consumption (OR = -0.288, CI = -2.863 –-0.090). Conclusion There was a trend of reduced postoperative pain after oral honey application. Honey also seems to reduce pain-related impairments. The need for additional opioids on the first day could be reduced. A larger controlled trial is now needed to varify the effect of honey on pain after tonsillectomy. Clinical trial registration number German Clinical Trials Register DRKS00006153. The authors confirm that all ongoing and related trials for this drug/intervention are registered.
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Prang KH, Canaway R, Bismark M, Dunt D, Kelaher M. Associations between patient experiences and clinical outcomes: a cross-sectional data linkage study of the Australian private healthcare sector. BMJ Open Qual 2019; 8:e000637. [PMID: 31523739 PMCID: PMC6711428 DOI: 10.1136/bmjoq-2019-000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/29/2019] [Accepted: 07/31/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- Khic-Houy Prang
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Rachel Canaway
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Marie Bismark
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - David Dunt
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Margaret Kelaher
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
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Geißler K, Ducke M, Volk GF, Meißner W, Guntinas-Lichius O. Pain on the first postoperative day after tonsillectomy in adults: A comparison of metamizole versus etoricoxib as baseline analgesic. PLoS One 2019; 14:e0221188. [PMID: 31412091 PMCID: PMC6693748 DOI: 10.1371/journal.pone.0221188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 07/31/2019] [Indexed: 01/22/2023] Open
Abstract
Objective To compare the effect of metamizole versus etoricoxib as baseline analgesic for treating postoperative pain after tonsillectomy. Design Single centre prospective cohort study. Setting Two consecutive cohorts of tonsillectomy patients. Participants 124 patients (n = 55 treated with etoricoxib, n = 69 with metamizole); median age 30.5 years; 50% women. Main outcome measures Patients rated their pain on first postoperative day using the questionnaires of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including numeric rating scales (NRS, 0–10) for pain determination. The influence of preoperative and postoperative parameters on patients' pain was estimated by univariate and multivariate statistical analysis. Results The demographic parameters showed no differences between the patients in the metamizole group and the etoricoxib group (all p>0.05) with one exception: Patients in the metamizole group had significantly more preoperative pain than patients in the etoricoxib group (p = 0.001). The metamizole group had a mean postoperative pain in activity of 4.4 ± 2.1 and the etoricoxib group of 4.5 ± 2.2. Maximal pain for the metamizole group and the etoricoxib group were 5.6 ± 2.2 and 6.1 ± 1.9, respectively. Pain in activity, maximal pain and minimal pain were not different between both groups (p = 0.652, p = 0.113, p = 0.276, respectively). Patients of the etoricoxib group received more frequently piritramide in recovery room as demand medication (p = 0.046). In the whole cohort, patients with peritonsillar abscess had more preoperative pain in comparison to chronic tonsillitis (p<0.001). Patients under 30.5 years reported higher maximal pain than older patients (p = 0.049). On the other hand, a significant influence of patients’ age on the pain in activity and minimal pain could not be demonstrated (p = 0.368, p = 0.508, respectively). Men reported lower minimal pain than women (p = 0.041). Also, patients with ASA status I had lower minimal pain than patients with higher ASA status (p = 0.019). The multivariate analysis did not show an association between postoperative pain in activity and preoperative counseling on postoperative pain management (p = 0.588, p = 0.174, respectively). Special preoperative counseling on postoperative pain management resulted in lower levels of maximal pain (p = 0.024). Linear regression demonstrated an independent association of higher pain in activity with higher mobility impairment (p = 0.034) and respiratory impairment (p = 0.002). The linear regression of minimal pain identified female gender (p = 0.005) as an independent influencing factor with higher pain levels. In terms of satisfaction, no preoperative pain therapy (p = 0.016) could be found as an independently significant influencing factor with higher satisfaction. Conclusion Etoricoxib does not have an advantage as baseline analgesic for post tonsillectomy pain in comparison to metamizole.
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Affiliation(s)
- Katharina Geißler
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
- * E-mail:
| | - Marina Ducke
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Gerd Fabian Volk
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Winfried Meißner
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
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Dissemination and Implementation of Patient-centered Indicators of Pain Care Quality and Outcomes. Med Care 2019; 57:159-166. [PMID: 30570589 DOI: 10.1097/mlr.0000000000001042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous approaches to measuring and improving nursing-sensitive, patient-centered metrics of pain quality and outcomes in hospitalized patients have been limited. METHODS In this translational research study, we disseminated and implemented pain quality indicators in 1611 medical and/or surgical, step-down, rehabilitation, critical access, and obstetrical (postpartum) units from 326 US hospitals participating in the National Database of Nursing Quality Indicators. Eligible patients were English-speaking adults in pain. Trained nurses collected patients' perceptions via structured interview including 9 pain quality indicators, demographic, and clinical variables; these patient experience data were merged with unit and hospital level data. Analyses included geographic mapping; summary statistics and 3-level mixed effects modeling. RESULTS Hospitals in 45 states and District of Columbia participated. Of 22,293 screened patients, 15,012 were eligible; 82% verbally consented and participated. Pain prevalence was 72%. Participants were 59.4% female; ages ranged from 19 to 90+ (median: 59 y); 27.3% were nonwhite and 6.5% were Hispanic. Pain intensity on average over the past 24 hours was 6.03 (SD=2.45) on a 0-10 scale. 28.5% of patients were in severe pain frequently or constantly. Race (nonwhite), younger age, being female and nonsurgical were associated (P<0.001) with greater pain. Care quality indicators ranking lowest related to discussion of analgesic side effects and use of nonpharmacologic approaches. CONCLUSIONS Unrelieved pain remains a high-volume problem. Individual factors and unit type were significantly associated with pain outcomes. Hospitals can employ these quality indicators to direct continuous quality improvement targeting pain care quality.
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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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Abstract
The paradox of patients who are in pain yet satisfied with their pain management has been documented repeatedly. Pain relief constitutes only one part of patient satisfaction with pain management. The quality of cancer pain management in Taiwan has not been evaluated from the patient's perspective. A cross-sectional design was used to survey 1,370 terminally ill cancer patients in Taiwan to characterize the status of, and satisfaction with cancer pain management by investigating the relative importance of pain intensity, pain relief experiences, and clinicians’ pain management practices. Cancer patients with pain had unsatisfactory pain relief within one week of admission (47.4 percent) and inadequate pain medication (23.6 percent). However, these patients perceived that clinicians adequately informed them about pain treatment. Patient satisfaction with pain management was primarily determined by examining the perceptions that medication dose was just right, responses to requests for pain medication were prompt, and understandable and consistent information about pain treatment was offered. In conclusion, Taiwanese cancer patients’ satisfaction with pain management was influenced more by perceived pain management practices than by pain relief itself.
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Lukas I, Kohl-Schwartz A, Geraedts K, Rauchfuss M, Wölfler MM, Häberlin F, von Orelli S, Eberhard M, Imthurn B, Imesch P, Leeners B. Satisfaction with medical support in women with endometriosis. PLoS One 2018; 13:e0208023. [PMID: 30496315 PMCID: PMC6264517 DOI: 10.1371/journal.pone.0208023] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 11/11/2018] [Indexed: 12/17/2022] Open
Abstract
Endometriosis affects various aspects of women's lives. We searched for predictors for patient satisfaction with medical support (PSwMS) in women with endometriosis. The study was designed as a multi-centre retrospective cohort study. We approached women with histologically confirmed endometriosis from 2010 until 2016, comparing women satisfied to women dissatisfied with medical support. We analysed data on characteristics of endometriosis, PSwMS and the influence of disease characteristics on PSwMS. Information on satisfaction with medical support was collected through a standardized questionnaire. After exclusion of 73 women because of inchoately filled in questionnaires, data from 498 women was evaluated. Altogether, it was observed that 54.6% (n = 272) of the study participants were satisfied with medical support and 45.4% (n = 226) were not. Feeling adequately informed by the time of diagnosis (p < 0.001), taking women's mental troubles seriously (p < 0.001) and supporting women in handling their pain (p < 0.001) were significantly associated with satisfaction. We found adequate information to be the most distinctive indicator for PSwMS. Further, acknowledging psychological distress and supporting women in handling their symptoms rather than to alleviate them, positively affect PSwMS. To achieve PSwMS, healthcare providers have to give adequate information on endometriosis and its management.
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Affiliation(s)
- Ilona Lukas
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Alexandra Kohl-Schwartz
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
- Division of Gynecological Endocrinology and Reproductive Medicines, University Women’s Hospital, Berne, Switzerland
| | - Kirsten Geraedts
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | | | - Monika M. Wölfler
- Department of Gynecology and Obstetrics, University Hospital Graz, Graz, Austria
| | - Felix Häberlin
- Department of Gynecology and Obstetrics, Canton Hospital St. Gallen, St. Gallen, Switzerland
| | - Stephanie von Orelli
- Department of Gynecology and Obstetrics, Triemli Hospital Zurich, Zurich, Switzerland
| | - Markus Eberhard
- Department of Gynecology and Obstetrics, Canton Hospital Schaffhausen, Schaffhausen, Switzerland
| | - Bruno Imthurn
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Patrick Imesch
- Department of Gynecology, University Hospital Zurich, Zurich, Switzerland
| | - Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
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Alaloul F, Williams K, Myers J, Jones KD, Sullivan K, Logsdon MC. Contextual Factors Impacting a Pain Management Intervention. J Nurs Scholarsh 2017; 49:504-512. [DOI: 10.1111/jnu.12319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Fawwaz Alaloul
- Iota Zeta, Assistant Professor, School of Nursing; Health Sciences Campus; K-Wing Louisville KY USA
| | - Kimberly Williams
- Acute Pain Service Charge Nurse; University of Louisville Hospital; Louisville KY USA
| | - John Myers
- Associate Professor, Department of Pediatrics; School of Medicine, Health Sciences Campus; Louisville KY USA
| | | | - Katelyn Sullivan
- Student, School of Nursing; Health Sciences Campus; Louisville KY USA
| | - M. Cynthia Logsdon
- Alpha and Iota Gamma, Professor, School of Nursing, University of Louisville; Associate Chief of Nursing for Research, University of Louisville Hospital; James Graham Brown Cancer Center; Louisville KY USA
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Golas M, Park CG, Wilkie DJ. Patient Satisfaction with Pain Level in Patients with Cancer. Pain Manag Nurs 2017; 17:218-25. [PMID: 27283267 DOI: 10.1016/j.pmn.2016.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/15/2016] [Accepted: 04/14/2016] [Indexed: 11/17/2022]
Abstract
Interest in satisfaction with pain management as a pain-related outcome variable wavered when investigators found poor correlations with pain intensity when they measured satisfaction with pain management rather than satisfaction with pain level. The aim was to explore the relationship between satisfaction with pain level and pain intensity among patients receiving ongoing outpatient cancer care. In a comparative, secondary data analysis of a cross-sectional sample of 806 cancer patients (57% male, mean age 56 ± 13 years, 77% Caucasian), the authors measured satisfaction with pain level as a single item (yes, no, not sure) and pain intensity as an average of current, least, and worst pain intensity (all 0-10 scales) in the past 24 hours. Of the 806 participants, 447 (56%) subjects were satisfied with their pain level, 291 (36%) were not satisfied and 68 (8%) were not sure. Satisfaction was moderately correlated with API (rho = -0.43, p < .001). Patients satisfied with their pain levels reported statistically lower mean API scores (2.26 ± 1.70) than those who were not satisfied (4.68 ± 2.07) or not sure (4.21 ± 2.2.1), p < .001. With pair wise post hoc comparisons, mean API scores of satisfied patients were significantly lower than those who were not satisfied or not sure. In contrast with other researchers who have not found associations between satisfaction with pain management and pain intensity, the authors demonstrated that when satisfaction is measured specifically, patients with higher pain intensity are not satisfied. The authors recommend that researchers use "satisfaction with pain level" instead of "satisfaction with pain management" as the pain satisfaction outcome.
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Affiliation(s)
- Mary Golas
- University of Illinois College of Nursing, Chicago, Illinois; Jesse Brown Veterans Administration Medical Center, Chicago, Illinois
| | - Chang Gi Park
- University of Illinois College of Nursing, Chicago, Illinois
| | - Diana J Wilkie
- University of Illinois College of Nursing, Chicago, Illinois; College of Nursing, University of Florida, Gainesville, Florida.
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Wajanavisit W, Chanplakorn P, Kulachote N, Charoenwanthanang P, Woratanarat P. Understanding the pain status of the patient: a survey of pain status and pain treatment in an orthopedic outpatient department. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0802.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background: Pain assessments help clinicians to evaluate their patients’ symptoms. However, patients’ satisfaction with pain management is difficult to interpret and may mislead the clinician into being satisfied with inadequate pain management.
Objective: We described and explored patients’ pain status, patients’ satisfaction with their pain management, the impact of pain on sleep habit and routine activities of daily living (ADLs), and the proportion of patients who had undertreatment of pain in the Orthopaedic Outpatient Department, Ramathibodi Hospital.
Methods: A prospective, cross-sectional survey study of pain characteristics and pain management of Orthopaedic outpatients aged over 18 years in the Orthopaedics Department, Ramathibodi Hospital using two parts of a verified questionnaire.
Results: In all, 863 patients were studied. Numbers of patients with acute or chronic pain were in similar proportions and mainly diagnosed as nociceptive pain (83.7%). Most of them suffered from moderate or severe pain (42.6% vs. 39.1%). Severity of symptoms was correlated with sleep disturbance and disturbance in ADLs. However, no correlation was revealed between satisfaction with pain management and the intensity of pain and there was also no correlation between satisfaction with pain management and sleep disturbance or disturbance in ADLs. Most commonly prescribed medications were nonsteroidal antiinflammatory drugs (NSAIDs) (58.8%). However, 93.4% of returning patients who suffered from severe pain were still treated with nonopioid analgesics.
Conclusion: Patients suffered from moderate to severe pain and had disturbances in their sleep habit and ADLs. Most of them were satisfied with previous pain management, which was usually with nonopioid analgesics including NSAIDs and muscle relaxants. This group included some patients who experienced a high intensity of pain. We recommend clinicians pay more attention to the pain intensity of individual patients and justify appropriate medication by using a step-up approach and multimodal analgesics
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Affiliation(s)
- Wiwat Wajanavisit
- MD, Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Pongsthorn Chanplakorn
- Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Noratep Kulachote
- Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | | | - Patarawan Woratanarat
- Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
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Ezenwa MO, Molokie RE, Wang ZJ, Suarez ML, Yao Y, Wilkie DJ. Satisfied or not satisfied: pain experiences of patients with sickle cell disease. J Adv Nurs 2015; 72:1398-408. [PMID: 25916256 DOI: 10.1111/jan.12678] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2015] [Indexed: 11/28/2022]
Abstract
AIMS To examine the relationship between pain and satisfaction in patients with sickle cell disease. BACKGROUND Frequency and severity of unrelieved sickle cell pain are positively associated with mortality. Yet, information is scarce on whether sickle cell patients are satisfied with their pain level. DESIGN A cross-sectional, correlational analysis of baseline data from a randomized clinical trial. METHODS A randomized sample of adult outpatients was recruited between February 2007-March 2011. Patients completed the PAINReportIt(®) , containing measures of pain, satisfaction and socio-demographics. We analysed data using Kendall's rank correlations, analysis of variance, Tukey-Kramer post hoc tests, Fisher's tests and proportional odds logistic regression. RESULTS There were statistically significant correlations between pain outcomes and satisfaction with pain level, but average pain intensity more strongly discriminated groups based on satisfaction with pain level. Among pain variables bivariately associated with patient satisfaction with pain level, only pain expectation maintained its significant relationship with satisfaction with pain level when average pain intensity was controlled. A smaller percentage of our sickle cell patients reported moderate to severe pain intensity (28%) or high composite pain index (39%), while reporting being satisfied with pain their level than reported in earlier studies using different measures and populations (70-94%). CONCLUSION Satisfaction with pain level was an unambiguous measure of patient satisfaction and a promising indicator of pain that did not show the paradoxical relationship between satisfaction and pain seen with past measures.
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Affiliation(s)
- Miriam O Ezenwa
- Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing, Illinois, USA
| | - Robert E Molokie
- College of Medicine, University of Illinois at Chicago, Illinois, USA
| | - Zaijie Jim Wang
- Department of Biopharmaceutical Sciences, University of Illinois at Chicago, Illinois, USA
| | - Marie L Suarez
- Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing, Illinois, USA
| | - Yingwei Yao
- Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing, Illinois, USA
| | - Diana J Wilkie
- Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing, Illinois, USA.,Center for End-of-Life Transition Research, Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing, Illinois, USA
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Wong WS, Chow YF, Chen PP, Wong S, Fielding R. A longitudinal analysis on pain treatment satisfaction among Chinese patients with chronic pain: predictors and association with medical adherence, disability, and quality of life. Qual Life Res 2015; 24:2087-97. [PMID: 25749925 DOI: 10.1007/s11136-015-0955-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patient satisfaction research in chronic pain treatment is scarce internationally and is nonexistent in Chinese communities like Hong Kong. This longitudinal study examined the relationships between medical adherence, pain treatment satisfaction, disability, and quality of life (QoL) in a sample of Chinese patients with chronic pain. METHODS A total of 178 patients with chronic pain were assessed at baseline, 3 and 6 months following baseline. Medical adherence and pain treatment satisfaction were assessed by the Participant Compliance Reporting Scale and the Pain Treatment Satisfaction Scale (PTSS), respectively. QoL, depression, pain catastrophizing, and pain-related fear were assessed using SF-12, the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D), the Pain Catastrophizing Scale, and the Tampa Scale for Kinesiophobia, respectively. Linear mixed effects models (LME) were fitted to identify predictors of pain treatment satisfaction, medical adherence, and QoL. RESULTS Results of univariate LME analyses showed significant quadratic time effects on four PTSS scores and significant associations between disability grade and PTSS scores (all p < 0.05). Medical adherence was not significantly associated with satisfaction regarding pain medication (model 1). Satisfaction with medication characteristics emerged as an independent predictor of medical adherence (model 2: std β = -0.11, p < 0.05) after controlling for sociodemographic and pain variables. Neither medical adherence nor pain treatment satisfaction predicted QoL outcomes (models 3 and 4). CONCLUSIONS Distinct trajectories in pain treatment satisfaction were displayed in the current sample of Chinese patients with different disability grading chronic pain. Within pain treatment, only medication characteristics significantly impacted patients' medical adherence.
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Affiliation(s)
- W S Wong
- Department of Psychological Studies and Centre for Psychosocial Health, The Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, Hong Kong SAR, China,
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Delivering Quality Pain Management: The Challenge for Nurses. AORN J 2015; 101:328-34; quiz 335-7. [DOI: 10.1016/j.aorn.2014.11.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/12/2014] [Accepted: 11/13/2014] [Indexed: 11/17/2022]
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Opioid use after fracture surgery correlates with pain intensity and satisfaction with pain relief. Clin Orthop Relat Res 2014; 472:2542-9. [PMID: 24777731 PMCID: PMC4079891 DOI: 10.1007/s11999-014-3660-4] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 04/16/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND In 2012, Medicare began to tie reimbursements to inpatient complications, unplanned readmissions, and patient satisfaction, including satisfaction with pain management. QUESTIONS/PURPOSES We aimed to identify factors that correlate with (1) pain intensity during a 24-hour period after surgery; (2) less than complete satisfaction with pain control; (3) less than complete satisfaction with staff attention to pain relief while in the hospital; and we also wished (4) to compare inpatient and discharge satisfaction scores. METHODS Ninety-seven inpatients completed measures of pain intensity (numeric rating scale), satisfaction with pain relief, self-efficacy when in pain, and symptoms of depression days after operative fracture repair. The amount of opioid used in oral morphine equivalents taken during the prior 24 hours was calculated. Through initial bivariate and then multivariate analysis, we identified factors that were associated with pain intensity, less than complete satisfaction with pain control, and less than complete satisfaction with staff attention to pain relief. RESULTS Patients who took more opioids reported greater pain intensity (r = 0.38). No factors representative of greater nociception (fracture type, number of fractures, days from injury to surgery, days from surgery to enrollment, or type of surgery) correlated with greater pain intensity. The best multivariable model for greater pain intensity included: depression or anxiety disorder (p = 0.019), smoking (0.047), and greater opioid intake (p = 0.001). Multivariable analysis for less than ideal satisfaction with pain control included the Pain Self-Efficacy Questionnaire (PSEQ) (odds ratio [OR], 0.95; 95% CI, 0.92-0.99) alone; for less than ideal satisfaction with staff attention to pain control, the PSEQ (OR, 0.96; 95% CI, 0.92-0.99) and opioid medication use before admission (OR, 3.6; 95% CI, 1.1-12) were included. CONCLUSIONS After operative fracture treatment, patients who take more opioids report greater pain intensity and less satisfaction with pain relief. Greater self-efficacy was the best determinant of satisfaction with pain relief. Evidence-based interventions to increase self-efficacy merit additional study for the management of postoperative pain during recovery from a fracture. LEVEL OF EVIDENCE Level II, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.
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Woldehaimanot TE, Eshetie TC, Kerie MW. Postoperative pain management among surgically treated patients in an Ethiopian hospital. PLoS One 2014; 9:e102835. [PMID: 25033399 PMCID: PMC4102595 DOI: 10.1371/journal.pone.0102835] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 06/24/2014] [Indexed: 11/18/2022] Open
Abstract
Background Incidence of postoperative pain has been reported to be between 47–100%. Ineffective postoperative pain management results in tangible and intangible costs. The purpose of this study was to assess the processes and outcomes of pain management in the surgical wards of Jimma University Specialized Hospital, Ethiopia. Methods and Findings A prospective cross sectional study was conducted among 252 postoperative patients during February 13 to April 30, 2012. A contextually modified and validated (Cronbach’s α coefficient of 0.78) American Pain Society Patient Outcome Questionnaire was used to assess pain experience of patients. Patients’ charts were reviewed to assess the pattern of analgesic use. Incidence of postoperative pain was 91.4%, and remained high over 3 measurements (McNemar’s; p<0.05), and 80.1% of the patients were undertreated. The mean pain intensity, and pain interference on functional status were 6.72±1.44 and 5.61±1.13 on a 10 point Numerical rating scale respectively; both being strongly correlated(r = 0.86: p<0.001). Pain intensity was varied by ethnicity, education and preoperative information (ANOVA; P<0.05). Only 50% of the patients were adequately satisfied with their pain management. As needed (prn), solo analgesic, null analgesic, and intramuscular orders were noted for 31.3%, 89.29%, 9.7% and 20.1% of the prescription orders respectively. Though under dose, diclofenac and tramadol were the top prescribed medications, and only 57% of their dose was administered. Linear regression model showed that the predictors of satisfaction were sex of an individual and pain interference with functional status. Conclusion Despite patients’ paradoxical high satisfaction with pain management, the majority of patients were inadequately and inappropriately treated. Thus, further research is needed to determine how best to break down current barriers to effective pain management.
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Schwenkglenks M, Gerbershagen HJ, Taylor RS, Pogatzki-Zahn E, Komann M, Rothaug J, Volk T, Yahiaoui-Doktor M, Zaslansky R, Brill S, Ullrich K, Gordon DB, Meissner W. Correlates of satisfaction with pain treatment in the acute postoperative period: Results from the international PAIN OUT registry. Pain 2014; 155:1401-1411. [DOI: 10.1016/j.pain.2014.04.021] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 04/14/2014] [Accepted: 04/15/2014] [Indexed: 11/30/2022]
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Wong EML, Chair SY, Leung DY, Chan SWC. Can a brief educational intervention improve sleep and anxiety outcomes for emergency orthopaedic surgical patients? Contemp Nurse 2014:4292-4321. [PMID: 24484432 DOI: 10.5172/conu.2013.4292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract An educational intervention (EI) is useful in preparing patients for orthopaedic surgery. This quasi-experimental study examined the effect of a brief EI on pain level, anxiety, pain inference on sleep, and sleep satisfaction among Chinese patients undergoing emergency orthopaedic surgery. The intervention group received usual care plus 20-minute EI which comprised a combination of patient education and a breathing relaxation exercise (BRE) whereas the control group received usual care only. The outcomes were evaluated before the EI and at days 2, 4 and 7 post-surgery. One hundred and fifty two participants completed the study. The intervention group had significantly lower pain levels (Brief pain inventory), anxiety levels (The Chinese state Anxiety scale), and lower pain inference scores on mood and better sleep satisfaction. Therefore, a brief EI with a breathing relaxation exercise is a feasible and useful intervention that can improve post-operative outcomes in emergency orthopaedic surgery.
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Affiliation(s)
- Eliza Mi-Ling Wong
- Assistant Professor, The Nethersole School of Nursing, Esther Lee Building, The Chinese University of Hong Kong, China
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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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Kung F, Gibson SJ, Helme RD. Development of a pain management strategies survey questionnaire - preliminary findings. ACTA ACUST UNITED AC 2013. [DOI: 10.1163/156856900750233794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Longitudinal Trends in the Treatment of Abdominal Pain in an Academic Emergency Department. J Emerg Med 2013; 45:324-31. [DOI: 10.1016/j.jemermed.2013.01.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 10/03/2012] [Accepted: 01/18/2013] [Indexed: 11/20/2022]
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Yang P, Sun LQ, Pang D, Ding Y. Quality of life in cancer patients with pain in beijing. Chin J Cancer Res 2013; 24:60-6. [PMID: 23359351 DOI: 10.1007/s11670-012-0060-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 12/13/2011] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the quality of life (QOL) of cancer pain patients in Beijing, and explore the effect of cancer pain control on patients' QOL. METHODS Self-developed demographic questionnaire, numeric rating scale and SF-36 questionnaire were used together among 643 cancer pain patients in 28 Grade 2nd to 3rd general hospitals and 2 Grade 3rd cancer hospitals. RESULTS The SF-36 eight dimensions scores ranged from 31.75 to 57.22 in these cancer pain patients. The t test and Wilcoxon rank sum test were used to compare the QOL between pain controlled (PC) group and pain uncontrolled (PUC) group, and the results showed that patients in PC group had the higher QOL scores in 6 areas of SF-36 (P<0.05). Binary logistic regression results found that pain management satisfaction scores (P<0.001), family average personal monthly income (P=0.029), current receiving chemotherapy (P=0.009) and cancer stage (P<0.001) were the predictors to cancer pain controlled results. CONCLUSION Cancer patients with pain in Beijing had poor QOL. Pain control will improve the QOL of cancer pain patients.
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Affiliation(s)
- Ping Yang
- Department of Medical & Surgical Nursing, Peking University School of Nursing, Beijing 100191, China
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Abstract
Regular assessment for the presence of pain and response to pain management strategies should be high priority in cancer patients. Pain is a multidimensional experience in cancer patients. Pain management will be most effective when treatments are individualized after exploring the various physical and non-physical components of pain, and the patient and family are educated and involved in decision making. This article discusses the various issues that are pertinent to the assessment of pain in cancer patients.
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Affiliation(s)
- Shalini Dalal
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, 77030, USA.
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Zoëga S, Ward S, Gunnarsdottir S. Evaluating the quality of pain management in a hospital setting: testing the psychometric properties of the Icelandic version of the revised American Pain Society patient outcome questionnaire. Pain Manag Nurs 2012; 15:143-55. [PMID: 23318415 DOI: 10.1016/j.pmn.2012.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 08/02/2012] [Accepted: 08/02/2012] [Indexed: 11/27/2022]
Abstract
Pain management is an important aspect of providing quality health care, and monitoring patient-related outcomes is a recommended quality improvement practice. Valid and reliable tools are needed for this purpose. The American Pain Society Patient Outcome Questionnaire (APS-POQ) is widely used to measure quality of pain management. The APS-POQ was recently revised to reflect advances in pain management. The purpose of this study was to test the psychometric properties of the revised version in Icelandic patients in the hospital setting. The questionnaire was translated according to an adaptation of Brislin's model. Data were collected from 143 patients on 23 wards in a university hospital. Participants were ≥ 18 years old, hospitalized for >24 hours, alert, not too ill to participate, and in pain ≥ 1 on a 0-10 scale in the past 24 hours. Mean (SD) age was 66 (18) years, 51.4% were women, 48.6% men. Principal component analysis with varimax rotation confirmed a five-component structure, but four items lowered reliability and were removed from the scales. The final version consists of four components, with Cronbach α >.70, explaining 64.2% of the variance. Participants had little difficulty in answering the questionnaire, but two additional items about participation in decisions and pain medications were added in response to patients' comments and suggestions. Administering the Icelandic version of the APS-POQ-R was found to be feasible, and the questionnaire has acceptable construct validity and reliability. The results support the use of the APS-POQ-R-I to evaluate the quality of pain management in hospitals in Iceland.
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Affiliation(s)
- Sigridur Zoëga
- Landspítali-National University Hospital of Iceland, University of Iceland, Reykjavik, Iceland.
| | - Sandra Ward
- School of Nursing, University of Wisconsin-Madison
| | - Sigridur Gunnarsdottir
- Landspítali-National University Hospital of Iceland, University of Iceland, Reykjavik, Iceland
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Dalal S, Hui D, Nguyen L, Chacko R, Scott C, Roberts L, Bruera E. Achievement of personalized pain goal in cancer patients referred to a supportive care clinic at a comprehensive cancer center. Cancer 2012; 118:3869-77. [PMID: 22180337 PMCID: PMC3310943 DOI: 10.1002/cncr.26694] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 09/28/2011] [Accepted: 10/12/2011] [Indexed: 11/12/2022]
Abstract
BACKGROUND Cancer pain initiatives recommend using the personalized pain goal to tailor pain management. This study was conducted to examine the feasibility and stability of personalized pain goal, and how it compares to the clinical pain response criteria. METHODS Records of 465 consecutive cancer patients seen in consultation at the Supportive Care Clinic were reviewed. Pain relief was assessed as clinical response (≥30% or ≥2 point pain reduction) and personalized pain goal response (pain ≤ personalized pain goal). RESULTS One hundred fifty-two (34%), 95 (21%), and 163 (37%) patients presented with mild (1-4), moderate (5-6), and severe (7-10) pain, respectively. Median age (59 years), males (52%), and advanced cancer status (84%) did not differ by pain category. Median personalized pain goal at initial clinic consult was 3 (interquartile range, 2-3), was similar across pain groups, and remained unchanged (P = .57) at follow-up (median, 14 days). Clinical response was higher among patients with severe pain (60%) as compared with moderate (40%) and mild pain (33%, P < .001). Personalized pain goal response was higher among patients with mild pain (63%) as compared with moderate (44%) and severe pain (27%, P < .001). By using personalized pain goal response as the gold standard for pain relief, the sensitivity of clinical response was highest (98%) among patients with severe pain, but it had low specificity (54%). In patients with mild pain, clinical response was most specific for pain relief (98%), but had low sensitivity (52%). CONCLUSIONS Personalized pain goal is a simple patient-reported outcome for pain goals. The majority of patients were capable of stating their desired level for pain relief. The median personalized pain goal was 3, and it was highly stable at follow-up assessment.
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Affiliation(s)
- Shalini Dalal
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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Pain and satisfaction in hospitalized trauma patients: the importance of self-efficacy and psychological distress. J Trauma Acute Care Surg 2012; 72:1068-77. [PMID: 22491629 DOI: 10.1097/ta.0b013e3182452df5] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Unmanaged pain has been found to predict delayed return to work, psychologic distress, and chronic pain and disability in patients with traumatic injury. However, little is known about the pain experience during hospitalization. The primary objective of this study was to determine pain intensity, pain interference, and satisfaction with pain treatment in orthopedic trauma patients at hospital discharge. A secondary objective was to examine whether patient self-efficacy and psychologic distress were associated with pain and satisfaction. METHODS Two hundred thirty-three orthopedic trauma patients were enrolled and completed a discharge assessment at a Level I trauma center. Pain was measured with the Brief Pain Inventory and satisfaction with the American Pain Society Patient Outcome Questionnaire. RESULTS Ninety-seven percent of patients reported pain at the time of hospital discharge, with 59% and 73% reporting moderate to severe pain intensity and interference, respectively. Overall, 86% of patients were satisfied with pain treatment. Multivariable regression analyses demonstrated that decreased self-efficacy was associated with moderate to severe pain intensity, increased depression was associated with moderate to severe pain intensity and interference, and increased pain intensity was associated with decreased satisfaction (p < 0.05). CONCLUSIONS Results suggest that orthopedic trauma patients have a significant pain burden but are satisfied with pain treatment during the hospital stay. Efforts are needed to improve pain assessment and management and findings imply that addressing self-efficacy and depressive symptoms may decrease pain and increase satisfaction at hospital discharge. Brief educational interventions that incorporate pain coping skills and self-management techniques may be a feasible approach to improving self-efficacy in the acute care setting. Additional recommendations include routine hospital screening for depression and increased communication between surgeons and mental health providers to identify patients at high risk for unmanaged pain and facilitate provision of early mental health services.
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Lorentzen V, Hermansen I, Botti M. A prospective analysis of pain experience, beliefs and attitudes, and pain management of a cohort of Danish surgical patients. Eur J Pain 2012; 16:278-88. [DOI: 10.1016/j.ejpain.2011.06.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- V. Lorentzen
- The Centre of Nursing Research - Viborg; Heibergs Alle 2; DK-8800; Viborg; Denmark
| | - I.L. Hermansen
- Department of Obstetrics and Gynaecology; Region Hospital Viborg, Skive, Kjellerup; Heibergs Alle; DK-8800; Viborg; Denmark
| | - M. Botti
- Epworth/Deakin Centre for Clinical Nursing Research; School of Nursing and Midwifery; Faculty of Health, Medicine; Nursing and Behavioural Sciences; Deakin University; 221 Burwood Highway; Burwood; Victoria; 3125; Australia
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Napeñas JJ, Nussbaum ML, Eghtessad M, Zakrzewska JM. Patients' satisfaction after a comprehensive assessment for complex chronic facial pain at a specialised unit: results from a prospective audit. Br Dent J 2011; 211:E24. [DOI: 10.1038/sj.bdj.2011.1054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2011] [Indexed: 11/09/2022]
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Teno JM, Gozalo PL, Lee IC, Kuo S, Spence C, Connor SR, Casarett DJ. Does hospice improve quality of care for persons dying from dementia? J Am Geriatr Soc 2011; 59:1531-6. [PMID: 21797834 DOI: 10.1111/j.1532-5415.2011.03505.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the effectiveness of hospice services for persons dying from dementia from the perspective of bereaved family members. DESIGN Mortality follow-back survey. SETTING Death certificates were drawn from five states (AL, FL, TX, MA, and MN). PARTICIPANTS Bereaved family members listed as the next of kin on death certificates when dementia was listed as the cause of death. MEASUREMENTS Ratings of the quality of end-of-life care, perceptions of unmet needs, and opportunities to improve end-of-life care. Two questions were also asked about the peacefulness of dying and quality of dying. RESULTS Of 538 respondents, 260 (48.3%) received hospice services. Family members of decedents who received hospice services reported fewer unmet needs and concerns with quality of care (adjusted odds ratio (AOR)=0.49, 95% confidence interval (CI)=0.33-0.74) and a higher rating of the quality of care (AOR=2.0, 95% CI=1.53-2.72). They also noted better quality of dying than those without hospice services. CONCLUSION Bereaved family members of people with dementia who received hospice reported higher perceptions of the quality of care and quality of dying.
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Affiliation(s)
- Joan M Teno
- Department of Community Health, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA.
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Naveh P, Leshem R, Dror YF, Musgrave CF. Pain Severity, Satisfaction With Pain Management, and Patient-Related Barriers to Pain Management in Patients With Cancer in Israel. Oncol Nurs Forum 2011; 38:E305-13. [DOI: 10.1188/11.onf.e305-e313] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Colorectal surgery patients' pain status, activities, satisfaction, and beliefs about pain and pain management. Pain Manag Nurs 2011; 14:184-192. [PMID: 24315241 DOI: 10.1016/j.pmn.2010.12.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 12/02/2010] [Accepted: 12/08/2010] [Indexed: 11/20/2022]
Abstract
This study describes surgical colorectal cancer patients' pain levels, recovery activities, beliefs and expectations about pain, and satisfaction with pain management. A convenience sample of 50 adult inpatients who underwent colorectal surgery for cancer participated. Patients were administered the modified American Pain Society Patient Outcome Questionnaire on postoperative day 2 and asked to report on their status in the preceding 24 hours. Patients reported low current (mean 1.70) and average (mean 2.96) pain scores but had higher scores and greater variation for worst pain (mean 5.48). Worst pain occurred mainly while turning in bed or mobilizing, and 25% of patients experienced their worst pain at rest. Overall, patients expected to have pain after surgery and were very satisfied with pain management. Patients with worst pain scores >7 reported interference with recovery activities, mainly general activity (mean 5.67) and walking ability (mean 5.15). These patients were likely to believe that "people can get addicted to pain medication easily" (mean 3.39 out of 5) and that "pain medication should be saved for cases where pain gets worse" (mean 3.20 out of 5). These beliefs could deter patients from seeking pain relief and may need to be identified and addressed along with expectations about pain in the preoperative nursing assessment.
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Abstract
Relief from pain is itself a marker of high-quality medical care. Quality assurance in the case of pain management could simply mean successful elimination of pain. Because the means of controlling pain are imperfect, it is essential to consider whether pain interventions actually achieve the primary goal of pain relief and also whether they are safe, cost-effective, and even capable of producing secondary benefits such as early recovery from surgery. Quality assurance and assessment in pain management therefore becomes a complex undertaking that must incorporate into its processes the often-conflicting goals of comfort versus safety versus patients' rights.
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Preference, expectation, and satisfaction in a clinical trial of behavioral interventions for acute and sub-acute low back pain. THE JOURNAL OF PAIN 2010; 11:1074-82. [PMID: 20466596 DOI: 10.1016/j.jpain.2010.02.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 01/14/2010] [Accepted: 02/04/2010] [Indexed: 11/21/2022]
Abstract
UNLABELLED The equivalency of behavioral interventions has led to the consideration of whether patient-related factors influence clinical trial outcomes. The primary purpose of this secondary analysis was to determine if treatment preference and patient expectation were predictors of trial outcomes and if selected patient-satisfaction items were appropriate as outcome measures. Perceived effectiveness, treatment preference, and patient expectation were assessed before random assignment, and patient satisfaction was assessed 6 months later. Patient preference was associated with perceived effectiveness for those with no treatment preference and those preferring graded exposure. Higher patient expectation was associated with higher perceived effectiveness ratings for all treatments in the clinical trial. Patients with no strong treatment preferences had larger 6-month improvements in pain intensity and disability, while patients with higher expectations had lower disability at baseline, 4 weeks, and 6 months. Patient satisfaction rates did not differ based on treatment received. Patient satisfaction was highest with treatment delivery and much lower with treatment effect. Patient satisfaction was uniformly associated with expectations being met, but only satisfaction with treatment effect was associated with lower pain and disability scores. These data support assessment of treatment preference and patient expectation as predictors and patient satisfaction as an outcome measure in low back pain (LBP) clinical trials. PERSPECTIVE These data indicate treatment preference potentially impacts rate of improvement for patients with low back pain. Patient expectation did not impact rate of improvement, but those with higher expectations had lower pain and disability scores throughout the trial. Optimal assessment of patient satisfaction should include items that separately consider treatment delivery and effect.
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Gordon DB, Polomano RC, Pellino TA, Turk DC, McCracken LM, Sherwood G, Paice JA, Wallace MS, Strassels SA, Farrar JT. Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) for quality improvement of pain management in hospitalized adults: preliminary psychometric evaluation. THE JOURNAL OF PAIN 2010; 11:1172-86. [PMID: 20400379 DOI: 10.1016/j.jpain.2010.02.012] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Revised: 01/29/2010] [Accepted: 02/16/2010] [Indexed: 11/17/2022]
Abstract
UNLABELLED Quality improvement (QI) is a compilation of methods adapted from psychology, statistics, and operations research to identify factors that contribute to poor treatment outcomes and to design solutions for improvement. Valid and reliable measurement is essential to QI using rigorously developed and tested instruments. The purpose of this article is to describe the evolution of the American Pain Society Patient Outcome Questionnaire (APS-POQ) for QI purposes and present a revised version (R) including instrument psychometrics. An interdisciplinary task force of the APS used a step-wise, empiric approach to revise, test, and examine psychometric properties of the society's original POQ. The APS-POQ-R is designed for use in adult hospital pain management QI activities and measures 6 aspects of quality, including (1) pain severity and relief; (2) impact of pain on activity, sleep, and negative emotions; (3) side effects of treatment; (4) helpfulness of information about pain treatment; (5) ability to participate in pain treatment decisions; and (6) use of nonpharmacological strategies. Adult medical-surgical inpatients (n = 299) from 2 hospitals in different parts of the United States participated in this study. Results provide support for the internal consistency of the instrument subscales, construct validity and clinical feasibility. PERSPECTIVE This article presents the initial psychometric properties of the APS-POQ-R for quality improvement purposes of hospitalized adult patients. Validation in additional groups of patients will be needed to demonstrate its generalizability.
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Affiliation(s)
- Debra B Gordon
- Department of Nursing Practice Innovations, University of Wisconsin Hospital and Clinics, Madison, Wisconsin 53792, USA.
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Beck SL, Towsley GL, Berry PH, Lindau K, Field RB, Jensen S. Core aspects of satisfaction with pain management: cancer patients' perspectives. J Pain Symptom Manage 2010; 39:100-15. [PMID: 19879107 DOI: 10.1016/j.jpainsymman.2009.06.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Revised: 06/01/2009] [Accepted: 06/17/2009] [Indexed: 11/18/2022]
Abstract
CONTEXT The coexistence of high levels of satisfaction and high levels of pain has been perplexing. OBJECTIVES The aims of this study were to 1) describe patient expectations related to the experience of cancer-related pain, 2) explore the cognitive processes and meaning that underlie patient judgments about satisfaction and dissatisfaction with pain management, and 3) explore the discrepancies between ratings of high satisfaction with pain management with high pain intensity. METHODS The sample included 33 patients: 18 with advanced cancer and 15 experiencing pain after a surgery for a cancer diagnosis. All patients had experienced "worst pain" of at least moderate intensity and were interviewed using standard pain measures from the American Pain Society Patient Outcome Questionnaire and open-ended questions about the underlying meaning of their answers. We systematically analyzed the transcribed qualitative data using NVivo software. RESULTS Fifty-five percent of patients were females and were aged 25-78 years. Most (75%) were satisfied or very satisfied with their overall pain management. Key findings indicate that for some, the worst pain rating was often brief, even momentary. Most patients expected pain relief. Four key themes were important to the quality of pain management: being treated right, having a safety net, being in a partnership with their health care team, and having pain treatment that was efficacious. Key aspects of the patient-provider relationship that mattered were how the nurses and doctors behaved toward them and how quickly they responded to reports of pain. For some, an important factor was whether they had control of the amount of pain they experienced. CONCLUSION The findings inform measurement of patient satisfaction with the quality of pain management.
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Affiliation(s)
- Susan L Beck
- University of Utah College of Nursing, Salt Lake City, Utah 84112-5880, USA.
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Ballantyne JC, Fleisher LA. Ethical issues in opioid prescribing for chronic pain. Pain 2009; 148:365-367. [PMID: 19906487 DOI: 10.1016/j.pain.2009.10.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Revised: 10/21/2009] [Accepted: 10/23/2009] [Indexed: 11/26/2022]
Affiliation(s)
- Jane C Ballantyne
- Penn Pain Medicine Center, Department of Anesthesiology and Critical Care, Tuttleman Building, 1840 South Street, Philadelphia, PA 19146, USA Department of Anesthesiology and Critical Care, University of Pennsylvania Health System, 3400 Spruce Street, 6 Dulles Building, Philadelphia, PA 19104, USA
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Ballantyne JC. Patient-centered health care: are opioids a special case? Spine J 2009; 9:770-2. [PMID: 19643676 DOI: 10.1016/j.spinee.2009.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Accepted: 06/12/2009] [Indexed: 02/03/2023]
Affiliation(s)
- Jane C Ballantyne
- Department of Anesthesiology and Critical Care, Penn Pain Medicine Center, Tuttleman Building, 1840 South St, Philadelphia, PA 19146, USA.
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Tasmuth T, Saarto T, Kalso E. How palliative care of cancer patients is organised between a university hospital and primary care in Finland. Acta Oncol 2009; 45:325-31. [PMID: 16644576 DOI: 10.1080/02841860500423898] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of this study was to find out how palliative care is organised between the Helsinki University Central Hospital (University Hospital) and primary care. The study consisted of 102 patients whose oncological treatment was terminated and the responsibility of palliative care was transferred to primary care. The patients were interviewed by phone using a structured questionnaire. Another questionnaire form was sent to the primary care physicians. Half of the patients were treated in more than one primary care unit. One third of the outpatients were unaware who was responsible for the care. Most of the patients wanted to be at home but this was achieved in less than half of the cases. Most patients were symptomatic while leaving the University Hospital and no improvement was seen thereafter. Every third patient reported of poor quality of palliative care in the primary care. Also the physicians reported a need for training in palliative care.
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DuPree E, Martin L, Anderson R, Kathuria N, Reich D, Porter C, Chassin MR. Improving Patient Satisfaction with Pain Management Using Six Sigma Tools. Jt Comm J Qual Patient Saf 2009; 35:343-50. [DOI: 10.1016/s1553-7250(09)35048-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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