Elsevier

Pain Management Nursing

Volume 9, Issue 3, September 2008, Pages 104-112
Pain Management Nursing

Original article
Pain Prevalence Study in a Large Canadian Teaching Hospital

https://doi.org/10.1016/j.pmn.2008.02.001Get rights and content

Abstract

Despite the continued evolution of pain management techniques and an increased awareness of the importance of effective pain management, pain continues to be poorly managed. Following an earlier organization-wide pain collaborative, nursing leaders representing acute and palliative pain services together conducted a pain prevalence study. The purpose of this cross-sectional study was to evaluate the prevalence of pain and the level of interference that pain has on patient activities at a large teaching hospital. Two valid pain measurement tools, the short form of the Brief Pain Inventory (SF-BPI) and the short form of the McGill Pain Questionnaire (SF-MPQ), were chosen to be self-administered. The study revealed a pain prevalence of 71% in a mix of 114 medical and surgical adult inpatients. The SF-BPI results indicated that 31.5% of patients reported pain of moderate to severe intensity and that 11.4% of patients reported pain of severe intensity. The Nursing Advisory Council has committed to supporting an annual prevalence study as part of a corporate goal to monitor pain management across the institution. Forthcoming research will focus on including cognitively impaired patients and conducting thorough chart audits of all patients enrolled in the study. This project provided an opportunity for advanced practice nurses who share a common interest in pain, to collaborate in seeking improvements in pain management for hospitalized patients.

Section snippets

Study Design

This study is a cross-sectional prevalence study of hospitalized patients' pain experience. Data collection occurred on a single day in November 2006 during National Pain Awareness Week.

Setting

The study occurred in a hospital that has more than 600 beds, with established acute, palliative, and chronic pain teams. The concept of a pain prevalence study was introduced in September 2006. An initial meeting of the five internal pain management nurse experts (three acute pain nurse practitioners and two

Results

The pain prevalence of the 114 respondents at our institution at the time of the survey was 71% (n = 81). See Figure 1 for patient flow through study. Results from the BPI indicated that 31.5% of patients reported pain of moderate-severe intensity (>4/10) and 11.4% reported severe pain intensity (>7/10) at the time of the survey. When asked to rate their pain at its worst in the last 24 hours, 76.3% reported pain >4/10 and 47.3% reported pain >7/10. When asked to report on the least pain

Discussion

Over several decades pain prevalence studies have been reported in the literature. True comparisons are difficult, owing to variances in methods and reporting structure. Nonetheless, some unsettling similarities are apparent. Eleven studies assessing pain prevalence of inpatient medical and/or surgical patients were reviewed. In these studies (Table 3), pain prevalence either at the time of interview (44%-91%) or in the last 24 hours (56%-78.6%) was similar to our prevalence of 71%. In these 11

Limitations

Several limitations must be acknowledged. Despite verbal support from the organization's nursing advisory council, and frequent dialogue between managers and investigators, communication gaps did occur. This translated to additional obstacles for the investigators to overcome on the day of the survey. The PCMs had indicated that they would communicate the study concept to their educators. On the day of the survey, the investigators found that this communication had not occurred.

The

Next Steps

Because most patients in the long-term care facility suffered from a cognitive impairment, the team plans to include this population by using a validated tool specific to this population, such as the Doloplus-2. After presenting preliminary results to the nursing advisory council in February 2007, there was a commitment made to ensure that next year there would be a dedicated person on each unit to ensure a higher survey completion rate. For future prevalence studies, the investigators plan to

Acknowledgements

The authors are grateful for all the statistical support and guidance provided by Alex Kiss, biostatistician, from the Institute for Clinical Evaluative Sciences.

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