Original articlePain Prevalence Study in a Large Canadian Teaching Hospital
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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