Why is pain still not being assessed adequately? Results of a pain prevalence study in a university hospital in Sweden

Authors

  • Barbro Wadensten,

    1. Authors:Barbro Wadensten, PhD, RN, Associate Professor, Department of Public Health and Caring Sciences, Uppsala University; Camilla Fröjd, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Senior Lecturer, Department of Surgical Science, Uppsala University; Christine L Swenne, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Senior Lecturer, Department of Public Health and Caring Sciences, Uppsala University; Torsten Gordh, PhD, MD, Professor, Multidisciplinary Pain Centre, Uppsala University Hospital, Uppsala; Lena Gunningberg, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Associate Professor, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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  • Camilla Fröjd,

    1. Authors:Barbro Wadensten, PhD, RN, Associate Professor, Department of Public Health and Caring Sciences, Uppsala University; Camilla Fröjd, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Senior Lecturer, Department of Surgical Science, Uppsala University; Christine L Swenne, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Senior Lecturer, Department of Public Health and Caring Sciences, Uppsala University; Torsten Gordh, PhD, MD, Professor, Multidisciplinary Pain Centre, Uppsala University Hospital, Uppsala; Lena Gunningberg, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Associate Professor, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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  • Christine L Swenne,

    1. Authors:Barbro Wadensten, PhD, RN, Associate Professor, Department of Public Health and Caring Sciences, Uppsala University; Camilla Fröjd, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Senior Lecturer, Department of Surgical Science, Uppsala University; Christine L Swenne, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Senior Lecturer, Department of Public Health and Caring Sciences, Uppsala University; Torsten Gordh, PhD, MD, Professor, Multidisciplinary Pain Centre, Uppsala University Hospital, Uppsala; Lena Gunningberg, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Associate Professor, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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  • Torsten Gordh,

    1. Authors:Barbro Wadensten, PhD, RN, Associate Professor, Department of Public Health and Caring Sciences, Uppsala University; Camilla Fröjd, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Senior Lecturer, Department of Surgical Science, Uppsala University; Christine L Swenne, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Senior Lecturer, Department of Public Health and Caring Sciences, Uppsala University; Torsten Gordh, PhD, MD, Professor, Multidisciplinary Pain Centre, Uppsala University Hospital, Uppsala; Lena Gunningberg, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Associate Professor, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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  • Lena Gunningberg

    1. Authors:Barbro Wadensten, PhD, RN, Associate Professor, Department of Public Health and Caring Sciences, Uppsala University; Camilla Fröjd, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Senior Lecturer, Department of Surgical Science, Uppsala University; Christine L Swenne, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Senior Lecturer, Department of Public Health and Caring Sciences, Uppsala University; Torsten Gordh, PhD, MD, Professor, Multidisciplinary Pain Centre, Uppsala University Hospital, Uppsala; Lena Gunningberg, PhD, RN, Leader, Nursing Research & Development, Uppsala University Hospital and Associate Professor, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Barbro Wadensten, Associate Professor, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. Telephone: +46 18 4716631.
E-mail:barbro.wadensten@pubcare.uu.se

Abstract

Aim.  The aim of this study was to investigate the prevalence of pain and pain assessment among inpatients in a university hospital.

Background.  Pain management could be considered an indicator of quality of care. Few studies report on prevalence measures including all inpatients.

Design.  Quantitative and explorative.

Method.  Survey.

Results.  Of the inpatients at the hospital who answered the survey, 494 (65%) reported having experienced pain during the preceding 24 hours. Of the patients who reported having experienced pain during the preceding 24 hours, 81% rated their pain >3 and 42·1% rated their pain >7. Of the patients who reported having experienced pain during the preceding 24 hours, 38·7% had been asked to self-assess their pain using a Numeric Rating Scale (NRS); 29·6% of the patients were completely satisfied, and 11·5% were not at all satisfied with their participation in pain management.

Conclusions.  The result showed that too many patients are still suffering from pain and that the NRS is not used to the extent it should be. Efforts to overcome under-implementation of pain assessment are required, particularly on wards where pain is not obvious, e.g., wards that do not deal with surgery patients. Work to improve pain management must be carried out through collaboration across professional groups.

Relevance to clinical practice.  Using a pain assessment tool such as the NRS could help patients express their pain and improve communication between nurses and patients in relation to pain as well as allow patients to participate in their own care. Carrying out prevalence pain measures similar to those used here could be helpful in performing quality improvement work in the area of pain management.

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