Dissatisfaction with post-operative pain management—A prospective analysis of 1071 patients
ABSTRACT A total number of 1071 patients was investigated using a modified questionnaire of the American Pain Society to evaluate the pain profile and satisfaction/dissatisfaction on the second post-operative day after different types of surgery (abdominal, traumatic, orthopaedic, urologic, gynaecologic, ENT). Patients were either treated with non-standardized pain management (no measurement of pain intensities, no regular administration of analgesics) (non-APS; n = 575) under responsibility of surgical specialties or with standardized pain management (regular assessment of pain and dose adaptation with i.v. PCA or epidurals) (APS; n = 496) by an anaesthesiology-based acute pain service.
Patients with a non-standardized pain management gave answers expressing higher pain intensities and breakthrough pain compared with APS-patients as a sign of their analgesic undertreatment (p ≤ 0.05). The differences between the non-APS and APS groups were also significant after major surgery (abdominal, urologic, traumatic, orthopaedic), showing the benefit of using i.v. PCA or epidurals. Furthermore, it could be demonstrated that patients in the APS treatment group were satisfied with their pain management to a significantly higher degree than patients in the non-APS group. 27.3% of non-APS versus 1.1% of APS-patients (p ≤ 0.05) were dissatisfied with their pain management. The majority of these patients did not want to experience the same management again.
The stepwise multivariate regression to estimate influencing variables on dissatisfaction (e.g. pain intensity, breakthrough pain, pain service, age, type of surgery) had yielded the surprising result that the most important factor for dissatisfaction was the patient's feeling that a complaint about pain had been taken seriously.
Our data has shown the necessity to improve pain management after surgery under the responsibility of surgical specialties, in order to avoid undertreatment and to increase patient's satisfaction. As a consequence of this prospective study, an interdisciplinary standardized pain management was introduced at the University Hospital. A repetition of this audit is planned.
- SourceAvailable from: Muhammad Waleed Darawad
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- "Some researchers related that to patients' previous experiences and their expectations for peak and trough pattern of pain, and concluded that the pattern of pain relief, not the pain severity, may be the critical determinant of satisfaction (George & Robinson, 2010). Conversely, factors that were found to increase patients' dissatisfaction with pain management include patients' feeling that their complaints of pain had not been taken seriously by HCPs (Roth et al., 2005) and longer waiting time for medication (Carlson et al., 2003). Patients' perceptions and beliefs regarding pain have also been found to contribute to pain management satisfaction. "
ABSTRACT: Pain is still undertreated among hospitalized patients. Recently, patient satisfaction with pain management has received significant attention. This field has not yet been explored among Jordanian patients. The purpose of this study was to determine the knowledge regarding pain characteristics, beliefs, and satisfaction that can be included in planning pain management strategies and protocols within Jordanian hospitals. Using descriptive cross-sectional methodology, the American Pain Society Patient Outcome Questionnaire (APS-POQ) was used to survey 375 inpatients from Jordanian hospitals. Participants reported relatively severe pain and pain interferences while being hospitalized and seemed to be well informed regarding pain and pain management. Participants reported high levels of pain management satisfaction. Also, the Arabic version of the APS-POQ was found to be reliable among the Jordanian population. Findings of this study are similar to those reported by earlier studies in other countries and support the need for applying the caring attitude in managing patients' reports of having pain. This study is the first in Jordan, opening the door for future studies to be conducted in this important field.Pain management nursing: official journal of the American Society of Pain Management Nurses 12/2012; 15(1). DOI:10.1016/j.pmn.2012.07.005 · 1.79 Impact Factor
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- "The advent of acute pain teams has improved the overall management of pain in acute settings, most notably in large general hospitals (McDonnell et al. 2003, 2005). Nonetheless, pain management is known to be a significant and recurring source of dissatisfaction for patients (Jensen et al. 2004, Kim et al. 2005, Roth et al. 2005). "
ABSTRACT: Aims and objectives. To examine the relationship between patient satisfaction and the incidence of severe and enduring pain through a health board wide hospital satisfaction questionnaire. Background. The incidence and management of acute postoperative pain and its relationship to patient satisfaction have been of great interest to clinicians over the last 20 years. Evidence suggests that despite many moves to address this problem with the advent of acute pain nurse specialists and dedicated pain teams, severe and enduring pain continues to be a problem. However, patients appear to report high satisfaction levels. Design. The study design was a postal questionnaire the results of which were analysed statistically. Methods. The postal questionnaire was sent to patients who had been discharged from acute hospitals in one health board in the previous two weeks. A total of three large acute hospitals were included. The data were analysed to produce descriptive statistics for all patients on the pain questions and then for patients with severe and enduring pain on the variables of age, gender, ethnic group, responses to pain questions and type of admission. Results. Twenty-six percent of patients reported having pain all or most of the time. Patients suffering from severe and enduring pain were younger females. Conclusion. Acute postoperative pain continues to be a problem, although patients continue reporting moderate satisfaction levels. Relevance to clinical practice. Acute postoperative pain is an ongoing issue for postsurgical patients. It is crucial to understand and recognise issues that can adversely contribute to increased pain severity.Journal of Clinical Nursing 09/2012; 21(23-24). DOI:10.1111/j.1365-2702.2012.04253.x · 1.23 Impact Factor
Conference Paper: Circuit Applications of Uniplanar Compact PBG[Show abstract] [Hide abstract]
ABSTRACT: This paper summarizes several novel two-dimensional periodic structures developed recently at the authors' group, with special emphasis on the uniplanar compact PBG (UC-PBG) structure and its applications. The unique characteristics of the UC-PBG, including low insertion loss, slow wave effect, and wide stopband behavior, are introduced, followed by a number of microwave circuit applications such as spurious-free bandpass filter, leakage elimination in conductor-backed CPW, and harmonic tuner for high power added efficiency amplifier.Microwave Conference, 1999. 29th European; 11/1999