Patient Perceptions of Pain Management Therapy: A Comparison of Real-Time Assessment of Patient Education and Satisfaction and Registered Nurse Perceptions
Anesthesia Pain Service, Huron Valley Sinai Hospital-Detroit Medical Center, Commerce, Michigan. Electronic address: .Pain management nursing: official journal of the American Society of Pain Management Nurses (Impact Factor: 1.53). 12/2012; 13(4):186-93. DOI: 10.1016/j.pmn.2010.04.004
Nurses must have an understanding of their patients' perception to assist in meeting analgesic goals. Adequate patient teaching is essential. The value of a simplified tool to assess patients' satisfaction has not been widely examined. This study examined if nurses' perceptions of their patients' satisfaction with pain management are congruent with patients' self-report, and if patients' level of satisfaction corresponds with the type of therapy used and adequacy of teaching related to their pain management plan. Data were collected though a survey in a community hospital. It was designed as an evaluative study of the variables in two nursing units and as a pilot study of the survey tool. Ratings of patient satisfaction by nurses (3.8 ± 0.88 [mean ± SD]) were similar to patients' self-ratings (4.08 ± 1.06). Higher self-report of pain (visual analog scale 4.00 ± 2.22) was associated with lower levels of satisfaction (3.80 ± 0.881). Patients reporting adequate teaching rated a higher satisfaction score (4.46) than patients reporting inadequate teaching [3.59; t (48) = -3.12; p = .003]. Patients receiving intravenous analgesia as needed had higher pain VAS scores (4.74) than patients receiving other analgesia protocols [3.37; t(48) = -2.26; p = .028]. Measuring patient satisfaction has become critical in evaluating adequacy of treatment. Factors that affect patients' satisfaction with pain management include the adequacy of teaching they receive and the type of therapy they are provided. A simple survey can be a useful tool in measuring satisfaction.
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ABSTRACT: Aim. To explore nurses’ and patients’ perceptions of care during main events of hospitalisation. Background. Main events during hospitalisation such as admission, transfer to the operation room and preparation for discharge have been identified as times when there is significant patient–caregiver interaction. It is during these interactions that there is an opportunity for the nurse to have a positive influence on the patient’s satisfaction with care. The patient’s perception of care has been studied but not qualitatively. Perceptions of care from the nurses’ perspectives have not been well studied. This study explored the patient’s perception of care as well as the nurse’s perception of the care he provided. Design. This study used an ethnographic methodology that included participant observation and unstructured interviews. Method. The research was conducted in two phases. First, participant observation was chosen to observe and understand nurse–patient and nurse–family behaviour. The second phase was an unstructured interview to elicit both the patient’s and the nurse’s views about the care experience. Results. Two major findings were the patient and the nurse had different perceptions of the care experience and the presence of family or a support person influenced the patient’s perception of care. Conclusion. The use of ethnography proved to be a valuable methodology for studying the interactions of patients, families and nurses. Qualitative methods such as ethnography can yield significant findings on perceptions that are unable to be gleaned by traditional quantitative methods but can serve to provide hypotheses for further study. Relevance to clinical practice. This study suggests that to maintain quality and patient satisfaction scores, hospitals will need to focus on the difference between the perceived care given and the perceived care received particularly during main events. The role of families and visitors supports positive perceptions of care.
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ABSTRACT: 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. 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. 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. 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). 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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ABSTRACT: Acute postoperative pain is still inadequately managed, despite the presence of acute pain services (APSs). This study aimed to investigate the existence, structure, and responsibilities of Dutch APSs and to review the implementation of the Dutch Hospital Patient Safety Program (DHPSP). Information was gathered by a digital questionnaire, sent to all 96 Dutch hospitals performing surgical procedures. Completed questionnaires were received from 80 hospitals (83%), of which 90% have an APS. Important duties of the APS are regular patient rounds, checking complex pain techniques (100%), supporting quality improvement of pain management (87%), pain education (100%), and pain research (21%). Regular in-hospital pain training is not provided in 46% of the hospitals. Thirteen percent of the hospitals offer no patient information about pain management. Almost all hospitals have an APS. They differ in both the way they are locally organized, along with the activities they employ. Future research needs to compare the effect of patient and nonpatient-related activities of APSs on outcomes related to pain management.
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