Wednesday, 16 August 2017

Do nurses agree when patients say they are in pain?

Roger Watson, Editor-in-Chief

"I was in pain but the nurses did nothing; they didn't take me seriously." How often have we heard things like that from patients? A great deal of research effort and time in clinical practice has been spent by nurses and other researchers developing methods to assess pain to improve assessment and, presumably, patient comfort. But are we any good at it? This is the topic of a study from Belgium by Dequeker et al. (2017) titled: 'Hospitalized Patients’ vs. Nurses’ Assessments of Pain Intensity and Barriers to Pain Managementand published in JAN. The aim of the study was to: 'identify if nurses and patients equally assessed pain intensity and patient-related barriers to pain management in hospitalized patients' and over 500 patients were involved. Over 170 patients completed the same pain rating scale as the nurses responsible for their care. The results showed that nurses only moderately agreed with patients about their pain. As pain intensity reported by the patient increased, nurses were more likely to undersestimate it. Nurses consistently underestimated patients beliefs about pain; for example, patients' beliefs that they were reluctant to take opiod medication. Nurses saw this as less of a problem than patients.

In conclusion, the authors said: 'Nurses should be educated about these beliefs and should be encouraged to actively explore patient-related barriers to pain management with their individual patients. When the nurse knows which barriers are present in a patient, he/she could educate the patient to reduce the barriers of the patient. Routine pain assessments should also be encouraged, because a lot of patients do not always report pain, unless asked. Nurses could also instruct patients in how to use pain assessment scales and wards, or even hospitals, could choose one pain scale and instruct their nurses on its use.'

You can listen to this as a podcast

Reference

Dequeker, S., Van Lancker, A. and Van Hecke, A. (2017), Hospitalized Patients’ vs. Nurses’ Assessments of Pain Intensity and Barriers to Pain Management. J Adv Nurs.  doi:10.1111/jan.13395