Correlation between pain relief and patient satisfaction.

Abstract

P is one of the most common complaints in patients referred to the emergency departments (ED). Accurate assessment of pain intensity, which is a necessary prerequisite to rational choice of analgesics, represents a clinically challenging proposition.1 Inadequate pain management is frequently seen in the ED’s. Lack of adequate pain relief remains a major challenge for health care providers. Patient satisfaction is influenced by multiple factors, and it is defined as a personal evaluation of treatment effectiveness, healthcare services and providers, which is subjective. It is important to mention that patient satisfaction at its most basic level does not necessarily reflect what really happened, but rather the patient’s expectations and perceptions of his or her experience from provider, and treatment performance.2 The objective of this study is to measure the correlation between pain relief and patients satisfaction at discharge and 7 days later, in which data were gathered through telephone interview. A prospective, observational study of patients with pain who presented to the ED of Hazrat Rasool Akram Hospital, Tehran, Iran from July 2005 to December 2005 was performed. This ED admits approximately 40,000 patients per year. A consecutive sample of patients presenting with an acute or recent (<3 months) painful injury was included in this study. Exclusion criteria were: patients younger than 18 years of age, and any patient with severe, multiple trauma designated to receive special trauma team care, any patient with altered level of consciousness or psychiatric disorder, and refusal to participate. As survey tool, we utilized the visual analog scale (VAS) 2, both at the admission and discharge time from the ED. In addition, patients were asked how they were satisfied on their pain relief in the ED on a 5 point Likert scale.3 Patients did not have access to their previously marked pain VAS. At the time of discharge, researchers asked the patients if their pain was relieved or not (on a 5 point Likert scale). Responses available on Likert scale were designated as follows: 1 poor, 2 fair, 3 good, 4 very good, 5 excellent. For analysis, satisfaction scores were converted to a binary score (1,2 unsatisfied), and (3,4,5 satisfied). Trained research associates who administered the survey recorded additional information on the patient’s chief complaint, age, gender, and the time from coming to the ED to receiving pain medication (waiting time) on the questionnaire. Patients who agreed for a telephone interview were called 7 days later, if they were satisfied with the care given in the ED, or not. The study was approved by the Ethics Committee of the Faculty of Medicine of the hospital. The results include descriptive statistics, and analysis of differences between means was calculated utilizing the Mann-Whitney method for nonparametric data, and categorical variables were analyzed with Chi square test. A p-value of less than 0.05 was considered significant. Statistical analysis was performed using SPSS version 15 for Windows. During the study period, 800 patients were admitted to the ED, and 641 of these patients (80.2%) complained of acute pain. Out of these, 405 patients had completed the data, and fulfilled the inclusion criteria accurately. Ninety-eight patients (24%) received pain medication with actual waiting time of 24.9 ± 3.9 minutes (95% CI: 17.1-32.6), and 307 patients did not receive any drug. The patients who did or did not receive pain medication were compared regarding pain intensity at the time of presentation and at discharge, and satisfaction at discharge and 7 days later (Table 1). A total of 50.4% of patients reported that their pain was not relieved in the ED. The mean decrease in pain intensity between the time of admission and discharge for patients who did have pain relief was 46.2 mm, or did not have pain relief was 0.8 mm. In our study, only 24% of patients received pain medication with a waiting time of 24.9 ± 3.9 minutes compared to another study, in which 45% of patients Brief Communication

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Cite this paper

@article{Kianmehr2009CorrelationBP, title={Correlation between pain relief and patient satisfaction.}, author={Nahid Kianmehr and Ali Hoseinpoor Rafati and Mani Mofidi and Maziar Moradi and Mohammad Zamanpoor}, journal={Saudi medical journal}, year={2009}, volume={30 10}, pages={1355-6} }