Factors Associated With High Levels of Patient Satisfaction With Pain Management.
Acad Emerg Med. 2012 Oct 4;
Authors: Shill J, Taylor DM, Ngui B, Taylor SE, Ugoni AM, Yeoh M, Richardson J
ACADEMIC EMERGENCY MEDICINE 2012; 19:000-000 © 2012 by the Society for Academic Emergency Medicine ABSTRACT: Objectives:? The objective was to determine, among emergency department (ED) patients, the factors associated with a high level of satisfaction with pain management. Methods:? This was a prospective cohort study in a single ED. Consecutive adult patients, with triage pain scores of ?4 (numerical rating scale?=?0 to 10), were enrolled. Variables examined included demographics, presenting complaint, pain scores, nurse-initiated analgesia, analgesia administered, time to first analgesia, specific pain communication, and whether "adequate analgesia" was provided (defined as a decrease in pain score to <4 and a decrease from the triage pain score of ?2). The level of patient satisfaction with their pain management (six-point scale: very unsatisfied to very satisfied) was determined by a blinded investigator 48?hours post discharge. Logistic regression analyses were undertaken. Results:? Data were complete for 476 patients: mean (±standard deviation [SD]) age was 43.6 (±17.2) years, and 237 were males (49.8%, 95% confidence interval [CI]?=?45.2% to 54.4%). A total of 190 (39.9%, 95% CI?=?35.5% to 44.5%) patients were "very satisfied" with their pain management, and 207 (43.5%, 95% CI?=?39.0% to 48.1%) patients received adequate analgesia. Three variables were associated with the patient being very satisfied: the provision of adequate analgesia (odds ratio [OR]?=?7.8, 95% CI?=?4.9 to 12.4), specific pain communication (OR?=?2.3, 95% CI?=?1.3 to 4.1), and oral opioid administration (OR?=?2.0, 95% CI?=?1.1 to 3.4). Notably, the provision of nurse-initiated analgesia to 211 patients (44.3%, 95% CI?=?39.8% to 48.9%) and the short time to analgesia (median?=?11.5?minutes; interquartile range [IQR]?=?2.0 to 85.8?minutes) were not associated with being very satisfied. Conclusions:? The receipt of adequate analgesia (as defined) is highly associated with patient satisfaction. This variable may serve as a clinically relevant and achievable target in the pursuit of best-practice pain management.
PMID: 23035970 [PubMed - as supplied by publisher]