Factors Associated With High Levels of Patient Satisfaction With Pain Management.

Link to article at PubMed

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

Abstract

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]

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