Bedside charting of pain levels in hospitalized patients with cancer: A randomized controlled trial

Abstract

Despite advances in the technology of cancer pain assessment and control, cancer pain often remains undertreated even in hospital settings. To determine whether a graphical display of cancer patients' pain levels might improve their treatment, the investigators conducted a randomized controlled trial. Patients assigned to the intervention group (N = 40) had periodic pain assessments by study staff, who graphically recorded their reported pain-intensity levels on bedside wall charts. Control group patients (N = 38) had periodic pain assessments by study staff but did not have this information displayed. The results failed to show a significant beneficial effect of the intervention on pain control, sleep, cancer-related symptoms, or analgesic dosing, but confidence intervals were broad. More research is needed to improve the quality of care for inpatients with cancer-related pain.

Educational interventions for cancer pain. A systematic review of systematic reviews with nested narrative review of randomized controlled trials

“…With respect to patient educational interventions, four interventions were exclusively applied to hospital inpatients [36,45,48,68]. The remainder targeted outpatients or ambulatory patients within the community.…”

Pain and palliative medicine

“…Kravitz performed a small randomized clinical trial in which two groups of inpatients were assessed regularly for pain, and one group had pain-intensity levels displayed at the bedside. No difference was found in pain control between the groups [87]. SUPPORT study investigators recorded the preferences of patients regarding pain control early in their disease course, as expressed by willingness to be dead rather than be in pain or willingness to have a treatment with shorter survival rather than be in pain, and found that these preferences had no bearing on whether that patient experienced severe pain a few days later in the hospitalization.…”

Pain and its treatment in hospitalized patients with metastatic cancer

“…The problems of pain management in the hospital setting involve, in different ways, nurses [2] as well as physicians [21], and also the discrepancy of pain evaluation between caregivers and patients. Several studies have shown that the regular use of assessment tools for patient pain could improve the caregiver's assistance and reduce patient discomfort [1,3,8]. However, it is difficult to measure the health care provider's response to patient pain because the multidimensional aspects of pain may interfere with the perception of quality of care [16].…”