Care‐related pain in hospitalized patients: Severity and patient perception of management

Ambrogi, Vanina; Montcel, Sophie Tezenas du; Collin, E.; Coutaux, A.; Bourgeois, Pierre; Bourdillon, François

doi:10.1002/ejp.549

Cited by 12 publications

(13 citation statements)

References 53 publications

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“…We found that procedural pain was correlated with anxiety before the procedure, a result consistent with the literature about procedural pain, especially in cancer patients [3,7,13,14]. Interestingly, the majority of our sample had bone marrow biopsy for diagnostic purpose, and it is, therefore, possible that they may experience anxiety due to the uncertainty of the results [7,15].…”

Section: Discussionsupporting

confidence: 87%

Management of the Procedural Pain Induced by Bone Marrow Biopsies: An Observational Study

Fawoubo¹,

Tricou²,

Perceau-Chambard³

et al. 2020

ACO

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Introduction: Bone marrow biopsy is an investigation procedure in hematology which might lead to procedural pain. Therefore, our study aimed to assess procedural pain intensity and to identify factors associated with pain experience. Methods: We performed an observational study of consecutive patients who underwent a bone marrow biopsy in a tertiary hospital hematology ward. The pain was assessed using a visual analogue scale (0-100 mm) before, during and after the procedure. We also collected data as premedication strategy, anxiety, physician’s experience and the experience of a previous biopsy. Results: Forty consecutive patients were recruited. The biopsies were mostly performed for diagnostic purposes (45%). Thirty percent had local anesthesia alone and 70% had local anesthesia plus any other medication. The mean pain before the procedure was 9mm (SD=1.7), during 36mm (SD=2.7) and after 9.5mm (SD=1.0). No statistical difference has been shown between the different pain prophylaxis (p=0.622). The level of anxiety before the procedure was significantly correlated with the procedural pain experienced (r2=0.323, p=0.042), while the length of the procedure and previous experience of the procedure were not. Conclusion: This study suggests that bone marrow procedural pain can be improved and highlights several promising mitigation-strategies to address this issue.

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Section: Discussionsupporting

confidence: 87%

Management of the Procedural Pain Induced by Bone Marrow Biopsies: An Observational Study

Fawoubo¹,

Tricou²,

Perceau-Chambard³

et al. 2020

ACO

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“…Patient information was anonymized and de-identified prior to analysis. We defined the levels of pain using the NRS as mild (1-3), moderate (4-6), and severe (7)(8)(9)(10). We listed the demographic data, including gender, age, weight, education, disease categories, and surgical history.…”

Section: Statisticsmentioning

confidence: 99%

“…During a one-day cross-sectional survey of pain prevalence, 59% (554/938) of patients reported pain within the previous 24 hours, while 58% (540/938) had experienced care-related pain within the previous 15 days. Care-related pain happened not only in the internal medicine units but also in the surgical units [10]. In Asia, Xiao et al conducted a 9-week structured and systemic interview to determine the pain prevalence amongst 3,248 patients in a Chinese hospital.…”

Section: Introductionmentioning

confidence: 99%

Pain prevalence in hospitalized patients at a tertiary academic medical center: Exploring severe persistent pain

Hung

Wang

et al. 2020

PLoS ONE

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Objective The pain prevalence of inpatients is not a well-studied medical issue in Asia. We have aimed to evaluate pain prevalence and characterize those patients who have suffered from severe, persistent pain. Methods We investigated pain prevalence using a quota sampling from 19 general wards during the year 2018. Using a structured questionnaire, eight interviewers visited patients at an age ≥ 20 years, and who had been staying in general wards for ≥ 3 days. Those patients were excluded if they were unable to respond to the interview questions. If they reported pain during hospitalization, the maximum pain level and the duration of pain suffered in the past 24 hours were assessed. Care-related pain was also surveyed. Results A total of 1,034 patients (M/F, 537/497) completed the survey. Amongst them, 719 patients (69.5%) experienced pain, with moderate and severe pain levels being 27.3% and 43%, respectively. Surgery was considered as it related to pain, including significantly severe pain. The top 3 care-related pain causes were needle pain, wound dressing, and change in position/chest percussion. Change in position/chest percussion and rehabilitation were associated with severe, persistent pain. Conclusions Pain is common in approximately 70% of inpatients, with surgery being associated with severe pain. Mobilization and rehabilitation may lead to severe, persistent pain. The periodic study of pain prevalence is essential in order to provide precise pain management.

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“…Thus, we selected the most relevant topics from FG analysis to design the content of the questionnaire (eg, the questions asked, the multiple-choice answers submitted) and added some new items about the PARO robot. The final 18-item questionnaire was structured in three sections: Painful situations and pain indicators in dementia: participants were asked to indicate daily painful situations in PwD among seven preselected items based on FG analysis and results from the literature,4,33,34 and to choose the most prevalent and most important indicators for the detection of pain in dementia.Feasibility of assessment tools: two pain measurement instruments were selected according to their psychometric proprieties, the ALGOPLUS ® scale35 and the PAINAD ® scale,36 and then submitted to participants, who were requested to indicate their level of agreement with four feasibility dimensions (ease of administration, understanding of the statements, availability of a validated French translation, time taken to administer the instrument) with a four-point Likert-type scale. These feasibility aspects were chosen according to the recommendations of a European consensus on outcome measures for psychosocial research in dementia care 37…”

Section: Methodsmentioning

confidence: 99%

“…Painful situations and pain indicators in dementia: participants were asked to indicate daily painful situations in PwD among seven preselected items based on FG analysis and results from the literature,4,33,34 and to choose the most prevalent and most important indicators for the detection of pain in dementia.…”

Section: Methodsmentioning

confidence: 99%

<p>Management of acute pain in dementia: a feasibility study of a robot-assisted intervention</p>

Demange¹,

Pino²,

Kerhervé³

et al. 2019

JPR

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Background: The management of pain is particularly challenging in patients with moderate to severe dementia owing to the loss of communication ability or underlying causes such as behavioral symptoms. It is often associated with health care professionals’ frustration and feeling of helplessness. The present study determined a framework and examined the feasibility of an innovative intervention using the PARO ® robot for the management of acute pain in dementia. Method: A mixed-methods research design combining qualitative (five focus groups) and quantitative (questionnaire survey) approaches was used to define the intervention framework. We recruited 57 health care professionals from various medical and paramedical specialties (eg, nursing auxiliaries, nurses, physicians, psychologists) and with expertise in gerontology. The feasibility of the intervention was subsequently assessed with 12 patients suffering from dementia in painful situations to validate the procedure. Results: Four main issues have been addressed: 1) the identification of a core group of painful situations associated with care (washing, dressing/change, transfer/mobilization), currently considered as inefficiently managed; 2) the selection of an appropriate assessment methodology including criteria and tools for pain evaluation; 3) the definition of health professionals' training needs and organizational requirements for their implementation; and 4) the perceived usefulness of a robot-assisted intervention for the management of pain in dementia in daily practice. The feasibility study showed that the predefined intervention framework was applicable and acceptable for the majority of professionals and patients. Conclusion: A consistent and feasible intervention framework for the management of painful situations associated with care in dementia using the PARO robot was defined. Understanding of professionals’ needs, opinions and perceived obstacles regarding the intervention was a useful step in the preparation of the forthcoming clinical trial.

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Care‐related pain in hospitalized patients: Severity and patient perception of management

Abstract: Our results of a survey of pain management in hospitalized patients relate to a wide variety of medical conditions and procedures. Health-care workers should be more systematic in managing CRP, and attention should be paid to patients at greatest risk of severe CRP.

Cited by 12 publications

References 53 publications

Management of the Procedural Pain Induced by Bone Marrow Biopsies: An Observational Study

Management of the Procedural Pain Induced by Bone Marrow Biopsies: An Observational Study

Pain prevalence in hospitalized patients at a tertiary academic medical center: Exploring severe persistent pain

<p>Management of acute pain in dementia: a feasibility study of a robot-assisted intervention</p>

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