Level of Perceived Satisfaction with Acute Pain Management among the Patients with Fracture of Long Bones in Teaching Hospital Jaffna

Abstract

Introduction Pain is an unpleasant sensation that has to be managed properly. In fracture patients, effective pain management plays a major role in their treatment. Although much efforts are put in by the doctors, there is uncertainty about the level of satisfaction with acute pain management. We hope to assess the level of satisfaction with acute pain management among fracture patients and the results could be used to improve the level of satisfaction in the future. Objectives To assess the level of perceived satisfaction with acute pain management and associated socio-demographic and health related factors among patients with long bones fractures in surgical casualty ward of Teaching Hospital Jaffna. Methodology An institutional based descriptive cross-sectional study was conducted at ward 24, Teaching Hospital, Jaffna. This study was conducted from October 2020 to March 2021. Data was collected through interviewer-administrated questionnaires from patients above 12 years of age with fractures of long bones who had undergone management within 12 hours of admission and analyzed with SPSS 21 (T-test and ANOVA). Femoral neck, intertrochanteric, subtrochanteric and femoral head fractures were grouped as hip fractures for ease of analysis. Perceived satisfaction score was calculated according to the participant’s answers to 11 Likert scale questions which were selected from The Pain Treatment Satisfaction Scale (PTSS), each scoring from 0 to 3. (Overall score 0 to 33) Numerical pain scale was used to assess the level of pain. Results Among 120 study participants, 70 were male and 50 were female. The median pain score immediately after fracture was 8, one hour after analgesic administration was 5 and after non-medical intervention following analgesic administration was 4. There was a significant association with the patient’s satisfaction and time taken for initial administration of analgesics (p=0.46), site of fracture (clavicle p=0.005) and type of non-medical intervention (pop cast p=0.049, intervention p=0.011). There were no significant association between patient’s perceived satisfaction with gender (p=0.218), age category (p=0.935), educational level (p=0.130), marital status (p=0.095), past medical history (p=0.957) and past surgical history (p=0.227). Conclusion Majority of the patients were satisfied with the acute pain management. Early onset analgesics administration & non-medical interventions and lower level of patient’s expectation regarding pain management in our community were the reasons for higher overall satisfaction.