Pain prevalence and predictors among inpatients in a major Italian teaching hospital. A baseline survey towards a pain free hospital

Abstract

Pain prevalence among inpatients is an important indicator of quality care; it may reach over 80% in various clinical settings. A cross-sectional survey was conducted in a teaching hospital to depict benchmark data regarding pain prevalence and predictors among the entire inpatient population. Overall 892 patients, 6 years old and hospitalized for at least 24 h in 57 hospital wards were interviewed using an internationally applied questionnaire. Patients self-reported their pain intensity at the time of the interview (T(0)) and worst pain perceived during the previous 24 h (T(-1)), using a numerical rating scale (NRS) and indicated current pain duration. Specific pain predictor data (hospital stay, gender, age and marital status) were obtained from patient medical charts. Pain prevalence at T(0) was 38% and 52% at T(-1). Pain was moderate to severe (NRS4) in approximately 25% of the patients at T(0) and in 40% at T(-1). High pain prevalence was found (at T(0) and T(-1), respectively) in Radiotherapy (63%;77%), Obstetrics (68%;54%), and Surgery (59%;45%) wards. Gender was a prominent determinant as pain was significantly associated with females. Pain prevalence was high among young adults or divorced/separated individuals and low among pediatric patients ( approximately 20%). Protracted hospitalization and prolonged pain duration were associated with major pain severity. Results yield Quality Assurance interventions to ameliorate pain undertreatment. Predictor analysis suggests that attention should be paid to pain management in young adults, socially vulnerable patients and those with protracted hospitalization and pain.

Commentary on ‘Adjusting the pH of lidocaine for reducing pain on injection’

“…The idea of a pain-free hospitalization as a cornerstone of a core set of measures designed to evaluate the quality of health-care delivery and inform quality improvement is becoming a reality in health care (1)(2)(3). Many of these hospital initiatives are directed at post-operative pain, palliative pain and oncologic pain.…”

Dor nas unidades de internação de um hospital universitário

“…Recent literature data has shown that over 50% of hospitalized patients complained of moderate to severe pain in the previous 24 hours, regardless of cause (surgical, neoplastic, traumatic, other) [15][16] . Some authors 9,17 assessed pain at two times of hospital admission, during the interview and the previous 24 hours and found the prevalence of 23%-64% 9 and 38%-52% 17 , respectively. In this study, we found an overall prevalence of 31.8% of pain during the interview (mean of 6.6 in NRS), with strong/severe pain in 44.2% of cases.…”

Opiophobie: état des lieux auprès des soignants à Beira Interior au Portugal

“…Malgré ces progrès, les niveaux de prévalence des douleurs dans les institutions de soins restent pré-occupants, allant de 40 à 80 % selon les lieux [16,23,27,29,30,35,36,46,47].…”