The prevalence of pain at pressure areas and pressure ulcers in hospitalised patients

Abstract

BackgroundPatients with pressure ulcers (PUs) report that pain is their most distressing symptom, but there are few PU pain prevalence studies. We sought to estimate the prevalence of unattributed pressure area related pain (UPAR pain) which was defined as pain, soreness or discomfort reported by patients, on an “at risk” or PU skin site, reported at a patient level.MethodsWe undertook pain prevalence surveys in 2 large UK teaching hospital NHS Trusts (6 hospitals) and a district general hospital NHS Trust (3 hospitals) during their routine annual PU prevalence audits. The hospitals provide secondary and tertiary care beds in acute and elective surgery, trauma and orthopaedics, burns, medicine, elderly medicine, oncology and rehabilitation. Anonymised individual patient data were recorded by the ward nurse and PU prevalence team. The analysis of this prevalence survey included data summaries; no inferential statistical testing was planned or undertaken. Percentages were calculated using the total number of patients from the relevant population as the denominator (i.e. including all patients with missing data for that variable).ResultsA total of 3,397 patients in 9 acute hospitals were included in routine PU prevalence audits and, of these, 2010 (59.2%) patients participated in the pain prevalence study. UPAR pain prevalence was 16.3% (327/2010). 1769 patients had no PUs and of these 223 patients reported UPAR pain, a prevalence of 12.6%. Of the 241 people with pressure ulcers, 104 patients reported pain, a UPAR pain prevalence of 43.2% (104/241).ConclusionOne in six people in acute hospitals experience UPAR pain on ‘at risk’ or PU skin sites; one in every 8 people without PUs and, more than 2 out of every five people with PUs. The results provide a clear indication that all patients should be asked if they have pain at pressure areas even when they do not have a PU.

Exploring the role of pain as an early predictor of category 2 pressure ulcers: a prospective cohort study

“…8 To determine if patients had localised skin pain on any pressure area skin site, they were asked two screening questions with yes or no responses: (1) at any time, do you get pain, soreness or discomfort at a pressure area (prompt: back, bottom, heels, elbows or other as appropriate to the patient)? and (2) do you think this is related to either; your PU OR lying in bed for a long time OR sitting for a long time?7 8…”

“…8 We conducted two large multicentre prevalence surveys in the hospital8 and community7 setting. It was identified that 12.6% (233/1769) of hospital patients with no observable PUs reported pressure area related pain.…”

The prevalence of pressure ulcers in community‐dwelling older adults: A study in an Indonesian city

“…Pressure ulcers (PUs) are a serious problem in health care settings globally. A PU is “a localized injury to the skin and/or the underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear.” PUs cause considerable patient suffering from pain, affect the patient's quality of life emotionally, physically, and socially, and even put patients at increased risk of death . In addition, PUs lead to an economic burden on health care systems …”

Promoção Da Saúde E Prevenção Da Lesão Por Pressão: Expectativas Do Enfermeiro Da Atenção Primária

“…However, international studies have an incidence ranging from 4.5% to 25.2% (United Kingdom), and a prevalence of 2.9% to 8.34% (Spain), 14.8% (England) and 19.1% (USA) in home care. [2][3][4][5] As regards to Brazil, there are few studies on the prevalence and incidence of the disease, however, with regard to home care, there are studies which showed a 41.2% to 59% risk for the development of pressure injury and a prevalence of between 8% and 23%, this is a cause for concern as it is something which can be prevented in up to 95% of cases, as determined by the Rio de Janeiro Declaration on the Prevention of Pressure Injury. [6][7][8][9][10] It is known that care for people with pressure injuries should occur in high and medium complexity health services, as well as Primary Health Care (phc), under the care of the Family Health Team (ESF), which refers to the establishment of guidelines which guide the practice of prevention, with the need to move towards health promotion actions.…”