Understanding the Paradox of Patient Pain and Patient Satisfaction

Abstract

Pain, in all probability, is the most common symptom experienced by individuals who interact with health care providers. It is understood as a complex and highly individual experience. This complexity is reflected in the paradoxical relationship between patient satisfaction and patient reported pain scores. Using a holistic, caring approach, nurses can optimize the effect of analgesia and facilitate comfort for the person living in pain. Caring for the patient in pain begins with heartfelt compassion and intention to help the person who is suffering. The author describes how the complex relationship and interchange between the patient and the holistic nurse explains the paradox.

Patients' satisfaction with the implementation of the concept of pain as the fifth vital sign to control postoperative pain

“…Studies show that there is a paradox between 's x 2 test) pain and satisfaction with analgesia. Although 50% to 76% of patients referred moderate to severe pain, 75% to 81% of them were happy with pain management 5 . This shows the complexity of such symptom.…”

“…Other studies consider the pain-satisfaction paradox, among them the way patient is taken care of by the team, and the physician-patient relationship. Patients report that the relationship with the nursing team is one of the most important aspects of care 5 . Most studies suggest that it seems to be no correlation between satisfaction and pain control 5,10 .…”

“…This shows the complexity of such symptom. People may be happy with a higher level of pain for several reasons, such as culture and religion 5 . A study reports that local culture tolerates a high pain level and that very often complaints are considered weakenesses 4 .…”

“…In addition to increasing costs and decreasing quality of life, inadequately treated pain may result in inpatients increased morbidity and mortality 1 . Postoperative pain control is critical for patients' integral assistance and its adequate management depends on a correct evaluation 5 . Due to the relevance of this clinical symptom, both the Agency for Healthcare Research and Quality and the American Society of Pain and the Joint Commission on Accreditation on Healthcare Organizations (JCAHO) recommend that, to optimally control pain, it should be regularly and adequately measured and in the same clinical environment of vital signs, being defined as the "fifth vital sign" 6 .…”

“…Due to the relevance of this clinical symptom, both the Agency for Healthcare Research and Quality and the American Society of Pain and the Joint Commission on Accreditation on Healthcare Organizations (JCAHO) recommend that, to optimally control pain, it should be regularly and adequately measured and in the same clinical environment of vital signs, being defined as the "fifth vital sign" 6 . Considering pain as the fifth vital sign is a way to systematize pain perceived by patiens 5 . Pain documentation may, alone, improve communications among professionals assisting patients 7 .…”