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A Prospective, Blinded Study Comparing In-hospital Postoperative Pain Scores Reported by Patients to Nurses Versus Physicians

Introduction: Referred to as the “fifth vital sign”, pain is unique in that it cannot be obtained accurately by objective measurements. Instead, providers rely on patient-reported scales, such as the numerical rating scale (NRS), to determine a patient’s pain level. Research has shown that patients...

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Autores principales: Foster, Devon, Shi, Glenn, Lesser, Elizabeth, Heckman, Michael G, Whalen, Joseph, Forte, Antonio J, Wilke, Benjamin K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6903882/
https://www.ncbi.nlm.nih.gov/pubmed/31886060
http://dx.doi.org/10.7759/cureus.6122
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author Foster, Devon
Shi, Glenn
Lesser, Elizabeth
Heckman, Michael G
Whalen, Joseph
Forte, Antonio J
Wilke, Benjamin K
author_facet Foster, Devon
Shi, Glenn
Lesser, Elizabeth
Heckman, Michael G
Whalen, Joseph
Forte, Antonio J
Wilke, Benjamin K
author_sort Foster, Devon
collection PubMed
description Introduction: Referred to as the “fifth vital sign”, pain is unique in that it cannot be obtained accurately by objective measurements. Instead, providers rely on patient-reported scales, such as the numerical rating scale (NRS), to determine a patient’s pain level. Research has shown that patients report different pain scores to nurses and physicians in the clinic setting. It is unknown if this also occurs in the acute postoperative period. We hypothesized that patients report similar pain scores to the nursing staff and physician postoperatively. The primary aim of this study was to examine the degree of agreement between these patient-reported pain scores. Methods: A prospective study was conducted on 90 postoperative patients. During rounds, the surgeon collected a patient-reported pain score using the 11-point verbal NRS. Following rounds, the nursing staff obtained a pain score using the same scale. The patient was blinded to the study. Results: The median score reported to both the surgeon and nurses was 3 (range: 0-10), with a median difference of 0 (range: -2.5 to 7). Fifty-four percent of patients reported the same score to both the surgeon and the nurse and 88% of patients reported scores within a 1-point difference. This corresponded to an interclass correlation coefficient of 0.90, indicating very good agreement. The degree of agreement in pain scores reported to surgeons and nurses was consistent according to sex and age. Conclusion: The results of the study demonstrate a high degree of agreement between the pain scores reported by the patients to both the nursing staff and the surgeon postoperatively, with 88% of the scores at most being 1-point different.
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spelling pubmed-69038822019-12-29 A Prospective, Blinded Study Comparing In-hospital Postoperative Pain Scores Reported by Patients to Nurses Versus Physicians Foster, Devon Shi, Glenn Lesser, Elizabeth Heckman, Michael G Whalen, Joseph Forte, Antonio J Wilke, Benjamin K Cureus Pain Management Introduction: Referred to as the “fifth vital sign”, pain is unique in that it cannot be obtained accurately by objective measurements. Instead, providers rely on patient-reported scales, such as the numerical rating scale (NRS), to determine a patient’s pain level. Research has shown that patients report different pain scores to nurses and physicians in the clinic setting. It is unknown if this also occurs in the acute postoperative period. We hypothesized that patients report similar pain scores to the nursing staff and physician postoperatively. The primary aim of this study was to examine the degree of agreement between these patient-reported pain scores. Methods: A prospective study was conducted on 90 postoperative patients. During rounds, the surgeon collected a patient-reported pain score using the 11-point verbal NRS. Following rounds, the nursing staff obtained a pain score using the same scale. The patient was blinded to the study. Results: The median score reported to both the surgeon and nurses was 3 (range: 0-10), with a median difference of 0 (range: -2.5 to 7). Fifty-four percent of patients reported the same score to both the surgeon and the nurse and 88% of patients reported scores within a 1-point difference. This corresponded to an interclass correlation coefficient of 0.90, indicating very good agreement. The degree of agreement in pain scores reported to surgeons and nurses was consistent according to sex and age. Conclusion: The results of the study demonstrate a high degree of agreement between the pain scores reported by the patients to both the nursing staff and the surgeon postoperatively, with 88% of the scores at most being 1-point different. Cureus 2019-11-11 /pmc/articles/PMC6903882/ /pubmed/31886060 http://dx.doi.org/10.7759/cureus.6122 Text en Copyright © 2019, Foster et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pain Management
Foster, Devon
Shi, Glenn
Lesser, Elizabeth
Heckman, Michael G
Whalen, Joseph
Forte, Antonio J
Wilke, Benjamin K
A Prospective, Blinded Study Comparing In-hospital Postoperative Pain Scores Reported by Patients to Nurses Versus Physicians
title A Prospective, Blinded Study Comparing In-hospital Postoperative Pain Scores Reported by Patients to Nurses Versus Physicians
title_full A Prospective, Blinded Study Comparing In-hospital Postoperative Pain Scores Reported by Patients to Nurses Versus Physicians
title_fullStr A Prospective, Blinded Study Comparing In-hospital Postoperative Pain Scores Reported by Patients to Nurses Versus Physicians
title_full_unstemmed A Prospective, Blinded Study Comparing In-hospital Postoperative Pain Scores Reported by Patients to Nurses Versus Physicians
title_short A Prospective, Blinded Study Comparing In-hospital Postoperative Pain Scores Reported by Patients to Nurses Versus Physicians
title_sort prospective, blinded study comparing in-hospital postoperative pain scores reported by patients to nurses versus physicians
topic Pain Management
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6903882/
https://www.ncbi.nlm.nih.gov/pubmed/31886060
http://dx.doi.org/10.7759/cureus.6122
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