Elsevier

Joint Bone Spine

Volume 70, Issue 5, September 2003, Pages 362-366
Joint Bone Spine

Original article
Pain management in a rheumatology department: a satisfaction survey

https://doi.org/10.1016/S1297-319X(03)00045-9Get rights and content

Abstract

Objectives. – To evaluate the quality of pain management in a teaching hospital rheumatology department.

Methods. – We conducted a satisfaction survey among all the patients admitted to the conventional rheumatology department of our teaching hospital over a 1-month period (88 patients with a mean length of stay of 5 d). The patients were asked to complete a questionnaire on the day of discharge. The professional staff was not informed of the survey.

Results. – The mean pain severity score at admission (visual analog scale, VAS) was 7.76 ± 1.76 and the mean score decrease with treatment was 7.27 ± 2.81. Expected pain relief and actual pain relief were correlated (R = 0.39; P = 0.001). Nearly all the patients (96.1%) reported have been encouraged to communicate about their pain. Information on the treatment was given to 89.3% of the patients; no significant differences in pain severity or pain relief were found between the patients who did and did not receive this information. The patients were satisfied with their management by the physicians (VAS: 8.83 ± 2.07) and nurses (VAS: 8.68 ± 1.72).

Conclusion. – Satisfaction with pain management (a subjective criterion) was good in our patients. However, no validated tools for measuring satisfaction are available, and measurements should be repeated to look for improvements over time. Limitations to these results include the placebo effect, the influence of memory, and the effects of the behavior of hospitalized patients. A repeat survey is needed.

Introduction

Quality assurance efforts in the area of pain management consist of a set of principles and methods used to establish pain management protocols within a department, to monitor their application, and to evaluate the benefits they provide to patients [1].

In France, centers for pain evaluation and treatment focus mainly on patients with chronic pain. Pain in postoperative patients is handled by the members of surgical teams, most notably anesthesiologists [2], [3]. Pain management is not evaluated in rheumatology departments, although pain is the most common reason for inpatient rheumatology care.

The objective of this study was to evaluate the quality of pain management in our rheumatology department, using three criteria: pain relief, quality of information, and satisfaction.

Section snippets

Survey

We evaluated satisfaction with pain management in patients admitted to the rheumatology department of the Lille Teaching Hospital, Lille, France, during a 1-month period (March to April) in 1999. All patients admitted to the conventional rheumatology unit during the study period were included in the study. The healthcare staff was not informed of the study. A questionnaire was given to each patient on the day of discharge. The questionnaire items are listed below.

  • 1.

    Pain severity at admission

Results

From March 1999 to April 1999, 88 patients, 49 women and 39 men, were admitted to the conventional rheumatology unit. Of these, 76 completed the questionnaire. Mean age was 56.8 years for the women and 54.4 years for the men. Reasons for admission included acute and chronic rheumatic conditions: eight patients had infections (septic arthritis or discitis), four had metastatic disease, 24 had chronic inflammatory joint disease, 24 had low back pain with nerve root pain (acute in 12 cases and

Discussion

This survey evaluated pain management in patients admitted to a rheumatology department.

Satisfaction is a subjective feeling that influences behavior and is dependent on the patient’s experience and history. According to expectation theory, the degree of satisfaction expresses the match between what is expected and what is perceived [4]. There are no standardized tools capable of measuring satisfaction accurately. Consequently, both our results and the data in the literature should be

Conclusion

Although the evaluation tool used in this study needs improvement, it provides information that can be used to develop actions aimed at improving analgesic treatment. In this study, it gave additional information on the pain experience of patients, while strengthening relationships among physicians, patients, nurses, and nurse assistants and shedding light on the various factors that affect patient satisfaction or dissatisfaction.

References (29)

  • Guide pour la mise en place d'une démarche qualité à l'hôpital. Paris

    (1995)
  • Poisson et al.

    Audit de la prise en charge de la douleur post opératoire

    La Presse Médicale

    (1996)
  • F. Larue et al.

    Développement d'un programme d'assurance qualité de l'analgésie postopératoire. Evaluation et traitement de la Douleur

  • Staines A. La gestion des attentes de la population à l’égard du système de santé :actions possibles de la part des...
  • Cited by (7)

    • Jordanian Patients' Satisfaction with Pain Management

      2014, Pain Management Nursing
      Citation Excerpt :

      Nowadays, health care institutions are focusing on patient satisfaction with pain management, which has become an important criterion for assessing quality of care (Beck, Towsley, Berry, Lindau, Field, & Jensen, 2010; Carlson, Youngblood, Dalton, Blau, & Lindley, 2003), and for pain prevention and relief (Dihle, Helseth, Kongsgaard, Paul, & Miaskowski, 2006). Patient satisfaction with pain management is a complex hypothetical construct, which is reflected in patient behaviors such as trust and confidence in health care providers (HCPs), expressing pleasant feelings, reduction of reported level of pain, and improved activity level (Louville et al., 2003; McCracken, Klock, Mingay, Asbury, & Sinclair, 1997). Patient satisfaction with pain management is an important part of the general patient satisfaction that HCPs are seeking, which can be influenced by different factors, including effectiveness of medications administered for pain control, HCPs' communication, and discussion of pain management approaches (Beck et al., 2010; Panteli & Patistea, 2007), preoperational explanation and information (Niemi-Murola et al., 2007), and HCPs' empathic care (Raftopolous, 2005).

    • Localized synovial hypertrophy in the anteromedial compartment of the osteoarthritic knee

      2005, Arthroscopy - Journal of Arthroscopic and Related Surgery
    View all citing articles on Scopus
    View full text