Prevalence of pain in public hospital: correlation between patients and caregivers

Abstract

The prevalence of patients suffering pain in hospital is high. This situation is censured during congresses on the study and treatment of pain, which highlight how little consideration the problem is given. Our study, which measured exactly how far pain is underestimated and inappropriately treated, took place as part of the project “Towards a Pain-Free Hospital” in San Bortolo Hospital, Vicenza. Data were collected by means of a questionnaire consisting of 5 questions and 2 numeric scales concerning the presence of pain, its intensity and its causes, and on the type of treatment received. Data were collected for each patient regarding their sex, the ward they were in, the type of analgesics used and how they were taken. Prevalence of pain in this study was 44% (95% CI, 41%–48%). It was higher among women than men (47% vs. 41%), as it was in the 62–72 years age group (49.7%) compared to other age groups and in the surgical wards as opposed to general medicine wards, without there being, however, a significant difference between groups. There was little agreement between patients' perceived pain and nurses' interpretation of their pain (Cohen's k =0.17, 95% CI, 0.09–0.25); these findings show a tendency for caregivers to underestimate the patient's pain. Among those patients in pain, 59% were taking analgesics. Of these, 67% were taking them only on a prn basis, 20% at fixed times and 12% both at fixed times and on a prn basis; 82% were being treated only with non-steroidal anti-inflammatory drugs (NSAIDs), 8% only with opioids, and 3.7% with both. Of the patients using NSAIDs, 72% were taking them on a prn basis, while 86% of those using opioids were taking them according to a fixed schedule. These data are rather disappointing as they indicate a certain negligence towards patients (40% of patient with pain were not treated) and an inappropriate use of analgesics.