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Numeric rating scale: patients' perceptions of its use in postoperative pain assessments
Jönköping University, School of Health and Welfare, HHJ. ADULT. Ryhov Hospital.
Jönköping University, School of Health and Welfare, HHJ. ADULT. Ryhov Hospital.
Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
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2014 (English)In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 27, no 1, 41-46 p.Article in journal (Refereed) Published
Abstract [en]

Aim

The purpose of this study was to describe how patients perceive the use of the numeric rating scale in postoperative pain assessments.

Background

There are recommendations to use a pain scale to follow patients' postoperative pain. Most patients prefer the NRS but there is a discrepancy between patients and healthcare professionals how to interpret the ratings from the pain assessments.

Methods

A descriptive design with a phenomenographic approach was used. Semi structured interviews were held with 25 patients.

Results

Three description categories emerged that illustrate patients' perceptions; use of the NRS facilitated communication of pain, it put demands on healthcare professionals and care routines and it contained interpretation difficulties.

Conclusion

The NRS has a place in pain management according to the patients but there is a need for a dialogue to give the patients the opportunity to describe their pain and set a common goal.

Place, publisher, year, edition, pages
2014. Vol. 27, no 1, 41-46 p.
Keyword [en]
Pain scale; Pain assessment; Postoperative pain; Patients' perceptions
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-25838DOI: 10.1016/j.apnr.2013.10.006ISI: 000331019400005PubMedID: 24332467Scopus ID: 2-s2.0-84892984387OAI: oai:DiVA.org:hj-25838DiVA: diva2:786155
Available from: 2015-02-04 Created: 2015-02-04 Last updated: 2017-04-10Bibliographically approved
In thesis
1. Postoperative pain assessment and impact of pain on early physical recovery, from the patients' perspective
Open this publication in new window or tab >>Postoperative pain assessment and impact of pain on early physical recovery, from the patients' perspective
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Pain is a common postoperative experience. Guidelines recommend performing regular pain assessments, which include self-rated pain and additional communication to capture patients' experiences. During hospitalisation, pain intensity is found to be a vital factor influencing other aspects of an early physical recovery, and is consequently an important item in questionnaires for recovery. These tools consist of extensive questionnaires which are difficult to use in everyday clinical work. A simplified method of monitoring postoperative recovery would benefit both patients and healthcare professionals.

Aim: The overall aim of this thesis was twofold: (A) to determine the ability of extending the use of pain ratings to reflect and predict early physical postoperative recovery and (B) to describe patients’ perspectives on pain assessments.

Methods: The studies were carried out at one (I), three (IV) and four hospitals (II, III) involving general surgical and orthopaedic inpatients. Two quantitative methods were used based on data from questionnaires and medical records. They consisted of one cross-sectional study (I) and one study with repeated measures (IV). An association was sought between pain intensity and postoperative recovery on days 1 and 2 (I, IV), and prehospital data (IV). Two qualitative methods were used involving a phenomenographic (III) approach and Critical Incident Technique (IV), where semi-structured interviews were performed postoperatively and analysed inductively in accordance with the approach.

Results: An association was found between moderate/severe average pain intensity compiled from monitoring records and impact on early physical postoperative recovery on day 1 (I). Retrospective average pain intensity at rest and during activity reflected impact on recovery on postoperative day 1 (IV). Severe pain intensity at rest and during activity on postoperative day 1 predicted impact on physical recovery items on day 2 (IV). The use of the Numeric Rating Scale (NRS 0-10) was considered to facilitate communication about pain, but to involve difficulties of interpretation and place demand on healthcare professionals and care routines (II). Patients’ descriptions of their experiences when in need of describing pain indicated two main areas: patients’ resources when needing to describe pain and ward resources for performing pain assessments (III). Descriptions of their actions when they were in pain indicated two main areas: patients used active strategies when needing to describe pain or patients used passive strategies when needing to describe pain (III).

Conclusions: This thesis contributes to knowledge about the possibility of using patients' self-rated average pain intensity to reflect early physical postoperative recovery on day 1 and to predict recovery on the following day. The pain scale gave patients and healthcare professionals a shared vocabulary, which facilitated communication. Furthermore, dialogue during pain assessments was described as critical in ascertaining whether pain intensity had an impact on different aspects of physical recovery. Environmental factors such as the attitude of healthcare professionals, workload and staffing influenced how pain assessments were performed.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2017. 77 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 080
Keyword
pain assessment, pain intensity, pain scale, physichal recovery, postoperative care
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-35346 (URN)978-91-85835-79-9 (ISBN)
Public defence
2017-05-10, Forum Humanum, School of Health and Welfare, Jönköping, 13:00 (English)
Opponent
Supervisors
Available from: 2017-04-20 Created: 2017-04-10 Last updated: 2017-04-12Bibliographically approved

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