Pain management: evaluation of practices adopted by health professionals of a secondary public hospital

Nascimento, Leonel Alves do; Cardoso, Mariana Guimarães; Oliveira, Samuel Andrade de; Quina, Eliane; Sardinha, Denise da Silva Scaneiro

doi:10.5935/1806-0013.20160019

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ORIGINAL ARTICLES • Rev. dor 17 (2) • Apr-Jun 2016 • https://doi.org/10.5935/1806-0013.20160019 copy

Pain management: evaluation of practices adopted by health professionals of a secondary public hospital

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Pain is the primary reason for looking for healthcare services. So, this study aimed at knowing healthcare professionals practices with regard to managing pain in a secondary public hospital of the Northern region of Paraná.

METHODS:

This is a descriptive and exploratory study with quantitative approach, carried out from March to May 2015 by means of a semi-structured questionnaire. Participated in the study 112 healthcare professionals (nurses, physicians, physiotherapists and nursing technicians). Data were analyzed by basic descriptive statistics.

RESULTS:

Pain was a vital sign for 88.4% of professionals; however only 18.8% have reported having some pain evaluation scale as working material. Pain is always recorded on medical charts by 49.1% of professionals. Difficulties to evaluate pain were reported by 46.4%. With regard to drug administration, 27 (24.2%) professionals have reported having some difficulty to administer drugs to patients. For 48.2%, patients must have moderate pain to receive analgesics. Half professionals have never participated in specific pain training courses and 73.2% have answered that patients lie when reporting pain presence and intensity.

CONCLUSION:

Deficiencies which may impair adequate pain management were observed. The lack of specific qualification regarding pain may lead professionals to ineffective approaches, often prolonging patients' distress.

Keywords:
Analgesia and pain measurement; Health attitudes and practice; Knowledge; Pain management

Questions	Categories of answers	# of quotes	%
How do you identify pain?	Behavioral aspects: face expression, tone of voice, weeping, way of acting	83	40.1
	By means of patients’ passive report about pain	51	24.6
	Clinical and physiologic aspects: sweating, tachycardia, hypertension, injury/harm diagnosis and classification	39	18.8
	By means of action asking about presence of pain	17	08.2
	Using pain evaluation scales	17	08.2
Total		207	100
How do you evaluate pain intensity?	Using pain intensity scales	44	28.2
	By means of patients’ verbal report using descriptors: mild, moderate or severe	41	26.3
	Observing and evaluating behavioral aspects: weeping, posture, expressions	38	24.4
	Observing clinical aspects: vital signs	22	14.1
	Observing frequency of complaints	06	03.8
	Observing patients’ diagnoses	05	03.2
Total		156	100
What do you record about pain evaluation?	Intensity	85	21.5
	Site	102	25.8
	Type	61	15.4
	Carried out interventions	82	20.8
	Improvement after analgesia	65	16.5
Total		395	100
Which are your difficulties in evaluating pain?	Knowing whether report is true or false	20	44.4
	Subjectivity of pain evaluation	12	26.7
	Patient-related aspects: non-communicating, confuse, psychiatric	10	22.2
	Lack of specific knowledge	03	06.7
Total		45	100
Which are your difficulties in administering analgesics?	Difficulties with medical prescription: no analgesia, delay in prescribing	11	40.7
	Lack of the drug in the institution	05	18.5
	Inadequate prescription with regard to pain: insufficient analgesia	04	14.8
	Doses and intervals between them	03	11.1
	Lack of controlled prescription form for psychotropic drugs	02	07.4
	Decide which analgesic to use	01	03.7
	Rarely used or new drugs	01	03.7
Total		27	100
Do you evaluate painafter administering analgesics?	Yes, always	50	44.6
	Yes, most of the times	51	45.5
	Yes, sometimes	05	04.5
	No answer	03	02.7
	No	03	02.7
Total		112	100

Frequency	n	%
Never	03	02.7
Yes, rarely	15	13.4
Yes, sometimes	82	73.2
Yes, most of the times	08	07.1
Yes, always	02	01.8
No answer	02	01.8
Total	112	100

Frequency	n	%
Improve patient-professional interaction	109	49.3
Training, ongoing information and education	70	31.7
Implement Pain Management Committee, Clinical Protocols, Standardized Scales	13	05.9
Standardize available analgesics	11	05.0
Standardize medical prescription of analgesia	07	03.2
Increase the frequency of medical revaluations	06	02.7
Increase the number of health professionals	04	01.8
Expedite analgesic administration to painful patients	01	00.5
Total	221	100

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[1] Correspondence to: Rua Odilon Braga, 199 - Conjunto Sebastião de Melo 86084-600 Londrina, PR, Brasil. E-mail: leonel_lan@hotmail.com