Evaluation of the pain intensity differences among hospitalized cancer patients based on a nursing information system


Autoři: Wei-Yun Wang aff001;  Chi-Ming Chu aff003;  Yi-Syuan Wu aff004;  Chun-Sung Sung aff005;  Shung-Tai Ho aff007;  Hsueh-Hsing Pan aff008;  Kwua-Yun Wang aff009
Působiště autorů: Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan aff001;  School of Nursing, National Defense Medical Center, Taipei, Taiwan aff002;  School of Public Health, National Defense Medical Center, Taipei, Taiwan aff003;  Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan aff004;  Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan aff005;  School of Medicine, National Yang-Ming University, Taipei, Taiwan aff006;  Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan aff007;  School of Nursing, National Defense Medical Center, Taipei, Taiwan aff008;  Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan aff009;  School of Nursing, National Defense Medical Center, Taipei, Taiwan aff010
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222516

Souhrn

Evaluating the absolute difference in pain intensity and the percentage difference in pain intensity could facilitate an understanding of pain reduction among cancer patients during repeated hospitalizations. Examinations of the absolute differences in pain intensity and the percentage differences in pain intensity according to the worst pain intensity and last evaluated pain intensity before discharge are lacking. The aim of this study was to evaluate the absolute and percentage difference in pain intensities among cancer patients with moderate or severe pain from their 1st to 18th hospitalizations from 2011–2013. A population-based retrospective cohort study was conducted. Pain intensity was assessed using scales and was recorded in a nursing information system. The absolute and percentage difference in pain intensities were examined via the one-sample Kolmogorov-Smirnov test, and group differences in moderate or severe pain were evaluated with the Mann-Whitney U test. For moderate pain patients, the mean absolute difference in pain intensity was 1.52, and the percentage difference in pain intensity was 29.0%; both these values were significant. More significant changes in the absolute and percentage difference in pain intensities were associated with severe pain patients. Both the average absolute difference in pain intensity (3.09) and the percentage difference in pain intensity (38.5%) in patients with severe pain were significantly higher than the average absolute difference in pain intensity (1.52) and the percentage difference in pain intensity (29.0%) in patients with moderate pain. Cancer patients with moderate and severe pain experienced pain reductions of approximately 30% and 40%, respectively. Early pain management intervention in patients with severe pain is necessary to achieve an obvious analgesic effect, and the formula of the percentage difference in pain intensity should be incorporated into the nursing information system to alert clinicians for early detection of the effectiveness of cancer pain management.

Klíčová slova:

Analgesics – Cohort studies – Hospitalizations – Charts – Inpatients – Nurses – Oncology – Pain management


Zdroje

1. Chauny JM, Paquet J, Lavigne G, Daoust R. Percentage of pain intensity difference on an 11-point numerical rating scale underestimates acute pain resolution. Eur J Pain. 2014;18: 1103–1111. doi: 10.1002/j.1532-2149.2014.00452.x 24449521

2. Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar JT, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain. 2008;9: 105–121. doi: 10.1016/j.jpain.2007.09.005 18055266

3. Farrar JT, Polomano RC, Berlin JA, Strom BL. A comparison of change in the 0–10 numeric rating scale to a pain relief scale and global medication performance scale in a short-term clinical trial of breakthrough pain intensity. Anesthesiology. 2010;112: 1464–1472. doi: 10.1097/ALN.0b013e3181de0e6d

4. Paice JA, Cohen FL. Validity of a verbally administered numeric rating scale to measure cancer pain intensity. Cancer Nurs. 1997;20: 88–93. 9145556

5. Voepel-Lewis T, Zanotti J, Dammeyer JA, Merkel S. Reliability and validity of the face, legs, activity, cry, consolability behavioral tool in assessing acute pain in critically ill patients. Am J Crit Care. 2010;19: 55–61; quiz 62. doi: 10.4037/ajcc2010624 20045849

6. Dobscha SK, Morasco BJ, Kovas AE, Peters DM, Hart K, McFarland BH. Short-term variability in outpatient pain intensity scores in a national sample of older veterans with chronic pain. Pain Med. 2015;16: 855–865. doi: 10.1111/pme.12643 25545398

7. Costa WA, Monteiro MN, Queiroz JF, Gonçalves AK. Pain and quality of life in breast cancer patients. Clinics (Sao Paulo). 2017;72: 758–763.

8. Bhatia R, Gibbins J, Forbes K, Reid C. "We all talk about it as though we’re thinking about the same thing." Healthcare professionals’ goals in the management of pain due to advanced cancer: a qualitative study. Support Care Cancer. 2014;22: 2067–2073. doi: 10.1007/s00520-014-2191-6 24633591

9. van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 2007;18: 1437–1449. doi: 10.1093/annonc/mdm056 17355955

10. Wang WY, Ho ST, Wu SL, Chu CM, Sung CS, Wang KY, et al. Trends in clinically significant pain prevalence among hospitalized cancer patients at an academic hospital in Taiwan: a retrospective cohort study. Medicine (Baltimore). 2016;95: e2099.

11. Li TY, Hsieh JS, Lee KT, Hou MF, Wu CL, Kao HY, et al. Cost trend analysis of initial cancer treatment in Taiwan. PLoS One. 2014;9: e108432. doi: 10.1371/journal.pone.0108432 25279947

12. Wright AA, Keating NL, Ayanian JZ, Chrischilles EA, Kahn KL, Ritchie CS, et al. Family perspectives on aggressive cancer care near the end of life. JAMA. 2016;315: 284–292. doi: 10.1001/jama.2015.18604 26784776

13. Krebs EE, Bair MJ, Carey TS, Weinberger M. Documentation of pain care processes does not accurately reflect pain management delivered in primary care. J Gen Intern Med. 2010;25: 194–199. doi: 10.1007/s11606-009-1194-3 20013069

14. Witkin LR, Farrar JT, Ashburn MA. Can assessing chronic pain outcomes data improve outcomes? Pain Med. 2013;14: 779–791. doi: 10.1111/pme.12075 23574493

15. Earle CC, Park ER, Lai B, Weeks JC, Ayanian JZ, Block S. Identifying potential indicators of the quality of end-of-life cancer care from administrative data. J Clin Oncol. 2003;21: 1133–1138. doi: 10.1200/JCO.2003.03.059 12637481

16. Heden L, von Essen L, Ljungman G. The relationship between fear and pain levels during needle procedures in children from the parents’ perspective. Eur J Pain. 2016;20: 223–230. doi: 10.1002/ejp.711 25845466

17. Hirschfeld G, Zernikow B. Variability of "optimal" cut points for mild, moderate, and severe pain: neglected problems when comparing groups. Pain. 2013;154: 154–159. doi: 10.1016/j.pain.2012.10.008 23182623

18. Volkman JE, DeRycke EC, Driscoll MA, Becker WC, Brandt CA, Mattocks KM, et al. Smoking status and pain intensity among OEF/OIF/OND veterans. Pain Med. 2015;16: 1690–1696. doi: 10.1111/pme.12753 25917639

19. Chen YF. The integrity and appropriateness of cancer pain assessment data in a medical center to promote pain-free hospital. National Digital Library of Theses and Dissertations in Taiwan. 2013. https://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi/ccd=X.xhed/record?r1=1&h1=0.

20. Martoni AA, Esposti CD, Cricca A, Rocchi G, Giaquinta S. Twice-daily pain monitoring as standard clinical practice for inpatients at a medical oncology unit: a descriptive study. Ann Oncol. 2007;18: 158–162. doi: 10.1093/annonc/mdl314 16971662

21. Fraenkel L, Falzer P, Fried T, Kohler M, Peters E, Kerns R, et al. Measuring pain impact versus pain severity using a numeric rating scale. J Gen Intern Med. 2012;27: 555–560. doi: 10.1007/s11606-011-1926-z 22081365

22. Kim HJ, Park JH, Kim JW, Kang KT, Chang BS, Lee CK, et al. Prediction of postoperative pain intensity after lumbar spinal surgery using pain sensitivity and preoperative back pain severity. Pain Med. 2014;15: 2037–2045. doi: 10.1111/pme.12578 25288391

23. Alghadir A, Anwer S, Anwar D, Nezamuddin M. The development and validation of hundred paisa pain scale for measuring musculoskeletal pain: a prospective observational study. Medicine (Baltimore). 2015;94: e1162.

24. Farrar JT, Portenoy RK, Berlin JA, Kinman JL, Strom BL. Defining the clinically important difference in pain outcome measures. Pain. 2000;88: 287–294. doi: 10.1016/s0304-3959(00)00339-0 11068116

25. Farrar JT, Berlin JA, Strom BL. Clinically important changes in acute pain outcome measures: a validation study. J Pain Symptom Manage. 2003;25: 406–411. doi: 10.1016/s0885-3924(03)00162-3 12727037

26. Farrar JT. Advances in clinical research methodology for pain clinical trials. Nat Med. 2010;16: 1284–1293. doi: 10.1038/nm.2249 20948532

27. Dijkstra BM, Berben SA, van Dongen RT, Schoonhoven L. Review on pharmacological pain management in trauma patients in (pre-hospital) emergency medicine in the Netherlands. Eur J Pain. 2014;18: 3–19. doi: 10.1002/j.1532-2149.2013.00337.x 23737462

28. Marinsek M, Kovacic D, Versnik D, Parasuh M, Golez S, Podbregar M. Analgesic treatment and predictors of satisfaction with analgesia in patients with acute undifferentiated abdominal pain. Eur J Pain. 2007;11: 773–778. doi: 10.1016/j.ejpain.2006.12.002 17251043

29. de Rond ME, de Wit R, van Dam FS, Muller MJ. A pain monitoring program for nurses: effect on the administration of analgesics. Pain. 2000;89: 25–38. doi: 10.1016/s0304-3959(00)00344-4 11113290

30. Carr EC, Meredith P, Chumbley G, Killen R, Prytherch DR, Smith GB. Pain: a quality of care issue during patients’ admission to hospital. J Adv Nurs. 2014;70: 1391–1403. doi: 10.1111/jan.12301 24224703

31. O’Malley AS, Grossman JM, Cohen GR, Kemper NM, Pham HH. Are electronic medical records helpful for care coordination? Experiences of physician practices. J Gen Intern Med. 2010;25: 177–185. doi: 10.1007/s11606-009-1195-2 20033621

32. Zylla D, Kuskowski MA, Gupta K, Gupta P. Association of opioid requirement and cancer pain with survival in advanced non-small cell lung cancer. Br J Anaesth. 2014;113: i109–i116. doi: 10.1093/bja/aeu351 25303989

33. Lucenteforte E, Collini F, Simonetti M, Messeri A, Caprilli S, Rasero L, et al. Assessing pain in hospital in-patients: a cross-sectional study in Tuscany, Italy. Intern Emerg Med. 2012;7: 477–482. doi: 10.1007/s11739-012-0815-8 22782336

34. Samuels JG, Fetzer S. Pain management documentation quality as a reflection of nurses’ clinical judgment. J Nurs Care Qual. 2009;24: 223–231. doi: 10.1097/NCQ.0b013e318194fcec 19525763

35. DeRemer CE, Fleming VH, Brown S, May JR. Evaluation of pain management documentation. South Med J. 2011;104: 629–633. doi: 10.1097/SMJ.0b013e3182296f20 21886080

36. Mearis M, Shega JW, Knoebel RW. Does adherence to National comprehensive cancer network guidelines improve pain-related outcomes? An evaluation of inpatient cancer pain management at an academic medical center. J Pain Symptom Manage. 2014;48: 451–458. doi: 10.1016/j.jpainsymman.2013.09.016 24439844

37. Zheng NT, Rokoske FS, Kirk MA, Lyda-McDonald B, Bernard SL. Hospices’ use of electronic medical records for quality assessment and performance improvement programs. J Pain Symptom Manage. 2014;48: 582–589. doi: 10.1016/j.jpainsymman.2013.11.010 24636959


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PLOS One


2019 Číslo 9

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