WESTPORT, CT (Reuters Health) Dec 28 - A Pain Monitoring Program that combines nurse education with a standardized daily pain rating scale can improve the documentation and assessment of patient pain, according to researchers in the Netherlands.
These new findings are important, according to Dr. Frits S. A. M. van Dam of Antoni van Leeuwenhoek Hospital in Amsterdam and multicenter colleagues, since "daily monitoring of pain is essential for both diagnostic purposes and for evaluating pain treatment."
The investigators conducted a quasi-experimental study of the Pain Monitoring Program in 703 patients; 345 participated in the intervention and the remainder were in a control group. They examined the effects of the program on communication, assessment, and documentation of patient pain for 1 month.
Overall poor results on each of the indicators were observed in the control group, Dr. van Dam and others write in the December issue of the Journal of Pain and Symptom Management. Only 30% of control patients recalled a nurse or physician talking with them about their pain. In addition, fewer than half of the nurses in the control group correctly assessed their patients' pain.
The Pain Monitoring Program effectively improved all aspects of pain management studied, with the exception of communication about pain. Nurses involved in the intervention improved in their ability to assess pain correctly--more than two thirds could do so after the first month--and documented significantly more aspects of patients' pain, including intensity, location, duration and "things that increase and decrease pain."
However, the program did not have a significant effect, overall, on communication between patients and their physicians or nurses about pain, even though only 12.2% of patients in this group were monitored less than 50% of the time. The authors speculate that the assessment of pain by asking a pain score is not considered to be 'communication' by some patients.
However, communication about pain did improve with the program in the subgroup of patients with moderate to severe pain, the Dutch researchers report. "This is an important result, because for patients with moderate to severe pain, effective pain management is particularly important," they note.
Given these results, along with the heterogeneous population studied, Dr. van Dam and colleagues recommend that the Pain Monitoring Program be implemented by nurses in other locations.
J Pain Symptom Manage 2000;20:424-439.
2000 Reuters Ltd.