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Factores Asociados con un Alto Nivel de Satisfacción de los Pacientes con su Manejo del Dolor
Author(s) -
Shill Jessica,
Taylor David McD.,
Ngui Bryan,
Taylor Simone E.,
Ugoni Antony M.,
Yeoh Michael,
Richardson Joanna
Publication year - 2012
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2012.01451.x
Subject(s) - medicine , triage , confidence interval , emergency department , odds ratio , patient satisfaction , logistic regression , pain management , physical therapy , prospective cohort study , emergency medicine , surgery , psychiatry
ACADEMIC EMERGENCY MEDICINE 2012; 19:1212–1215 © 2012 by the Society for Academic Emergency Medicine Abstract Objectives: The objective was to determine, among emergency department (ED) patients, the factors associated with a high level of satisfaction with pain management. Methods: This was a prospective cohort study in a single ED. Consecutive adult patients, with triage pain scores of ≥4 (numerical rating scale = 0 to 10), were enrolled. Variables examined included demographics, presenting complaint, pain scores, nurse‐initiated analgesia, analgesia administered, time to first analgesia, specific pain communication, and whether “adequate analgesia” was provided (defined as a decrease in pain score to <4 and a decrease from the triage pain score of ≥2). The level of patient satisfaction with their pain management (six‐point scale: very unsatisfied to very satisfied) was determined by a blinded investigator 48 hours post discharge. Logistic regression analyses were undertaken. Results: Data were complete for 476 patients: mean (±standard deviation [SD]) age was 43.6 (±17.2) years, and 237 were males (49.8%, 95% confidence interval [CI] = 45.2% to 54.4%). A total of 190 (39.9%, 95% CI = 35.5% to 44.5%) patients were “very satisfied” with their pain management, and 207 (43.5%, 95% CI = 39.0% to 48.1%) patients received adequate analgesia. Three variables were associated with the patient being very satisfied: the provision of adequate analgesia (odds ratio [OR] = 7.8, 95% CI = 4.9 to 12.4), specific pain communication (OR = 2.3, 95% CI = 1.3 to 4.1), and oral opioid administration (OR = 2.0, 95% CI = 1.1 to 3.4). Notably, the provision of nurse‐initiated analgesia to 211 patients (44.3%, 95% CI = 39.8% to 48.9%) and the short time to analgesia (median = 11.5 minutes; interquartile range [IQR] = 2.0 to 85.8 minutes) were not associated with being very satisfied. Conclusions: The receipt of adequate analgesia (as defined) is highly associated with patient satisfaction. This variable may serve as a clinically relevant and achievable target in the pursuit of best‐practice pain management.