| Probing the paradox of patients' satisfaction with inadequate pain management. | |
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MedLine Citation:
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PMID: 11888719 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The paradox of patients who are in pain, yet satisfied with their pain management, has been previously reported. To probe this paradox, we used cross-sectional data collected in the primary care setting on cancer patients' patterns of pain and pain treatment, beliefs and expectations about pain and pain relief, willingness to report pain and take pain medication, care from the provider, and satisfaction with their pain management (n = 316). Descriptive findings were similar to other studies: more than 75% of patients were satisfied or very satisfied with their overall pain management, despite almost half of all patients reporting recent moderate to severe pain. Univariate and bivariate analyses were consistent with the hypothesis that patients may expect and are therefore satisfied with the "peak and trough" pattern of pain severity that occurs with "as-needed" administration of analgesics. However, multivariate analyses failed to directly support this hypothesis. Instead, regression analyses identified factors related to characteristics of patients' pain experiences, patients' beliefs about pain and its inevitability, the frequency that patients reported their pain, and aspects of the patient--provider relationship. Predictors of patients' satisfaction with how their primary care doctor managed their pain included: whether or not the patient was told that treating pain was an important goal, whether or not the patient reported sustained long-term pain relief, and the degree to which the patient was willing to take opioids if prescribed by the doctor or nurse (adjusted R(2) = 0.22). Qualitative data collected from patients who were in severe pain during the past three days but satisfied with their pain management (n = 88) further suggest the importance of the patient--provider relationship in shaping patient expectations. Based on these findings, we recommend that future research on outcomes in pain management place greater emphasis on the potential impact of the patient-provider relationship. |
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Authors:
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Ree Dawson; Judith A Spross; Erica S Jablonski; Doris R Hoyer; Deborah E Sellers; Mildred Z Solomon |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of pain and symptom management Volume: 23 ISSN: 0885-3924 ISO Abbreviation: J Pain Symptom Manage Publication Date: 2002 Mar |
Date Detail:
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Created Date: 2002-03-12 Completed Date: 2002-05-10 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8605836 Medline TA: J Pain Symptom Manage Country: United States |
Other Details:
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Languages: eng Pagination: 211-20 Citation Subset: IM |
Affiliation:
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Frontier Science and Technology Research Foundation, Chestnut Hill, MA, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cross-Sectional Studies Female Humans Male Middle Aged Pain / physiopathology, therapy* Pain Measurement Patient Satisfaction* |
| Grant Support | |
ID/Acronym/Agency:
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R01 HS08691/HS/AHRQ HHS |
| Comments/Corrections | |
Comment In:
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J Pain Symptom Manage. 2002 Oct;24(4):361-3
[PMID:
12505203
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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