Document Detail

Who's asking? Patients may under-report postoperative pain scores to nurses (or over-report to surgeons) following surgery of the female reproductive tract.
MedLine Citation:
PMID:  19151986     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine if postoperative pain reporting via standardised visual analogue scale (VAS) is affected by which member of the healthcare team collects the information. MATERIALS AND METHODS: A standardised ten-point VAS measured postsurgical pain level among patients (n = 60) undergoing laparotomy via Pfannenstiel incision. All study patients received the same patient-controlled analgesia and uniform post-operative orders were used. VAS data were gathered from patients by surgeons (MD) and nurses (RN) 6 h and 24 h after surgery; RNs and MDs independently recorded patients' VAS pain scores in variable order. RESULTS: When assessed 6 h after surgery, the average pain level reported by patients to RNs was significantly lower than that reported to MDs (3.3 +/- 2.8 vs. 4.0 +/- 2.4; P = 0.02). Average patient pain levels remained lower when reported to RNs 24 h post-operatively compared to that reported to MDs, although this difference was not significant (1.9 +/- 2.1 vs. 2.1 +/- 2.1; P = 0.39). Whenever post-surgical patients provided different VAS scores for pain level to RNs and MDs, the higher pain reading was always reported to the MD. CONCLUSION: This study identified important variances in subjective pain reporting by patients that appeared to be influenced by who sampled the data. We found patients gave lower VAS pain scores to RNs compared to MDs; the reverse pattern was never observed. Post-surgical patients may communicate pain information differently depending on who asks them, particularly in the early post-operative period. Accordingly, patient pain data gathered over time by a care team with a heterogeneous composition (i.e., RNs, MDs) may not be fully interchangeable. Patient projections of pain severity and/or intensity appear to vary as a function of who evaluates the patient.
Eric Scott Sills; Marc G Genton; Anthony P H Walsh; Salim A Wehbe
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-01-17
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  279     ISSN:  1432-0711     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-03-26     Completed Date:  2009-06-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  771-4     Citation Subset:  IM    
The Sims Institute/Sims International Fertility Clinic, Rosemount Hall, Rosemount Estate, Dundrum, Dublin 14, Ireland.
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MeSH Terms
Analgesia, Patient-Controlled
Gynecologic Surgical Procedures / adverse effects*
Laparotomy / adverse effects
Nurse-Patient Relations*
Pain Measurement
Pain, Postoperative / diagnosis*
Physician-Patient Relations*

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