EXPERIENCES OF PATIENTS TREATED IN THE REANIMATION UNIT REGARDING PAIN EXPERIENCE, ADEQUATE PAIN ASSESSMENT AND PAIN ALLEVIATION
Abstract
An intensive care and reanimation unit (ICU) is a hospital ward that provides optimal care and treatment for critically ill patients. The reanimation unit is a very stressful environment for patients. Aims of the study were to evaluate and identify the pain experience of ICU patients and adequate assessment of pain. This study was conducted as a prospective, observational study involving 121 patients treated in the Reanimation Department, Emergency Center, Clinical Center of Vojvodina. All the examined patients over 18 years of age hospitalized in this Department who met inclusion criteria were interviewed at the bedside. Data were collected by using the questionnaire filled in by a doctor during their conversation with a patient. Thirty-two point two percent of patients were hospitalized from 3 to 7 days, the same percentage of patients were hospitalized for more than 7 days, while 21.5% were hospitalized 1–3 days and 14.1% for one day. Sixty-one point eight percent of the patients reported inability of speech, 14.5% of patients stated their inability of speech and not knowing who to refer to as a problem. Sixty-four point four six percent of patients received analgesic therapy soon after complaining of pain, while 4.13% of patients reported not having analgesics after complaining of pain. Eighty-four point one percent of patients received therapy intravenously. Fifty-six percent of patients answered positively and 3.5% of patients were not satisfied with prescribed analgesics. Fifty-five point three seven percent of patients had the strongest daytime pain. Many factors contributed to increased pain intensity: the extent of performed surgical treatment, surgical wound, injuries and fractures, numerous medical procedures, prolonged immobility in bed and back pain as a consequence.
References
Normal
0
false
false
false
EN-US
X-NONE
X-NONE
DefSemiHidden="false" DefQFormat="false" DefPriority="99"
LatentStyleCount="371">
UnhideWhenUsed="true" QFormat="true" Name="heading 2"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 3"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 4"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 5"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 6"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 7"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 8"/>
UnhideWhenUsed="true" QFormat="true" Name="heading 9"/>
Name="index 1"/>
Name="index 2"/>
Name="index 3"/>
Name="index 4"/>
Name="index 5"/>
Name="index 6"/>
Name="index 7"/>
Name="index 8"/>
Name="index 9"/>
UnhideWhenUsed="true" Name="toc 1"/>
UnhideWhenUsed="true" Name="toc 2"/>
UnhideWhenUsed="true" Name="toc 3"/>
UnhideWhenUsed="true" Name="toc 4"/>
UnhideWhenUsed="true" Name="toc 5"/>
UnhideWhenUsed="true" Name="toc 6"/>
UnhideWhenUsed="true" Name="toc 7"/>
UnhideWhenUsed="true" Name="toc 8"/>
UnhideWhenUsed="true" Name="toc 9"/>
Name="Normal Indent"/>
Name="footnote text"/>
Name="annotation text"/>
Name="header"/>
Name="footer"/>
Name="index heading"/>
UnhideWhenUsed="true" QFormat="true" Name="caption"/>
Name="table of figures"/>
Name="envelope address"/>
Name="envelope return"/>
Name="footnote reference"/>
Name="annotation reference"/>
Name="line number"/>
Name="page number"/>
Name="endnote reference"/>
Name="endnote text"/>
Name="table of authorities"/>
Name="macro"/>
Name="toa heading"/>
Name="List"/>
Name="List Bullet"/>
Name="List Number"/>
Name="List 2"/>
Name="List 3"/>
Name="List 4"/>
Name="List 5"/>
Name="List Bullet 2"/>
Name="List Bullet 3"/>
Name="List Bullet 4"/>
Name="List Bullet 5"/>
Name="List Number 2"/>
Name="List Number 3"/>
Name="List Number 4"/>
Name="List Number 5"/>
Name="Closing"/>
Name="Signature"/>
UnhideWhenUsed="true" Name="Default Paragraph Font"/>
UnhideWhenUsed="true" Name="Body Text"/>
Name="Body Text Indent"/>
Name="List Continue"/>
Name="List Continue 2"/>
Name="List Continue 3"/>
Name="List Continue 4"/>
Name="List Continue 5"/>
Name="Message Header"/>
Name="Salutation"/>
Name="Date"/>
Name="Body Text First Indent"/>
Name="Body Text First Indent 2"/>
Name="Note Heading"/>
Name="Body Text 2"/>
Name="Body Text 3"/>
Name="Body Text Indent 2"/>
Name="Body Text Indent 3"/>
Name="Block Text"/>
Name="Hyperlink"/>
Name="FollowedHyperlink"/>
Name="Document Map"/>
Name="Plain Text"/>
Name="E-mail Signature"/>
Name="HTML Top of Form"/>
Name="HTML Bottom of Form"/>
Name="Normal (Web)"/>
Name="HTML Acronym"/>
Name="HTML Address"/>
Name="HTML Cite"/>
Name="HTML Code"/>
Name="HTML Definition"/>
Name="HTML Keyboard"/>
Name="HTML Preformatted"/>
Name="HTML Sample"/>
Name="HTML Typewriter"/>
Name="HTML Variable"/>
Name="Normal Table"/>
Name="annotation subject"/>
Name="No List"/>
Name="Outline List 1"/>
Name="Outline List 2"/>
Name="Outline List 3"/>
Name="Table Simple 1"/>
Name="Table Simple 2"/>
Name="Table Simple 3"/>
Name="Table Classic 1"/>
Name="Table Classic 2"/>
Name="Table Classic 3"/>
Name="Table Classic 4"/>
Name="Table Colorful 1"/>
Name="Table Colorful 2"/>
Name="Table Colorful 3"/>
Name="Table Columns 1"/>
Name="Table Columns 2"/>
Name="Table Columns 3"/>
Name="Table Columns 4"/>
Name="Table Columns 5"/>
Name="Table Grid 1"/>
Name="Table Grid 2"/>
Name="Table Grid 3"/>
Name="Table Grid 4"/>
Name="Table Grid 5"/>
Name="Table Grid 6"/>
Name="Table Grid 7"/>
Name="Table Grid 8"/>
Name="Table List 1"/>
Name="Table List 2"/>
Name="Table List 3"/>
Name="Table List 4"/>
Name="Table List 5"/>
Name="Table List 6"/>
Name="Table List 7"/>
Name="Table List 8"/>
Name="Table 3D effects 1"/>
Name="Table 3D effects 2"/>
Name="Table 3D effects 3"/>
Name="Table Contemporary"/>
Name="Table Elegant"/>
Name="Table Professional"/>
Name="Table Subtle 1"/>
Name="Table Subtle 2"/>
Name="Table Web 1"/>
Name="Table Web 2"/>
Name="Table Web 3"/>
Name="Balloon Text"/>
Name="Table Theme"/>
Name="List Paragraph"/>
Name="Intense Quote"/>
Name="Subtle Emphasis"/>
Name="Intense Emphasis"/>
Name="Subtle Reference"/>
Name="Intense Reference"/>
UnhideWhenUsed="true" Name="Bibliography"/>
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
Name="Grid Table 1 Light Accent 1"/>
Name="Grid Table 6 Colorful Accent 1"/>
Name="Grid Table 7 Colorful Accent 1"/>
Name="Grid Table 1 Light Accent 2"/>
Name="Grid Table 6 Colorful Accent 2"/>
Name="Grid Table 7 Colorful Accent 2"/>
Name="Grid Table 1 Light Accent 3"/>
Name="Grid Table 6 Colorful Accent 3"/>
Name="Grid Table 7 Colorful Accent 3"/>
Name="Grid Table 1 Light Accent 4"/>
Name="Grid Table 6 Colorful Accent 4"/>
Name="Grid Table 7 Colorful Accent 4"/>
Name="Grid Table 1 Light Accent 5"/>
Name="Grid Table 6 Colorful Accent 5"/>
Name="Grid Table 7 Colorful Accent 5"/>
Name="Grid Table 1 Light Accent 6"/>
Name="Grid Table 6 Colorful Accent 6"/>
Name="Grid Table 7 Colorful Accent 6"/>
Name="List Table 1 Light Accent 1"/>
Name="List Table 6 Colorful Accent 1"/>
Name="List Table 7 Colorful Accent 1"/>
Name="List Table 1 Light Accent 2"/>
Name="List Table 6 Colorful Accent 2"/>
Name="List Table 7 Colorful Accent 2"/>
Name="List Table 1 Light Accent 3"/>
Name="List Table 6 Colorful Accent 3"/>
Name="List Table 7 Colorful Accent 3"/>
Name="List Table 1 Light Accent 4"/>
Name="List Table 6 Colorful Accent 4"/>
Name="List Table 7 Colorful Accent 4"/>
Name="List Table 1 Light Accent 5"/>
Name="List Table 6 Colorful Accent 5"/>
Name="List Table 7 Colorful Accent 5"/>
Name="List Table 1 Light Accent 6"/>
Name="List Table 6 Colorful Accent 6"/>
Name="List Table 7 Colorful Accent 6"/>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-style-noshow:yes;
mso-style-priority:99;
mso-style-parent:"";
mso-padding-alt:0in 5.4pt 0in 5.4pt;
mso-para-margin-top:0in;
mso-para-margin-right:0in;
mso-para-margin-bottom:8.0pt;
mso-para-margin-left:0in;
line-height:107%;
mso-pagination:widow-orphan;
font-size:11.0pt;
font-family:"Calibri","sans-serif";
mso-ascii-font-family:Calibri;
mso-ascii-theme-font:minor-latin;
mso-hansi-font-family:Calibri;
mso-hansi-theme-font:minor-latin;
mso-bidi-font-family:"Times New Roman";
mso-bidi-theme-font:minor-bidi;}
Ahmad M, Al-Daken L, Ahmad H. Quality of life for patients in medical-surgical wards. Clin Nurs Res 2014;23:206-17. [CrossRef] [PubMed]
Alasad J, Abu Tabar N, Ahmad M. Patients' experience of being in intensive care units. Journal of Critical Care 2015;30:859. [CrossRef] [PubMed]
Arroya-Navao C, Figueroa-Ramos M, Puntillo K, Stanik J, Thompson C, White C et al. Pain related to tracheal suctioning in awake acutely and critically ill adults: a descriptive study. Intensive critical care Nursing 2008; 24:20-7. [CrossRef] [PubMed]
Aslan F, Badir A, Arli SK, Cakmakci H. Patient’s ex-perience of pain after cardiac surgery. Contemporary Nurse 2009-10;34(1):48-54. [CrossRef] [PubMed]
Backes DS, Lunardi Filho WD, Lunardi VL. The huma-nization process of the hospital environment centered around the worker. Rev Esc Enferm USP 2006; 40(2): 221-7. [CrossRef] [PubMed]
Barbosa TP, Beccaria LM, Pereira M. Evaluation of postoperative pain experience in intensive care unit patients. Rev Bras Ter Intensiva 2011;23(4):470-7. [CrossRef] [PubMed]
Barr J, Fraser L, Puntillo K. Clinical practice guidelines for the management of pain, agitation, anddelirium in adult patients in the intensive care unit. Critical Care Medicine 2013;41:263-306. [CrossRef] [PubMed]
Berben SA, Meijs TH, van Grunsven PM, Schoonhoven L, van Achterberg T. Facilitators and barriers in pain-management for trauma patients in the chain of emergency care. Injury 2012;43(9):1397-402. [CrossRef] [PubMed]
Chanques G, Jaber S, Barbotte E, Violet S, Sebbane M, Perrigault PF et al. Impact of systematic evaluation of pain and agitation in an intensive care unit. Crit Care Med 2006;34(6):1691-9. [CrossRef] [PubMed]
Chung J, Lui J. Postoperative pain management: Study of patients’level of pain and satisfaction with health care providers’responsiveness to their reports of pain. Nursing and Health Sciences 2003;5:13-21. [CrossRef] [PubMed]
Darawad M, Al-Hussami M, Saleh A, Al-Sutari M, Mustafa M. Predictors of ICU patients’ pain manage-ment satisfaction: A descriptive cross-sectional sur-vey. Australian Critical Care 2015;28:129-33. [CrossRef] [PubMed]
Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care 2006;15(4):420-7. [CrossRef] [PubMed]
Gélinas C, Harel F, Fillion L, Puntillo KA, Johnston CC. Sensitivity and specificity of the critical-care pain observation tool for the detection of pain in intubated adults after cardiac surgery. J Pain Symptom Manage 2009;37(1):58-67. [CrossRef] [PubMed]
Mansouri P, Javadpour S, Zand F, Ghodsbin F, Sabetian G, Masjedi M. Implementation of a protocol for integrated management of pain, agitation, and delirium can improve clinical outcomes in the intensive care unit: a randomized clinical trial. J Crit Care 2013; 28(6):918-22. [CrossRef] [PubMed]
Mularski RA. Pain management in the intensive care unit. Critical Care Clinics 2004;20(3):381-401. [CrossRef] [PubMed]
Novaes MA, Knobel E, Bork AM, Nogueira-Martins LA, Bosi Ferraz M. Stressors in ICU: perception of the patient, relatives and health care team. Intensive Care Med 1999;25:1421-6. [CrossRef] [PubMed]
Olsen B, Rustøen T, Sandvik L, Jacobsen M, Valeberg B. Results of implementing a pain management algo-rithm in intensive care unit patients: The impact on pain assessment, length of stay, and duration of venti-lation. Journal of Critical Care 2016;36:207-11. [CrossRef] [PubMed]
Olsen BF, Rustoen T, Sandvik L, Miaskowski C, Jacobsen M, Valeberg BT. Development of a pain management algorithm for intensive care units. Heart Lung 2015;44(6):521-7. [CrossRef] [PubMed]
Payen JF, Chanques G, Mantz J, Hercule C, Auriant I, Leguillou JL et al. Current practices in sedation and analgesia for mechanically ventilated critically ill pa-tients: a prospective multicenter patient-based study. Anesthesiology 2007;106(4):687-95. [CrossRef] [PubMed]
Penglin M, Liu J, Xi X, Du B, Yuan X, Lin H et al. Practice of sedation and the perception of discomfort during mechanical ventilation in Chinese intensivecare units. Journal of Critical Care 2010;25:451-7. [CrossRef] [PubMed]
Rashid M. Developing scales to evaluate staff per-ception of the effects of the physical environment on patient comfort, patient safety, patient privacy, family integration with patient care, and staff working con-ditions in adult intensive care units: a pilot study. Crit Care Nurs Q 2007;30(3):271-83. [CrossRef] [PubMed]
Rose L, Smith O, Gelinas C, Haslam L, Dale C, Luk E et al. Critical care nurses' pain assessment and mana-gement practices: a survey in Canada. Am J Crit Care 2012;21(4):251-9. [CrossRef] [PubMed]
Sevilay E, Nevra D, Gulay A, Umut A, Sevban A. Vital signs: Valid indicators to assess pain in intensive care unit patients? An observational, descriptive study, Nursing & Health Sciences 2018;20:502-8. [CrossRef] [PubMed]
Siffleet J, Young J, Nikoletti S, Shaw T. Patients’ self‐report of procedural pain in the intensive care unit. J Clin Nurs 2007;16(11):2142-8. [CrossRef] [PubMed]
Skrobik Y, Ahern S, Leblanc M, Marquis F, Awissi DK, Kavanagh BP. Protocolized intensive care unitmanage-ment of analgesia, sedation, and deliriumimproves analgesia and subsyndromal delirium rates. Anesth Analg 2010;111(2):451-63. [CrossRef] [PubMed]
Svendsen K, Borchgrevink PC, Fredheim O, Hamunen K, Mellbye A, Dale O. Choosing the unit of measure-ment counts: the use of oral morphine equivalents in studies ofopioid consumption is a useful addition to defined daily doses. Palliat Med 2011;25(7):725-32. [CrossRef] [PubMed]
Topolovec-Vranic J, Canzian S, Innis J, Pollmann-Mudryj MA, McFarlan AW, Baker AJ. Patient satis-faction and documentation of pain assessments and management after implementing the adult nonverbal pain scale. Am J Crit Care 2010;19(4):345-54. [CrossRef] [PubMed]