Dix P, Sandhar B, Murdoch J, MacIntyre P A
Royal Devon and Exeter Hospital, Barrack Rd, Exeter, EX2 5DW, UK.
Br J Anaesth. 2004 Feb;92(2):235-7. doi: 10.1093/bja/aeh052.
Little attention has been paid to pain on medical wards, with publications limited to the management of surgical patients. We wanted to establish the prevalence and severity of pain in the general medical setting, and how this compared with other clinical specialties.
All consenting adult in-patients were assessed daily for 5 days. Patients recorded the occurrence and severity of pain, and whether their pain was bearable. The pain team reviewed patients with unbearable pain.
1594 questionnaires were completed, representing 54% of the target population. 887 patients reported pain, 17% with pain scores over 6, and 10% with unbearable pain. The distribution of pain was similar for all ward types with 52% of patients on medical wards reporting pain. Of these, 20% reported severe pain and 12% unbearable pain. When patients with pain scores over 6 were analysed by consultant specialty, elderly care, general medicine, and general surgery scored highest. In each specialty 20-25% of patients with pain reported a pain score over 6. In patients reviewed by the pain team, reasons for poor analgesia included inadequate information, pain assessment, analgesic prescribing, and administration and patient reporting.
Patients in all hospital specialities experience pain. Until the issue of pain management in medical patients is fully addressed the situation will not improve.
内科病房的疼痛问题很少受到关注，相关出版物仅限于外科患者的管理。我们想确定普通内科环境中疼痛的患病率和严重程度，以及与其他临床专科相比情况如何。
对所有同意参与的成年住院患者进行为期5天的每日评估。患者记录疼痛的发生情况和严重程度，以及疼痛是否可以忍受。疼痛治疗小组对疼痛无法忍受的患者进行复查。
共完成1594份问卷，占目标人群的54%。887名患者报告有疼痛，17%的患者疼痛评分超过6分，10%的患者疼痛无法忍受。所有病房类型的疼痛分布相似，内科病房52%的患者报告有疼痛。其中，20%报告有重度疼痛，12%报告疼痛无法忍受。当按顾问专科对疼痛评分超过6分的患者进行分析时，老年护理、普通内科和普通外科的评分最高。在每个专科中，20%至25%有疼痛的患者报告疼痛评分超过6分。在疼痛治疗小组复查的患者中，镇痛效果不佳的原因包括信息不足、疼痛评估、镇痛处方、给药以及患者报告等方面。
所有医院专科的患者都会经历疼痛。在内科患者的疼痛管理问题得到充分解决之前情况不会改善。
