Jeanfaivre Valérie, Diviné Catherine, Akalin Marie-Noëlle, Anacharsis Françoise, Montagne Annie, Le Parco Jean-Claude
Service de Médecine Interne, Hôpital Albert-Chenevier, Creteil.
Ann Med Interne (Paris). 2003 Dec;154(8):499-508.
The purpose of this study is to estimate the prevalence of pain in hospitalized patients and to compare pain assessments performed by patients, caregivers and physicians. This cross-sectional study was based on evaluating pain with three questionnaires. Two structured questionnaires explored the patient's and physician's points of view about hospital pain management. Caregivers used the validated Doloplus-2 scale. The three assessments were considered consistent when all three indicated the presence or absence of pain. All inpatients (447) were included. The prevalence of pain was 57% when assessment was performed by caregivers and 53% when it was performed by physicians. Among patients included in the prevalence study, 366 could express themselves and agreed to answer the self-assessment questionnaire (82%): 66% of these patients reported pain. Patients and physicians often reported leg pain. Assessment of pain produced a higher level of pain intensity when performed by patients than when by physicians. Furthermore, 88% of patients reporting pain received pain relief treatment: nevertheless patients felt that their pain was satisfactorily managed in only half of their locations, and they had a less positive appreciation of their level of pain management than physicians did. Our study showed that many psychiatric patients declared they suffered pain. Full consistency between the three assessments was noted for half the cases. One out of ten patients experiencing pain was not identified.
本研究的目的是评估住院患者的疼痛患病率,并比较患者、护理人员和医生所做的疼痛评估。这项横断面研究基于用三份问卷评估疼痛。两份结构化问卷探讨了患者和医生对医院疼痛管理的看法。护理人员使用经过验证的Doloplus-2量表。当三项评估均表明疼痛存在或不存在时,这三项评估被认为是一致的。纳入了所有住院患者(447名)。护理人员进行评估时疼痛患病率为57%,医生进行评估时为53%。在患病率研究纳入的患者中,366名能够表达自己并同意回答自我评估问卷(82%):这些患者中有66%报告有疼痛。患者和医生经常报告腿部疼痛。患者进行疼痛评估时产生的疼痛强度水平高于医生进行评估时。此外,报告疼痛的患者中有88%接受了疼痛缓解治疗:然而,患者觉得他们的疼痛仅在一半的部位得到了满意的控制,并且他们对疼痛管理水平的评价不如医生积极。我们的研究表明,许多精神科患者宣称他们遭受疼痛。半数病例中三项评估完全一致。每十名经历疼痛的患者中有一名未被识别出来。