Wheeler Erlinda, Hardie Thomas, Klemm Paula, Akanji Ibironke, Schonewolf Erin, Scott Janna, Sterling Beth
Department of Nursing, University of Delaware, Newark, Delaware 19716, USA.
Pain Manag Nurs. 2010 Jun;11(2):108-14. doi: 10.1016/j.pmn.2009.06.005. Epub 2009 Sep 18.
Pain is the leading reason individuals seek emergency care. Studies have concluded that acute pain conditions are underevaluated and undertreated in the emergency department (ED). There is a paucity of information about how the severity of pain influences the time spent in the ED before being seen by a physician. Therefore, this study focuses on what role pain plays regarding time to treatment in the ED, i.e., to examine the effects of patients' perceived level of pain on wait time in the ED. The CDC's National Hospital Ambulatory Medical Survey 2003 data were used in this study. The sample consisted of 12,860 caucasians and African Americans with a mean age of 44.52 years. Analysis of covariance was used to explore differences in length of waiting time in ED based on race, triage nurses rating of the immediacy of the need to be seen by a physician, and the level of pain the patient reported. The findings showed that patients' reports of pain had very little effect on the length of waiting time. Given the sample size, we feel there is adequate power to detect the effect of pain in determining the length of waiting time to see a physician if it were present. In addition, African Americans had a statistically significant longer wait (15.29 minutes) than Whites. The effect of race might be interpreted as another example of health disparities or could be a hospital-level effect which was not examined within this model.
疼痛是人们寻求急诊治疗的主要原因。研究得出结论，急诊部门对急性疼痛状况的评估和治疗不足。关于疼痛严重程度如何影响在急诊室见到医生之前所花费的时间，相关信息匮乏。因此，本研究聚焦于疼痛在急诊治疗时间方面所起的作用，即研究患者感知的疼痛程度对在急诊室等待时间的影响。本研究使用了美国疾病控制与预防中心（CDC）2003年的全国医院门诊医疗调查数据。样本包括12860名白人和非裔美国人，平均年龄为44.52岁。协方差分析用于探讨基于种族、分诊护士对患者需要立即就诊的紧迫性评分以及患者报告的疼痛程度，急诊室等待时间的差异。研究结果显示，患者的疼痛报告对等待时间长短的影响很小。鉴于样本量，我们认为如果疼痛在确定看医生的等待时间方面有影响的话，我们有足够的能力检测到这种影响。此外，非裔美国人的等待时间在统计学上显著长于白人（15.29分钟）。种族的影响可能被解释为健康差距的另一个例子，或者可能是一种未在该模型中检验的医院层面的影响。
