Brown Tristam, Shetty Amith, Zhao Dong Fang, Harvey Nathan, Yu Teresa, Murphy Margaret
Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia.
Emerg Med Australas. 2018 Aug;30(4):523-529. doi: 10.1111/1742-6723.12945. Epub 2018 Mar 23.
Pain management and patient satisfaction are key markers for health systems performance. There is a lack of consensus on the role of analgesia, its adequacy, and its links to patient satisfaction in the ED. The present study aimed to assess the relationship between adequacy of analgesia and patient satisfaction in the ED setting.
Consenting adult patients (n = 115) presenting to the ED with pain were enrolled, and their pain tracked throughout admission with 11 point numerical pain scores. Eleven point numerical scores were also utilised to measure satisfaction and compassion at the end of each ED stay. The primary outcome was patient satisfaction score ≥7.
Of 115 enrolled patients, 94 (81.7%) were eligible for analysis. Median time to physician evaluation was 54.0 min (inter-quartile range [IQR] 35.0-98.0) and median ED length of stay was 205 min (IQR 129.0-280.0). Fifty-four patients (57.5%) received analgesia during their stay, of whom 36 (38.3%) had a significant response to analgesia (≥2 change in pain score). Median time to analgesia was 87.5 min (IQR 66.1-108.9). Patient satisfaction was inversely associated with male sex, and positively correlated (Spearman's rank correlation P < 0.05) with increasing age, significant change in pain score (±2) and compassion scores.
In the present study of patients presenting to the ED with pain, oligoanalgesia remains a significant issue. Male sex was inversely associated with satisfaction, whereas compassion, and significant change in pain score were associated with improved patient satisfaction. Of the factors analysed, staff compassion demonstrated the strongest correlation with satisfaction.
疼痛管理和患者满意度是卫生系统绩效的关键指标。对于急诊科镇痛的作用、充分性及其与患者满意度的关系，目前尚无共识。本研究旨在评估急诊科环境中镇痛充分性与患者满意度之间的关系。
纳入同意参与研究的成年患者（n = 115 例），这些患者因疼痛前来急诊科就诊，并在整个住院期间用 11 点数字疼痛评分法跟踪其疼痛情况。在每次急诊科就诊结束时，还使用 11 点数字评分法来衡量满意度和同情心。主要结局是患者满意度评分≥7 分。
在 115 例纳入研究的患者中，94 例（81.7%）符合分析条件。医生评估的中位时间为 54.0 分钟（四分位间距[IQR] 35.0 - 98.0），急诊科住院中位时长为 205 分钟（IQR 129.0 - 280.0）。54 例患者（57.5%）在住院期间接受了镇痛治疗，其中 36 例（38.3%）对镇痛有显著反应（疼痛评分变化≥2 分）。镇痛的中位时间为 87.5 分钟（IQR 66.1 - 108.9）。患者满意度与男性性别呈负相关，与年龄增长、疼痛评分显著变化（±2 分）和同情心评分呈正相关（Spearman 等级相关性 P < 0.05）。
在本项针对因疼痛前来急诊科就诊患者的研究中，镇痛不足仍是一个重要问题。男性性别与满意度呈负相关，而同情心以及疼痛评分的显著变化与患者满意度提高相关。在分析的因素中，医护人员的同情心与满意度的相关性最强。
