Department Anesthesiology, OLVG Hospital, Amsterdam, The Netherlands.
University Medical Center Utrecht, Utrecht, The Netherlands.
PLoS One. 2020 May 8;15(5):e0232082. doi: 10.1371/journal.pone.0232082. eCollection 2020.
Thirty patients (60%) found it satisfying or very satisfying to communicate their pain with the app. Pain experienced after surgery was scored by patients as 'no': 3 (6%), 'little': 5 (10%), 'bearable': 25 (50%), 'considerable': 13 (26%) and 'severe': 1 (2%). Forty-five patients (90%) were positive about the ease of recording. Forty-five patients (90%) could correctly record their pain with the app. Thirty-eight patients (76%) agreed that in-app notifications to record pain were useful. Two patients (4%) were too ill to use the application. Based on usability feedback, we will redesign the pain intensity wheel and the in-app pain chart to improve clarity for patients to understand the course of their pain.
The median patient recorded pain app score 4.0 (range 0 to 10) and nurse recorded numerical rating scale (NRS) for pain NRS 4.0 (range 0 to 9) were not statistically different (p = 0.06). Forty-two percent from a total of 307 patient pain app scores were ≥ 5 (on a scale from 0 no pain at all to 10 worst imaginable pain). Of these, 83% were recorded as 'bearable' while only in 18% of the recordings patients asked for additional analgesia. The results suggest that self-recording the severity of postoperative pain by patients with a smartphone application could be useful for postoperative pain management. The application was perceived as user-friendly and had high satisfaction rates from both patients and stakeholders. Further research is needed to validate the 11-point numeric and faces pain scale with the current gold standards visual analogue scale (VAS) and NRS for pain.
30 名患者（60%）表示通过应用程序表达疼痛的体验非常满意或满意。术后疼痛评分结果为：无（6%）、轻度（10%）、可忍受（50%）、明显（26%）和严重（2%）。45 名患者（90%）对记录的简便性给予积极评价。45 名患者（90%）能够正确使用应用程序记录疼痛。38 名患者（76%）认为应用程序内的疼痛记录通知很有用。有 2 名患者（4%）因病情太重而无法使用该应用程序。根据可用性反馈，我们将重新设计疼痛强度轮和应用内疼痛图表，以提高患者对疼痛过程的理解清晰度。
患者记录的疼痛应用程序评分中位数为 4.0（范围 0 至 10），护士记录的数字评分量表（NRS）疼痛评分中位数为 4.0（范围 0 至 9），两者无统计学差异（p=0.06）。在总共 307 名患者的疼痛应用程序评分中，有 42%的评分≥5（评分范围为 0 表示完全无痛，10 表示可想象到的最严重疼痛）。在这些评分中，83%被记录为“可忍受”，而只有 18%的记录表明患者需要额外的镇痛。这些结果表明，患者使用智能手机应用程序自行记录术后疼痛的严重程度可能对术后疼痛管理有用。该应用程序被认为易于使用，患者和利益相关者的满意度都很高。需要进一步的研究来验证 11 点数字和面部疼痛量表与当前的金标准视觉模拟评分量表（VAS）和 NRS 疼痛之间的关系。
