Faculty of Medicine, University of Queensland, St Lucia, Australia.
Faculty of Medicine, University of Queensland, St Lucia, Australia; Logan Hospital, Meadowbrook, Australia.
Australas Emerg Care. 2021 Jun;24(2):127-134. doi: 10.1016/j.auec.2020.10.003. Epub 2020 Nov 10.
Despite more than 30 years of research, pain in the emergency department (ED) setting is frequently undertreated. EDs prioritise process measures that often have tenuous links to patient-reported outcomes. However, process measures, such as time to the administration of first analgesic medication, are neither direct objective measures of analgesia nor appropriate surrogate markers of pain relief. Since pain is a subjective symptom that lacks an objective measure, pain research in any clinical environment, including EDs, should rely upon patient-reported outcomes. This scoping review examined patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs) of pain care in the adult emergency department at the micro, meso and macro-level over the last ten years. We reviewed pain care research conducted on adults in EDs over the last ten years and identified 57 articles using 14 patient-reported outcomes of pain care falling into five broad areas, most without validation or adaption to the ED setting. Despite efforts made to incorporate PROs and PROMs into acute pain care research in the ED over the last ten years, there is still no gold-standard PROM in widespread use. We recommend the adaptation of existing tools with rigorous validation in ED populations.
尽管已经进行了 30 多年的研究，但急诊科（ED）的疼痛治疗仍然常常不足。ED 优先考虑的是与患者报告的结果关联性不强的流程措施。然而，流程措施，如首次镇痛药物给药时间，既不是镇痛的直接客观测量指标，也不是疼痛缓解的合适替代标志物。由于疼痛是一种缺乏客观测量指标的主观症状，因此包括急诊科在内的任何临床环境中的疼痛研究都应依赖于患者报告的结果。本范围综述检查了过去十年中成人急诊科微观、中观和宏观层面上的患者报告的疼痛护理结果（PROs）和患者报告的疼痛护理结局测量（PROMs）。我们回顾了过去十年中在急诊科进行的成人疼痛护理研究，确定了 57 篇文章，这些文章使用了疼痛护理的 14 个患者报告结果，分为五个广泛的领域，其中大多数没有经过验证或适应急诊科的环境。尽管在过去十年中，急诊科急性疼痛护理研究中已经努力纳入了 PRO 和 PROM，但仍没有广泛使用的金标准 PROM。我们建议对现有的工具进行适应性修改，并在急诊科人群中进行严格验证。
