Implementing a Pain Assessment Survey and Team Approach Method to Effectively Assess and Treat Pain in Poststroke Patients.

OBJECTIVES

To monitor and treat pain effectively in stroke patients in an inpatient rehabilitation facility using an efficient Pain Assessment Survey.

DESIGN

The study was conducted as a 2-part project. Part 1 was a preintervention study conducted to assess the prevalence of pain in poststroke patients using a Pain Assessment Survey. Factors such as central and peripheral mechanisms, psychological factors, and autonomic input were used to study the surveyed population. Other potential risk factors, such as age and sex, were also incorporated into statistical gathering. The correlation between the presence of pain and poststroke patients was assessed, and an enhanced pain assessment was created and implemented in the admission process of poststroke patients. This helped comprise part of the second portion of the study, the postintervention study.

SETTING

Participants were chosen from an inpatient rehabilitation facility. Each part of the project was conducted over a 6-month period.

PARTICIPANTS

Patients (N=184) were randomly selected. Eighty-two patients were included in the preintervention survey, and 102 patients were included in the postintervention survey. Those who had pain prior to stroke that remained unchanged or if the pain was secondary to another diagnosis were excluded from the study.

INTERVENTION

Patients with complaints of poststroke pain (PSP) were intervened immediately upon admission using a team approach. This included all personnel involved in the patient's care to resolve pain before discharge. Different types of medications and non-medical modalities were used for pain control.

MAIN OUTCOME MEASURE

The prevalence of PSP in poststroke patients.

RESULTS

The preintervention survey revealed a pain prevalence of 31.7%, whereas the postintervention study showed a prevalence of 11.8% in poststroke patients on admission. The odds that a poststroke patient would be discharged without pain and with a proper pain assessment and management was 96.2, with a statistically significant value of .0015.

CONCLUSION

The team approach to pain management resulted in all patients being successfully treated and discharged pain free. This further demonstrates the importance of using both a pain assessment survey and team approach to assess PSP in poststroke patients.