Emons M I, Scheeper-von der Born T H, Petzke F, Ellenrieder V, Reinhardt L, Meißner W, Erlenwein J
Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
Klinik für Gastroenterologie und gastrointestinale Onkologie, Universitätsmedizin Göttingen, Göttingen, Deutschland.
Schmerz. 2021 Dec;35(6):391-400. doi: 10.1007/s00482-021-00550-9. Epub 2021 Apr 20.
BACKGROUND, OBJECTIVES: Deficits in the quality of pain management in hospitals have been described for years. The aim of this study was to assess structures and processes of pain management in departments for internal medicine in German hospitals.
Data were collected using a standardized telephone interview (non-university hospital departments) on a randomized sample of hospitals (circa 1/3 of hospitals); all German departments of university hospitals were invited to participate and questioned separately using an online questionnaire (SurveyMonkey®).
Data from 139 non-university departments (response rate: 21%) and 33 university hospital departments (only 21 questionnaires were fully answered, response rate 17 and 11%, respectively) were collected. Of 619 non-university hospital departments contacted, 441 explicitly refused to participate in the survey, most often on the grounds that there was no interest in pain management. Pain was regularly recorded as an independent parameter during the medical visit in 89% of the non-university hospital and 96% of the university hospital departments; written standardized treatment protocols for pain therapy were available in 57% of the non-university hospital departments (54% university hospital departments). In 76% of the non-university hospitals departments (100% university hospital departments), an acute pain service was also available for patients of internal medicine departments for co-treatment. Written cooperation agreements were less common (35% non-university hospital departments, 18% university hospital departments).
The described implementation of pain management was satisfying in the participating departments. However, in consideration of the low participation and high rejection of participation due to explicit disinterest in the topic, the results should be critically assessed and presumably characterized by a significant positive bias.
背景、目的：多年来，医院疼痛管理质量存在缺陷已为人所知。本研究旨在评估德国医院内科各科室疼痛管理的结构和流程。
通过标准化电话访谈（非大学医院科室）对随机抽取的医院样本（约占医院总数的1/3）收集数据；邀请德国所有大学医院科室参与，并使用在线问卷（SurveyMonkey®）单独进行询问。
收集了139个非大学医院科室的数据（回复率：21%）和33个大学医院科室的数据（仅21份问卷得到完整回复，回复率分别为17%和11%）。在联系的619个非大学医院科室中，441个明确拒绝参与调查，最常见的理由是对疼痛管理不感兴趣。在89%的非大学医院科室和96%的大学医院科室中，疼痛在医疗问诊时被定期记录为一个独立参数；57%的非大学医院科室（54%的大学医院科室）有书面的疼痛治疗标准化方案。在76%的非大学医院科室（100%的大学医院科室），也为内科患者提供急性疼痛服务以进行联合治疗。书面合作协议较少见（35%的非大学医院科室，18%的大学医院科室）。
参与调查的科室中所描述的疼痛管理实施情况令人满意。然而，考虑到参与率低以及因对该主题明显不感兴趣而导致的高拒绝率，应对结果进行批判性评估，结果可能存在显著的正向偏差。
