Oligoanalgesia In Emergency Department: Concordance Between Health Care Workers And Patients Assessment Of Pain Severity

Research Article
Olakulehin OA, Akanbi OO, Onilede DA, Ajamu OJ, Oyebamiji EO and Ibitow
Pain, Emergency department, health care workers, Patients, concordance and oligoanalgesia

Pain remains the most common complaint of patients visiting emergency department (ED), yet incidence of poor pain control remains on two digit figures in most emergency units with few references to effect of health worker assessment of pain. We investigate the degree and role of concordance of severity of pain assessment between the patients and health care workers in our emergency department. This prospective study recruited a total of 180 participants into the study with equal distribution between the doctors, nurses and patients. Relevant data were obtained through a pre form structured questionnaire. Data obtained include participants’ sociodemographic characteristics, pain score on 100mm visual analog scale for different commonly performed painful procedures in emergency. A total of 637 procedures were analysed from 60 doctors, 60 nurses and 60 patients. The overall mean pain score for the doctors, nurses and patients were 6.2(±1,243), 3.968(±1.644) and 3.960(±1.823) respectively this was statistically significant when health care workers were compared with the patients (doctors versus patients p=0.0044, nurses versus patients p=0.0066). Nasogastric tube intubation was ranked as the most painful procedure by the patients, while health care workers ranked fracture of the long bone as the most painful procedure there was a poor correlation between health care workers and patients ranking of severity of pain (r < 0.5). The discordance and poor correlation between the health care workers and patients rating of pain was associated with poor assessment of pain and assumption by health care workers that patients exaggerate their pain.