Quality Pain Management in the Hospital Setting

• Main Author: Sigríður Zoëga 1973-
• Other Authors: Háskóli Íslands
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: 2014
• Subjects: Doktorsritgerðir; Iceland
• Online Access: http://hdl.handle.net/1946/19855

Background and aims: Pain management is an important factor in quality health care. Reviewing the literature shows that quality pain management (QPM) is vaguely defined and that pain is still prevalent and severe in many hospitalized patients, despite efforts to improve quality in the past decades. The aims of the study were to explore, define, and assess QPM in the hospital setting. This project is based on three studies, reported in four papers (I-IV). Material and methods: In the first study (Paper I) Morse’s method of concept evaluation was used to analyze the literature to identify the structural aspects of QPM, and to put forward a definition of the concept. In the second study (Paper II), a descriptive, cross-sectional design was used to evaluate the psychometric properties of the American Pain Society Questionnaire (APS-POQ-R), purport to measure patient outcomes in relation to pain management. In the third study a descriptive point-prevalence design was used to assess QPM from the patient’s perspective (Paper III), and explore the pain management processes in a university hospital (Paper IV). APS-POQ-R, Icelandic version (APS-POQ-R-I), was used to collect data from patients, but clinical and medication data were collected from medical records and the hospital-data warehouse, by checklists made by the researchers. A modified version of the Pain Management Index (PMI) was used to measure the adequacy of the pain treatment in paper IV. For the second and third studies the sample consisted of patients, 18 years and older, who had been hospitalized for at least 24 hours, understood Icelandic, and were able to participate in the study. For the second study the patients had to have experienced pain (defined as ≥ 1 on 0-10 scale) in the past 24 hours. For the third study all patients could participate, regardless of pain. The studies were conducted in 23 inpatient wards on surgical and medical services in Landspítali, The National University Hospital of Iceland. Results: In line with the Donabedian health care ...