Hospitalized Patients’ vs. Nurses’ Assessments of Pain Intensity and Barriers to Pain Management

Background Several studies reported poor to moderate agreement between patient- and nurse-reported pain assessment. Many of these studies focused on a specific patient group. So far, no study studied the level of agreement in the assessment of patient-related barriers between patients and nurses. Aims The aim of the study was to identify if nurses and patients equally assessed pain intensity and patient-related barriers to pain management in hospitalised patients. Design A cross-sectional study was performed in two hospitals. Participants Inclusion criteria for patients were: (1) being at least 18 years; (2) understanding the Dutch language; and (3) giving informed consent. All nurses responsible for the participating patients and present at the time of the survey were invited to participate. Methods Data were collected between October 2012 - April 2013. Patients and nurses completed the Numeric Rating Scale to measure pain intensity. Patient-related barriers to pain management were measured using the barriers to pain assessment and management scale developed by Elcigil et al. (2011). Results A moderate agreement between patients and nurses was found for the assessment of pain intensity. Multiple logistic regressions showed a significant association between pain intensity reported by patients and the under-, over- and adequate estimation of pain by nurses. Nurses significantly underrated the belief patients had regarding pain management. Conclusions Nurses should be educated about these beliefs and should be encouraged to actively explore patient-related barriers to pain management with their individual patients. Routine pain assessments should also be encouraged and should be explained to patients. This article is protected by copyright. All rights reserved.