NEW STUDY. Hospitalized patients suffer a surprising amount of pain without it receiving attention. In a Sahlgrenska Academy study, two of three patients report that they have been in pain, and the perceived pain is significantly higher than the limit considered acceptable by the medical system. The study also shows that women have to experience more pain than men for the staff to note it in their patient health records.
The study interviewed 700 patients who were admitted to different departments in several hospitals in the Västra Götaland Region about what bothered them most. Among other things, they indicated how they experienced their pain. The patients were asked the questions on a single day, and both researchers and students at Sahlgrenska Academy from the University of Gothenburg participated in the data collection.
Patients’ voices need to be heard
The experience of symptoms was measured using the VAS scale, a scientifically-established ten-point psychometric response scale. Patients who enter zero are not bothered at all by the symptom, while ten means that they experience the symptom as completely unbearable.
In the study, two of three patients said that they had pain, which they rated on average as a six on the ten-point scale.
“A common guideline in health care is that the patient receives pain relief if the experience of pain is four or higher. Therefore, we were surprised that so many patients say they suffered from pain, and that they rate the pain on average so high on the VAS scale. We need to ask patients how they experience symptoms and discomfort more,” says Professor Joakim Öhlén, who led the research at Sahlgrenska Academy.
“The study is important because it draws attention to how patients are doing. Our care system needs to be more aware of the importance of systematically estimating pain for all patients who are hospitalized,” says Kristin Falk, associate professor of Health and Care Sciences at Sahlgrenska Academy.
Symptoms are not treated equally
Far from all of symptoms patients experience are noted in health records by hospital staff. Of the patients reporting pain in the study, hospital staff noted this for 58 percent. Only 35 percent of patient nausea, 19 percent of their fatigue and 8 percent of their psychological discomfort were documented in health records.
Compared with men, women needed to report higher levels on the scale for all of these symptoms before staff would note the symptom in the health record:
- Women had to rate their pain over five for it to be documented, for men 4.5 was sufficient.
- Women had to rate their nausea over four for it to be noted in the health record; men only needed to rate it as just over two.
- Women had to rate their psychological discomfort over six for it to be documented; men only needed to rate it as just over three.
“Symptoms do not seem to be addressed equally in our hospital, and this may indicate that staff expect women to endure more than men, or that staff do not take women’s experiences as seriously,” says Hanna Falk, one of the researchers behind the study at Sahlgrenska Academy.
The study also shows that patients who are hospitalized are often troubled by a number of symptoms, where fatigue (76 percent), pain (65 percent) and sleep disorders (52 percent) were the most common.
“On an ordinary day at a hospital, patients experience extensive human suffering, while undergoing examinations and treatments. To support patients and alleviate suffering, staff need to be aware of the suffering and the questions that patients are having. This requires a hospital environment that allows for giving attention and comfort,” says Eva Jakobsson Ung, associate professor of nursing at Sahlgrenska Academy.
The researchers noted that patients who are hospitalized are in general very sick. One year after the survey, 18 percent of patients who had responded to questions were no longer alive, while 29 percent of those who would not or could not be included in the study had died. This suggests that palliative care, which has active symptom relief as one of its cornerstones, should to be given more widely in hospitals, according to Ingela Henoch, associate professor at Sahlgrenska Academy.
Many researchers have contributed to this study, which resulted in several scientific articles. Here you can read the latest article Differences in symptom distress based on gender and palliative care designation among hospitalized patient, which was published by the Journal of Nursing Scholarship in September 2016: LINK
Links to other studies in the project:
http://www.ncbi.nlm.nih.gov/pubmed/25308151
http://www.ncbi.nlm.nih.gov/pubmed/24861486
