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      Do we really know if they are in pain? A cross‐sectional study in hospitalised adult patients in Spain

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          Abstract

          Aims

          To describe the prevalence and characteristics of pain in adult hospitalised patients, as well as to analyse the concordance between patient‐reported and recorded pain and its impact on analgesic management.

          Design

          A cross sectional study.

          Methods

          The study was performed on a sample of 611 patients, from October to December 2017. Data were obtained from patient interviews, review of medical and nursing records and review of electronic prescribing.

          Results

          The prevalence of pain at the time of the interview was 36.7%. The median VAS score was 4. 90% of the patients had their pain assessed within the last 24 h; however, concordance between patient‐reported pain and recorded pain in the nursing record was slight.

          Conclusion

          Pain is still often documented inadequately. Despite the wide use of analgesics, half of the patients with moderate to severe pain do not have adequate pain management. A systematic assessment and recording of pain promotes appropriate analgesic prescription.

          Implications for the profession and patient care

          The findings of our study provide insight into the main gaps in the correct management of pain in hospitalised patients. A systematic assessment and recording of the pain suffered by the patient facilitates its control and allows a better management of the analgesic prescription by the physician. This information could help hospital managers to develop training programmes on pain assessment and on the importance of doctor–nurse collaboration to improve pain management, increasing the quality of care and reducing hospital costs.

          Reporting method

          The study has adhered to the relevant EQUATOR guidelines, according to The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

          Related collections

          Most cited references32

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          The IASP classification of chronic pain for ICD-11

          This article describes a proposal for the new diagnosis of chronic primary pain (CPP) in ICD-11. Chronic primary pain is chosen when pain has persisted for more than 3 months and is associated with significant emotional distress and/or functional disability, and the pain is not better accounted for by another condition. As with all pain, the article assumes a biopsychosocial framework for understanding CPP, which means all subtypes of the diagnosis are considered to be multifactorial in nature, with biological, psychological, and social factors contributing to each. Unlike the perspectives found in DSM-5 and ICD-10, the diagnosis of CPP is considered to be appropriate independently of identified biological or psychological contributors, unless another diagnosis would better account for the presenting symptoms. Such other diagnoses are called "chronic secondary pain" where pain may at least initially be conceived as a symptom secondary to an underlying disease. The goal here is to create a classification that is useful in both primary care and specialized pain management settings for the development of individualized management plans, and to assist both clinicians and researchers by providing a more accurate description of each diagnostic category.
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            Poorly controlled postoperative pain: prevalence, consequences, and prevention

            Tong Gan (2017)
            This review provides an overview of the clinical issue of poorly controlled postoperative pain and therapeutic approaches that may help to address this common unresolved health-care challenge. Postoperative pain is not adequately managed in greater than 80% of patients in the US, although rates vary depending on such factors as type of surgery performed, analgesic/anesthetic intervention used, and time elapsed after surgery. Poorly controlled acute postoperative pain is associated with increased morbidity, functional and quality-of-life impairment, delayed recovery time, prolonged duration of opioid use, and higher health-care costs. In addition, the presence and intensity of acute pain during or after surgery is predictive of the development of chronic pain. More effective analgesic/anesthetic measures in the perioperative period are needed to prevent the progression to persistent pain. Although clinical findings are inconsistent, some studies of local anesthetics and nonopioid analgesics have suggested potential benefits as preventive interventions. Conventional opioids remain the standard of care for the management of acute postoperative pain; however, the risk of opioid-related adverse events can limit optimal dosing for analgesia, leading to poorly controlled acute postoperative pain. Several new opioids have been developed that modulate μ-receptor activity by selectively engaging intracellular pathways associated with analgesia and not those associated with adverse events, creating a wider therapeutic window than unselective conventional opioids. In clinical studies, oliceridine (TRV130), a novel μ-receptor G-protein pathway-selective modulator, produced rapid postoperative analgesia with reduced prevalence of adverse events versus morphine.
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              A systematic review of the pain scales in adults: Which to use?

              The study analysed the Visual Analogue Scale (VAS), the Verbal Rating Scale (VRS) and the Numerical Rating Scale (NRS) to determine: 1. Were the compliance and usability different among scales? 2. Were any of the scales superior over the other(s) for clinical use?
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                Author and article information

                Contributors
                anamaria.recio@universidadeuropea.es
                Journal
                Nurs Open
                Nurs Open
                10.1002/(ISSN)2054-1058
                NOP2
                Nursing Open
                John Wiley and Sons Inc. (Hoboken )
                2054-1058
                03 October 2023
                December 2023
                : 10
                : 12 ( doiID: 10.1002/nop2.v10.12 )
                : 7668-7675
                Affiliations
                [ 1 ] Faculty of Biomedical and Health Science, Nursing Department Universidad Europea de Madrid Madrid Spain
                [ 2 ] Clinical Pharmacologist in the Department of Clinical Pharmacology Hospital Universitario Clínico San Carlos Madrid Spain
                [ 3 ] Anaesthesiologist at the Anaesthesia Department Hospital Universitario Clínico San Carlos Madrid Spain
                [ 4 ] Head of Clinical Clinical Pharmacology Department Hospital Universitario Clínico San Carlos Madrid Spain
                [ 5 ] Institute for Health Research of the Hospital Clínico San Carlos (IdISSC) Madrid Spain
                [ 6 ] Department of Pharmacology Faculty of Medicine, Universidad Complutense de Madrid Madrid Spain
                Author notes
                [*] [* ] Correspondence

                Ana María Recio Vivas, Faculty of Biomedical and Health Science, Nursing Department, Universidad Europea de Madrid, Madrid, Spain.

                Email: anamaria.recio@ 123456universidadeuropea.es

                Author information
                https://orcid.org/0000-0002-2220-3840
                https://orcid.org/0000-0002-0701-7855
                https://orcid.org/0000-0002-4983-7675
                https://orcid.org/0000-0003-1951-7280
                Article
                NOP22007 NOP-2022-Sep-1614.R1
                10.1002/nop2.2007
                10643832
                37789558
                b33e8cf2-aa0c-4e50-95ab-b8ea9896f070
                © 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 08 January 2023
                : 05 August 2022
                : 17 September 2023
                Page count
                Figures: 1, Tables: 5, Pages: 8, Words: 5889
                Categories
                Empirical Research Quantitative
                Empirical Research Quantitative
                Custom metadata
                2.0
                December 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.4 mode:remove_FC converted:14.11.2023

                analgesics,inpatients,pain management,pain measurement,prevalence

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