Assessment of pain and adequacy of pain management in hospitalized cancer patients

Abstract

The author investigated pain experiences of 90 cancer patients and the adequacy of pain treatment they have received during their stay at a large medical center in T city between October 1994 and August 1995. Pain was assessed by the Shortened BPQ and results are summarized as follows: As for rating of “worst pain” during the 24 hour period. 70% of the patients reported they had “severe” pain. As for ratings on “pain now,” 43% the cancer patients reported “moderate to severe” pain. Over 46% of the patients reported a pain relief score of 0(not at all) or 1(somewhat) even after receiving pain medication. Adequacy of analgesic treatment was evaluated by comparing the patient’s reported level of pain and the analgesic use, namely, the pain management index(PMI). the PMI indicated that 58% of the patients were undertreated for the pain control. In review of nurse’s notes, systematic pain assessment was scarcely recorded, although pain documentation appeared in 70% of the noted: and the contents were mostly simple description. In conclusion, the results of patient’s pain ratings, the PMI and poor documentation in the nurse’s notes implied poor pain assessment and management.