Purpose : The present study was initiated to provide preliminary data for effective nursing intervention for pain by understanding the pain assessment and the actual conditions of pain intervention done by nurses through nursing roster.
Methods: The research was conducted on 180 patients that were complaining of pain after being admitted to the intensive care unit of internal and surgical wards at G hospital in I city from April to September, 2007 for the duration of six months by employing a descriptive research method to investigate nursing activities done by nurses on pain management from the nursing roster.
The result has been confirmed by the research instrument; nursing roster questionnaires (pain assessment, pain intervention, evaluation after pain intervention). Data was analyzed into the frequency, the percentage, the average, the standard deviation, t-test and ANOVA using the SPSSWIN 11.5 program. For variables which were statistically significant, Duncan’s ex post facto test was performed.
Results: Results of the present study are as follows.
1) Through the pain assessment, it was shown that a surgical area is the area with the most pain (142 patients) and the pain other than in the surgical area was a chest pain with as many as 13 patients. Aspects of pain were revealed in this order; shooting stabbing and tearing pain. With scores taken by NRS (whose score range is from 0 to 10), an average pain score (7.47) was obtained and this indicated that the research subjects; intensive care unite patients were experiencing more pain than the average pain.
2) Regarding the medication intervention, narcotic painkillers were used the most and 35.5% of surgical patients used a patient controlled analgesia device that administers constant painkillers. Non-medication interventions were seen as information service the most with 97.2%, followed by information service and massage (2.2%) and information service, vibrator service and massage (0.6%). Among the routes for medication administration, IV was the most frequent with 67.2% and through that, 94.4% did not have any side effects of medication while 2.8 had nausea/vomiting and 0.6% had dizziness.
3) The average pain score after the pain intervention was shown to be 3.14±1.89, decreased below the average pain, which in turn, indicated that the pain had been eased. After the intervention, out of 28 subjects whose pain scores were above 5 26 subjects asked for the re-assessment (92.9%)
4) There was a statistically significant difference in the subjects’ characteristics and their pain in accordance with pain scores, diagnoses and administration methods. In the case of cancer diagnosis, the pain score was higher than that of other diseases. Moreover, the pain assessment score was lower when painkillers were constantly administered than when they were not.
Conclusion: Through the results above, it is shown that though nurses could assess the level of pain and understand the pain area and aspects with use of a numeric rating scale, the assessment level of the pain aspects remained as 83%. The subjects complained of moderate pain (score 7) and described quite various aspects of pain.
All the subjects, who were experiencing pain, were proven to be taking pain relief medications as the first stage of pain intervention, and after the medication intervention, the pain subsided to score 3 and the nurses witness pain reduction in 87% of the patients. Furthermore, for cancer patients the score of pain complaints was higher than patients with other diseases and the pain score of the subjects with patient controlled analgesia devices was comparably low, which in turn proved that the training in the use of a patient controlled analgesia device could ease the subjects’ pain.
Although nurses keep pain scores for objective assessments of pain, there are great individual differences in expressing pain and they tend to be very subjective. Hence, nurses should be more sensitive in assessing the subjects’ pain and administer accordingly, and moreover they should encourage patients to use their own nursing intervention along with the medication intervention.