[Patient perspective of pain assessment by nursing personnel : Qualitative cross-sectional study on use of the NRS]

Schmerz. 2017 Apr;31(2):123-130. doi: 10.1007/s00482-016-0181-y.
[Article in German]

Abstract

Background: The assessment of pain as a part of adequate pain management is an integral part of the clinical routine. Much research has been carried out concerning use, relevance and validity of different assessment scales; however, patients' perspective of pain assessment has not yet been studied in Germany. The aim of the present study was to collate patients' experiences regarding pain assessment based on the numeric rating scale (NRS).

Materials and methods: The survey was conducted as a qualitative cross-sectional study based on the grounded theory methodology by Strauss and Corbin. Interviews were carried out with 15 surgery patients. A semi-structured interview guide was used to collect data. The structured analysis was performed using MAXQDA. Data were first openly coded followed by thematic coding. Finally, the codes were compared and linked via axial coding. The data analysis was completed by object-related theory construction.

Results: Patients have only vague ideas about the consequences of their responses. They experience pain assessment as a nursing routine, which was perceived as being largely insignificant for therapy. On reflection patients sporadically saw the scaling as being a problem as a reference value is missing and the quality of pain as well as the procedure fail the predetermined measurement system. Metric values not only reflect the level of pain but are also intentionally used to enable targeted measures, e.g. discharge from hospital.

Conclusion: The survey results indicate that the validity of the measurement and therefore the indicated therapy is influenced by subjective concepts. Patients themselves suggested alternatives for detecting the quality of pain. The data should be replicated in larger samples and also take possible influences on the perception of the assessment into account.

Keywords: Grounded theory; Outcome, patient reported; Pain management; Pain measurement, validity; Reference values.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement / nursing*
  • Pain Measurement / psychology*
  • Pain Measurement / statistics & numerical data
  • Patient Satisfaction*
  • Psychometrics
  • Qualitative Research
  • Reproducibility of Results