Förekomst och behandling av smärta samt interventioner som bidrar till förbättrat smärtomhändertagande hos patienter på sjukhus

Abstract

Background: Pain is common in hospitalized patients. Despite the availability of various treatment methods and effective drugs foroptimal pain alleviation, research has revealed that pain treatment remains suboptimal. Aim: e overall aim was to investigate the prevalence and treatment of pain in hospitalized patients, and whether interventions can improve pain management. Methods: A combination of methods was employed for data collection and analysis. Study I is a quantitative cross-sectional study. An intervention comprising the use of pain guidelines, education and nurses with responsibility for pain management was implemented between baseline (n=) and follow up (n=). Study II is a cross-sectional study that examined the occurrence and treatment of pain in hospitalized children and adolescents aged - years. Study III is a qualitative interview study where content analysis was employed. Out of adult patients who had undergone orthopaedic surgery, nine received oral information and nine both oral and written information about pain treatment. Study IV is a controlled intervention study comprising patients with cancer pain, half of whom were allocated to a control group and the other half to an intervention group. A multidimensional pain questionnarie was used in which the patients rated their pain. After the baseline measurements, the completed questionnaires were given to the care team, while only the researchers had access to those of the control group. e follow up measurement took place - days later. Results: Study I revealed significant differences in terms of increased use of pain rating and improved drug prescription. Study II highlighted deficiencies in pain rating and drug prescription in hospitalized children and adolescents. e children reported that drugs as well as different non-pharmacological methods provided pain relief. Study III demonstrated that the patients perceived that oral and written information provided them with knowledge that enabled involvement in their own pain treatment, whereas oral information alone was difficult to remember and use postoperatively. Study IV showed a significantly lower pain intensity and less influence on other pain-related dimensions and symptoms, as a result of drug adjustments in the intervention group. Conclusion: e present thesis contributes knowledge about the occurrence and treatment of pain in hospitalized patients. Interventions can facilitate improved pain management, both in terms of pain rating and treatment. Improved pain treatment can reduce pain and lead to less impact on other dimensions and symptoms. More research in the area is needed to design several interventions that can alleviate pain, increase knowledge and raise awareness of the need for greater focus on ethical and humanitarian aspects of caring for patients with pain.