Nurses’ response to pain communication from patients: A post-test experimental study

Background: Inadequate communication about pain can result in increased pain for patients. Objectives: The purpose of the current pilot study was to test how nurses respond when patients use their own words, a pain intensity scale, or both to communicate pain. Design: A post-test only experimental design was used with three pain description conditions, personal and numeric; personal only; numeric only. Setting: The setting included six hospitals and one school of nursing located in the northeastern United States. Participants: Participants included 122 registered medical surgical nurses. Methods: Nurses were randomly assigned to condition, and read a vignette about a trauma patient with moderately severe pain. The vignettes were identical except for the patientʹs pain description and age. The nurses then wrote how they would respond to the patientʹs pain. Two blind raters content analyzed the responses, giving nurses one point for including each of six a priori criteria derived from the Acute Pain Management Panel [1992. Acute Pain Management: operative or medical procedures and trauma. Clinical practice guideline (AHCPR Publication No. 92-0032)., Rockville, MD, USA] and the American Pain Society [2003. Principles of analgesic use in the treatment of acute pain and cancer pain, Glenville, IL, USA]. Results: Nurses planned similar numbers of pain management strategies across the three conditions, with a mean of 2.1 (SD=1.14) strategies out of the recommended six. Conclusions: Nurses did not respond with more pain management strategies when patients describe pain in their own words, or in their own words and a pain intensity scale. The relatively small number of pain management strategies planned by the nurses suggests that nurses use few strategies to respond to moderately severe pain problems.