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Volume 15, Issue 5, Pages 247-258 (October 1999)


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Strategies in postoperative pain assessment: validation study

Björn Sjöströma, Lars Owe Dahlgrenb, Hengo Haljamäec

Accepted 24 August 1999.

Abstract 

Pain assessment and management are major clinical problems that many categories of health-care professionals have to deal with. Although there are many potentially successful approaches available for pain management, there is still a shortage of knowledge about the strategies used by staff members for the actual assessment of pain and how reliable these strategies are. The fact that patients often undergo a great deal of suffering from pain and lack of adequate pain relief may be considered an indicator of this shortage of knowledge. Clinical studies from different parts of the world reveal that the incidence of pain reported by patients is still high, with about 75% reporting moderate pain and an additional 15% severe pain. The aim of the present study was to validate different categories used in acute pain assessment and their accuracy in a new clinical sample and to explore further different dimensions of how staff members experience pain assessment. Intensive care nurses (n = 10) were carrying out pain assessment of postoperative patients (n = 30). Each pain assessment was followed by a detailed interview and indicating the estimated pain intensity on a visual analogue scale (VAS, 0–10 cm). The pain ratings by the nurses were compared to those of the patients to assess the accuracy of the pain assessments of the staff members. A previously developed category system for describing the initial empirical material regarding criteria the nurses relied on when assessing pain, combined with what experience has taught them in this respect, was used to assess the validity of previous observations. The results indicate that similar approaches were still used by the nurses but the accuracy of pain assessment had considerably improved.

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a Department of Advanced Nursing Education, Göteborg University, Box 300, Göteborg, SE-405 30, Sweden

b Department of Education and Psychology, Linköping University, Linköping, Sweden

c Department of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Göteborg, Sweden

 1I = Informant C= The denotation CA means that the category refers to preference of criteria (C) and the index A refers to the location of the category in the sequence from A–D.2E = Experimentor.

PII: S0964-3397(99)91443-X

doi:10.1054/iccn.1999.1443


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