Factors Influencing Patient Satisfaction on Patient-Controlled Analgesia (PCA) for Postoperative Pain Management
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Abstract
Background: Patient-controlled analgesia (PCA) has been
shown to ameliorate the clinical outcome and previous
studies investigating the use of patient-controlled analgesia
have incorporated the evaluation of patient satisfaction.
This study aims to evaluate the factors that influence
patient satisfaction on postoperative patient-controlled
analgesia at King Chulalongkorn Memorial Hospital
Objective: To evaluate the factors affecting patient
satisfaction on postoperative patient-controlled analgesia
(PCA) in a tertiary care center
Setting: Acute pain service at King Chulalongkorn
Memorial Hospital, 1500-bed tertiary hospital.
Research design: Prospective and descriptive study.
Patient: Patients over 18 years of age undergoing
elective and emergency surgery under anesthesia with
postoperative patient-controlled analgesia provided
under supervision and care of acute pain service at King
Chulalongkorn Memorial Hospital from October 2013 to
September 2014.
Methods: Verbal Numeric Rating Scale for pain intensity
and patient satisfaction score (0-10; 0=worst and 10=best)
for postoperative pain assessment of 280 patients were
recorded by acute pain staffs at 24th hour and end of
service. The data were statistically analyzed by SPSS
version 22. Categorical data and continuous data
were analyzed by Chi-square tests and unpaired t-test
respectively. Multiple logistic regression was also used.
P < 0.05 was considered statistically significant.
Results: At the end of the study, 85.4% of patients
reported satisfaction score ≥ 8. Factors associated with
good satisfaction score were lower VNRS, P= 0.006.
Odd ratio= 0.316 (95%CI=0.140-0.716) and absence of
vomiting, P= 0.003. Odd ratio=0.327 (95%CI=0.155-0.691)
Conclusion: The majority of the patients reported high
levels of satisfaction on postoperative patient-controlled
analgesia (PCA). Factors contributing to high satisfaction
were lower VNRS and absence of vomiting.
Article Details
References
anesthesia outcomes are both common and important to
avoid? The perspective of a panel of Expert anesthesiologists.
Anesth Analg 1999; 88:1085-91.
2. Sinatra R. Causes and consequences of inadequate
management of acute pain. Pain Med 2010; 11:1859-71.
3. Shea RA, Brooks JN, Dayholl NE, et al. Pain intensity and
postoperative pulmonary complications among the elderly
after abdominal surgery. Heart Lung 2002; 31:440-9.
4. Carr DB, Goudas LC. Acute pain. Lancet 1999; 353:2051-8.
5. Sauaia A, Min SJ, Leber C, Erbacher K, Abrams F, Fink R.
Postoperative pain management in elderly patients:
correlation between adherence to treatment guidelines and
patient satisfaction. J Am Geriatr Soc 2005; 53:274-82.
6. McNeil JA, Sherwood GD, Starck PL, et al. Assessing clinical
outcomes: patient satisfaction with pain management. J Pain
Symp Manage 1998; 16:29-40
7. Ferguson R, Williams ML, Beard B. Combining quality
improvement and staff development efforts to decrease
patient-controlled analgesia pump errors. J Nurses Staff Dev
2010; 26:E1-4.
8. Momeni M, Crucitti M, De Kock M. Patient-controlled
analgesia in the management of postoperative pain. Drugs
2006; 66:2321-37.
9. Dawson R, Spross JA, Jablonski ES, et al. Probing the
paradox of patients’ satisfaction with inadequate pain
management. J Pain Symptom Manage 2002; 23:211-20.
10. Miaskowski C, Nichols R, Brody R, et al. Assessment of
satisfaction utilizing the American Pain Society’s Quality
Assurance Standards on acute and cancer-related pain.
J Pain Symptom Manage 1994; 9:5-11.
11. Jamison RN, Ross MJ, Hoopman P, et al. Assessment of
postoperative pain management: patient satisfaction and
perceived helpfulness. Clin J Pain 1997; 13:229-36.
12. Johnson LR, Magnami B, Chan V, et al. Modifers of
patient-controlled analgesia efficacy. I. Locus of control. Pain
1989; 39:17-22
13. Sherwood G, Adams-McNeill J, Starck PL, et al. Quality
assessment of hospitalized patients’ satisfaction with pain
management. Res Nurs Health 2002; 23:486-95.
14. McCracken LM, Klock PA, Mingay DJ, et al. Assessment of
satisfaction with treatment of chronic pain. J Pain Symptom
Manage 1997; 14:292-9
15. Ratrout HF, Hamdan-Mansour AM, Seder SS, et al. Patient
satisfaction about using patient-controlled analgesia in
managing pain post surgical intervention. Clin Nurs Res
2014; 23:353-68.