PATIENT SATISFACTION AND PAIN SEVERITY AS OUTCOMES IN PAIN MANAGEMENT- A LONGITUDINAL VIEW OF ONE SETTINGS EXPERIENCE

Longitudinal data from quality assurance studies of pain outcomes (pai n severity and patient satisfaction) were critically examined to explo re the reasons that patients are satisfied with their care even when t hey are in pain. Data were acquired from three sources: self-report su rveys of patients during inpatient admission or ambulatory clinic visi t (N = 306), telephone interviews of patients after discharge (N = 869 ), and chart reviews (N = 112). These data were compared to baseline d ata obtained 2 years ago, before the implementation Of a number of pro grams designed to improve pain management. Findings reveal little chan ge from baseline with respect to patient satisfaction with pain manage ment-an overwhelming percentage are satisfied or highly satisfied. Sim ilarly, there has been little change in pain intensity ratings-on aver age, patients' worst pain is approximately 7 on a 0-10 scale. In addit ion, almost all analgesic orders continue to be written for ''as neede d'' administration. Based on these findings, we postulate that patient s are satisfied even though they are in pain because they experience a commonly expected peak and trough pattern of pain relief a pattern th at occurs with ''as needed'' administration. That is, we conclude that pattern of pain relief not pain severity, may be the critical determi nant of satisfaction.