ASSESSMENT OF POSTOPERATIVE PAIN - IMPACT OF CLINICAL-EXPERIENCE AND PROFESSIONAL-ROLE

Background: Unrelieved postoperative pain is still reported to be a ra ther common clinical problem which may be related to inadequate routin es for pain assessment. Therefore, the aim of the study was to describ e strategies used by experienced and less experienced nurses and physi cians in their assessment of postoperative pain and to relate differen t approaches, clinical experience, and professional role to the accura cy of the pain ratings. Methods: Data collection was based on repeated interviews with nurses (n = 30) and physicians (n = 30) in connection with clinical pain assessments (n = 180) including VAS-scoring. Resul ts: Commonly used strategies in the pain assessment were: - how the pa tient looks, - what the patient says, - the manner of talking, and - p ast experience of similar circumstances. The mean VAS-score given by t he patients (6.1 +/- 1.1) was significantly (P < 0.001) higher than th at rated by the staff members (4.9 +/- 1.2). Nurses as well as physici ans overestimated low and underestimated high levels of pain indicated by the patients. The accuracy of the ratings by nurses, especially by more experienced ones (greater than or equal to 10 years in nursing), was found to be less precise than that of physicians. The pain assess ment of these very experienced nurses was characterized by a systemati c underestimation. Conclusions: The present study emphasizes a need fo r definition of more precise strategies for clinical postoperative pai n assessment which better take into consideration the pain experiences and needs of individual patients (C) Acta Anaesthesiologica Scandinav ica 41 (1997).