International Journal of Anesthesiology & Pain Medicine

Cross Sectional Study of Pain Management Practice at Medical Wards of Jimma University Specialized Hospital (JUSH), Southwest Ethiopia

Background: Data on the practice of assessment and management of pain at medical ward of JUSH is scant.

Objective: To examine the state of assessment and management of pain at JUSH medical wards.

Materials and Methods: A cross sectional study was conducted to evaluate the assessment and management of pain at JUSH medical wards from August 1-September 30/2014 GC. A total of 161 patients were included. Data was collected using interview and observation. Information about sociodemographic variables and about pain- collected through independent scoring of pain, and characterization of pain at admission, 4^th hr, 8^th hour 12^th and 24^th hr of their admission time using FPS (Facial Pain Scale) which was later categorized as: no, mild, moderate and severe pain if it falls at 0, 1-3, 5-7, and 8-10 respectively. Finally, individual patient’s chart review was done. For the purpose of this study 9 data collectors were recruited and trained. Supervision was conducted during data collection. Data was analyzed using SPSS 20. Ethical clearance was obtained from the ethical committee of College of Public Health and Medical Science (CPHMS).

Results: From a total 195 admitted patients over 55 days, 161 patients who fulfilled the inclusion criteria were included in the study. The mean age (SD) was 49.89 (1.60) years, 29 (18.01%) were aged 65 or more and age ranges 19-84. About 69(42.8%) were females. The mean age (SD) of females and males was 42.99 (13.51) and 55.08 (15.10) years respectively. Before admission, 45 (28.30%), 80 (50.31%), and 22 (13.83%) had mild, moderate and severe pain respectively. At admission, 54 (33.96%), 88 (55.34%), and 4(2.51%) had mild moderate and severe pain respectively. After admission, 113 (%), 29(%) and 1 (%) had mild, moderate and severe pain respectively. About 80 (49.69%) and 51 (31.68%) of patients felt the worst degree of pain before and at admission respectively. Concerning the effect of pain, 71 (48.63%), 43(29.45%), and 23 (15.75%) of patients who experienced pain expressed that the pain interfered with their sleep, physical activity, and mood respectively. Pain aggravating conditions mentioned at 8^th hour were IV/IM/IM medication, LP/ID/catheter. At 24^th hr, 43 (26.71%) of the patients both received analgesics their pain assessment and management documented, among these, 17 (39.53%) and 27 (62.79%) of drugs were ordered on regular and irregular basis respectively. The most commonly ordered drugs were diclofenac, paracetamol, and multiple, accounting for 21 (48.84%), 18 (41.8%), 4 (9.30%) respectively. Also six (3.73%) of all patients received analgesics as well as assessment and management of pain documented, and 12 (7.45%) patients’ assessment and management was documented without the patient’s receipt of analgesics. And 100 (62.11%) of patents neither received analgesics nor their assessment of pain/management documented. Pain was not measured using scales or ratings at all.

Author(s):

Zenawi Negash, Sahilu Assegid, Cherinet Abebe

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