Hospitalized patients' vs. nurses' assessments of pain intensity and barriers to pain management.

AIMS: The aim of the study was to identify if nurses and patients equally assessed pain intensity and patient-related barriers to pain management in hospitalized patients.

BACKGROUND: Several studies reported poor to moderate agreement between patient- and nurse-reported pain assessment. Many of these studies focused on a specific patient group. So far, no study studied the level of agreement in the assessment of patient-related barriers between patients and nurses.

DESIGN: A cross-sectional study was performed in two hospitals.

PARTICIPANTS: Inclusion criteria for patients were: (1) being at least 18 years; (2) understanding the Dutch language; and (3) giving informed consent. All nurses responsible for the participating patients and present at the time of the survey were invited to participate.

METHODS: Data were collected between October 2012 - April 2013. Patients and nurses completed the Numeric Rating Scale to measure pain intensity. Patient-related barriers to pain management were measured using the barriers to pain assessment and management scale developed by Elcigil et al. (Journal of Pediatric Hematology Oncology 2011, 33:S33).

RESULTS: A moderate agreement between patients and nurses was found for the assessment of pain intensity. Multiple logistic regressions showed a significant association between pain intensity reported by patients and the under-, over- and adequate estimation of pain by nurses. Nurses significantly underrated the belief patients had about pain management.

CONCLUSIONS: Nurses should be educated about these beliefs and should be encouraged to actively explore patient-related barriers to pain management with their individual patients. Routine pain assessments should also be encouraged and should be explained to patients.