番茄社区

ORLANDO -- Perception of pain among inpatients with inflammatory bowel disease (IBD) correlated positively with that assessed by their physicians and nurses, but the same can't be said for anxiety, researchers reported here.

Among 42 patients who self-reported anxiety and psychological distress using a visual analog scale (VAS), their assessments correlated only weakly with those of physicians (r=0.21) or nurses (r=0.29), reported Roni Weisshof, MD, of the University of Chicago Medicine Inflammatory Bowel Disease Center in Chicago, and colleagues at .

"Addressing and alleviating IBD patients' pain and psychological distress are important goals of management," said Weisshof regarding his reason for between patients and the healthcare professionals who treat them.

“What one can take from the results is the poor correlation regarding the anxiety assessment between the patients and the care team. We should improve our abilities to weigh patients’ anxiety situation,” he explained to 番茄社区.

Laurie A. Keefer, PhD, of the Icahn School of Medicine at Mount Sinai in New York City, who was not involved with the study, agreed that “clinicians may want to use a more sensitive scale to measure anxiety, fear, and worry among inpatients.”

The team asked 48 IBD patients at the University of Chicago Medicine to rate their pain severity and anxiety on a scale of 0-100 (with 100 being the worst). Patients' physicians and nurses then completed the same scales for their patients.

The researchers also collected clinical and medication data from the patients' medical records in order to stratify patients based on their reason for hospitalization, type of IBD, age, and prior opioid use.

A total of 19 patients (39%) received previous opiate therapy, 40 (83%) received analgesics during their admission, and 10 (21%) underwent a surgical intervention during their hospitalization. More than half of patients were female (n=27), and the median age was 28.

There was no significant difference in pain or anxiety scores based on age, IBD type, opiate use, or surgical intervention, the researchers added.

VAS pain assessment by patients and doctors (r=0.74, P=0) and patients and nurses was highly correlated (r=0.69, P=0). The correlations were independent of patient age, disease, or previous exposure to opiates, with the exception of worse pain correlation between younger patients and doctors (r=0.53, P=0.01).

“This is an interesting, but not necessarily hugely surprising, finding — since pain has become the ‘5th vital sign,’ providers and patients have been consistently trained to report on this symptom,” Keefer told 番茄社区. “The finding that younger patients were a little less well correlated with their providers points to potentially having less experience reporting pain in hospitalized settings, although years of diagnosis/disease severity are not reported here.”

Weisshof and colleagues also found that the perception of patient pain was similar among physicians and nurses (r=0.54, P=0.001).

“While these findings are very reassuring as for pain perceptions within the teams, it should encourage us to continue and assess our patients,” Weisshof told 番茄社区. “I believe that the team approach we take, using combined teams of physicians and nurses while taking care of these patients, proves itself as beneficial in many ways including this point of view.”

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