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Who’s asking? Patients may under-report postoperative pain scores to nurses (or over-report to surgeons) following surgery of the female reproductive tract

Archives of Gynecology and Obstetrics volume 279, pages 771–774 (2009)Cite this article

Abstract

Objective

To determine if postoperative pain reporting via standardised visual analogue scale (VAS) is affected by which member of the healthcare team collects the information.

Materials and methods

A standardised ten-point VAS measured postsurgical pain level among patients (n = 60) undergoing laparotomy via Pfannenstiel incision. All study patients received the same patient-controlled analgesia and uniform post-operative orders were used. VAS data were gathered from patients by surgeons (MD) and nurses (RN) 6 h and 24 h after surgery; RNs and MDs independently recorded patients’ VAS pain scores in variable order.

Results

When assessed 6 h after surgery, the average pain level reported by patients to RNs was significantly lower than that reported to MDs (3.3 ± 2.8 vs. 4.0 ± 2.4; P = 0.02). Average patient pain levels remained lower when reported to RNs 24 h post-operatively compared to that reported to MDs, although this difference was not significant (1.9 ± 2.1 vs. 2.1 ± 2.1; P = 0.39). Whenever post-surgical patients provided different VAS scores for pain level to RNs and MDs, the higher pain reading was always reported to the MD.

Conclusion

This study identified important variances in subjective pain reporting by patients that appeared to be influenced by who sampled the data. We found patients gave lower VAS pain scores to RNs compared to MDs; the reverse pattern was never observed. Post-surgical patients may communicate pain information differently depending on who asks them, particularly in the early post-operative period. Accordingly, patient pain data gathered over time by a care team with a heterogeneous composition (i.e., RNs, MDs) may not be fully interchangeable. Patient projections of pain severity and/or intensity appear to vary as a function of who evaluates the patient.

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Conflict of interest statement

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Author information

Affiliations

  1. The Sims Institute/Sims International Fertility Clinic, Rosemount Hall, Rosemount Estate, Dundrum Road, Dundrum, Dublin 14, Ireland

    Eric Scott Sills & Anthony P. H. Walsh

  2. Department of Obstetrics and Gynaecology, School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland

    Eric Scott Sills & Anthony P. H. Walsh

  3. Department of Econometrics, University of Geneva, Geneva, Switzerland

    Marc G. Genton

  4. Department of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, RI, USA

    Salim A. Wehbe

Authors
  1. Eric Scott Sills
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  2. Marc G. Genton
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  3. Anthony P. H. Walsh
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  4. Salim A. Wehbe
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Correspondence to Eric Scott Sills.

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Sills, E.S., Genton, M.G., Walsh, A.P.H. et al. Who’s asking? Patients may under-report postoperative pain scores to nurses (or over-report to surgeons) following surgery of the female reproductive tract. Arch Gynecol Obstet 279, 771–774 (2009). https://doi.org/10.1007/s00404-009-0938-y

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  • DOI: https://doi.org/10.1007/s00404-009-0938-y

Keywords

  • Post-operative pain
  • Visual analogue scale
  • Nurse
  • Surgeon
  • Discordance