Caregiver assessments of patient pain are important for diagnostic and other reasons. Distracting environments when vital-sign measurement during intake were linked with inaccurate estimates of pain by nurses and nursing support staff (for example, licensed vocational nurses).
The study examined the influence of distracting environments and the accuracy of patient pain assessments by nurses and nursing support staff.
Multiple methods were used to collect information at 19 clinics at two hospitals and six affiliated sites in the VA system in three large urban centers in Southern California. These included chart reviews as well as surveys completed by caregivers and (primary care, urgent care, women’s heath, cardiology, and oncology) patients. Healthy and frail patients answered the survey, which was administered by an interviewer. Patient perceptions of environmental factors were rated on a 4-point scale with response options: extremely, moderately, not very, or not at all. The questions asked of patients were:
- How private was the room or space you were in?
- How free from interruption was the time you spent with the nurse?
- How easy was it for you to understand what the nurse said?
- How rushed did your time with the nurse feel?
- How distracted by other things did the nurse seem to be?
- How caring a person did the nurse seem to be?
Nursing staff was asked questions from the Confidence in Pain Management Scale and the Negative Pain Belief Scale, among others. After patient surveys were matched with those of their caregivers, data from 456 patients and 94 caregivers were available for analysis.
The composite factor including all of the questions related to distracting environments, reported in the methods section here, were, according to the authors, “significantly and negatively associated with nursing staff pain overestimation.”
- Data was only collected at VA facilities.
- Participating patients were predominantly male.
- Only outpatients participated in this study.