Short summary

Patients with acute abdominal pain receive insufficient pain relief and information about pain management during hospital admission. The aim of the study is to investigate how patient involvement in pain management during hospital stay affects pain score, patient satisfaction and experience from hospital arrival to recovery after discharge for patients with acute abdominal pain.

Rationale

Patients with acute abdominal pain represent one of the most common categories of patients in emergency department and about half of emergency surgical admissions. Generally, they receive insufficient pain relief and information about pain management during hospital admission. Patient involvement in care and treatment has generally improved patient satisfaction, compliance and output of treatment. In addition, involved patients experience to be in control of the situation which improves responds on treatment.

The aim of this study is to investigate how patient involvement in pain management during hospital stay affects pain score, patient satisfaction and experience from hospital arrival to recovery after discharge for patients with acute abdominal pain.

Description of the cohort

The study has a before-and-after design. In total, 420 patients will be recruited from emergency and surgical department at Odense University Hospital and Svendborg Hospital.

The cohort are patients with acute abdominal pain who are referred to hospital for a surgeon assessment, at least 18 years of age, ability to speak and read Danish, an expected compliance to study intervention and a hospital stay of more or equal to 8 hours. Exclusion criteria are end-stage patients, patients with known pancreatitis, cancer and inflammatory bowel disease.

The study intervention includes patient administered analgesics by use of pain score and the WHO analgesic ladder. Analgesics for non-injection use are handed out to the patient and administered by the patient. Analgesics provided as injections are administered by the nurses. Pain scores and self-administered analgesics are documented on a special designed sheet that is used as basis for a conversation between the patient and health professionals. As a minimum, twice a shift, the patient and the health professional evaluate in cooperation the degree of pain and the use of analgesic. At discharge, use of pain score and the WHO analgesic ladder at pain management during recovery are discussed with the patient.

Data and biological material

Data will be collected by means of review of medical files, three patient questionnaires (at discharge, one week and one month after discharge) and qualitative interviews one week after discharge.

Data collected from the medical records include: demographic data, pain scores, type and amount of analgesics provided, length of hospital stay and 30 days readmission rate.

Patient questionnaire will collect data concerning pain scores, satisfaction and experience of pain management, patient involvement, interference with daily activity and beliefs on pain management.

Qualitative interviews will explore patients' experience of pain management during hospital stay and after discharge.

Collaborating researchers and departments

Surgical Department, Odense University Hospital

Institute of Clinical Research, University of Southern Denmark

• Postdoc Helen Schultz, PhD
• Professor Niels Qvist, MD

Surgical Department, Odense University Hospital

• Clinical Nurse Specialist Ulla Skræp, MCN
• Anaesthesia Nurse Lisbeth Madsen
• Nurse Line Abrahamsen
• Surgeon, senior consultant Kristian Aagaard Poulsen, MPM
• Surgeon, senior consultant Erik Zimmermann
• Surgeon Susanne Jensen

Emergency Department, Odense University Hospital, Odense

• Professor Annmarie Touborg Lassen, MD
• Head Nurse Charlotte Mose Hansen, MPM-student
• Clinical Nurse Specialist Lise Ewald Rekvad, MCN

Emergency Department, Odense University Hospital, Svendborg

• Ward Manager Susanne Falck Schmidt
• Clinical Nurse Specialist Jette Littau-Larsen