Background Patients with limited ability to communicate cannot have a proper evaluation of pain using self-evaluation tools. Therefore they might not receive the appropriate analgesic treatment. Our audience was the medical and paramedical staff of our hospital. These people are involved in care management of patients with limited ability to communicate.
Purpose The objectives of the study were to assess their knowledge and to evaluate their motivation to use appropriate tools: the behavioural tools.
Materials and methods A questionnaire was sent out to all medical and nursing staff in osteoarticular wards (rheumatology and orthopaedics) and had to be completed the same day. The people queried work in outpatient and conventional wards. The main outcome measured the existence of tools to evaluate acute pain, the sensitivity of staff to patients with limited ability to communicate, and the staff’s awareness and knowledge of existing behavioural tools.
Results A total of 53 questionnaires was returned. The function of the participants was divided as follows: nurses (65%), nursing auxiliaries (30%), residents and physiotherapist (about 5%). A large majority (94%) reported that they evaluated patient pain using a self-report tool. The rest of the participants admitted that they were not using any instruments. To the question ‘Have you identified in your ward the presence of patients with limited ability to communicate?’, we obtain a 100% of positive answers by the orthopaedics ward staff, against 58% only in the rheumatology ward. Despite the fact that behavioural tools are not used in these 2 wards 20% of the staff acknowledged their existence and a few of them were able to name a specific tool. The overall majority (87%) of staff members were keen to use a behavioural tool in their daily practice. The others (13%) didn’t know about them but were not opposed to learning. However, they requested a decision-making template to choose the right tool.
Conclusions Within the two wards, we observed a real difference in identifying the presence of patients with limited ability to communicate. This observation was not expected. It may highlight the fact that the medical and nursing staff are not sufficiently trained to identify such patients’impairment in some wards. There is a need to ensure appropriate identification of this sub-group of patients and to be able to offer them an appropriate tool with which to rate and communicate the severity of their pain. The staff motivation was very encouraging for setting up behavioural assessment tools. This should lead to the correct use of analgesic drugs which are delivered by hospital pharmacists.
No conflict of interest.
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