title: Acceptability of severe pain among hospitalized adults.
abstract: BACKGROUND
  It is unclear why some hospitalized adults experiencing severe pain report that this degree of pain is acceptable to them.
  
  
  METHODS
  A 25% random sample of cognitively intact patients admitted to nine medical/surgical units in a New York City hospital were enrolled. Patients were interviewed daily, Monday to Friday from April 1, 2001 through February 14, 2003, to collect information on the presence of pain, pain intensity, analgesic use, and acceptance of pain. Patients were asked to rate their current level of pain using a four-point scale.
  
  
  RESULTS
  Three hundred ninety-two of 1254 patients ( 31%) experiencing severe pain reported that their pain was acceptable to them. Variables significantly associated with an episode of acceptable severe pain in multivariate analyses included resolution of the painful episode (odds ratio = 4.7; 95% confidence interval [CI], 3.54-6.17), recent surgery (odds ratio = 1.5; 95% CI, 1.11-1.99), African American compared to white (odds ratio = 0.7; 95% CI, 0.48-0.955), age (odds ratio = 0.985; 95% CI, 0.977-0.993), and patients taking analgesics (odds ratio = 0.7; 95% CI, 0.46-0.964 for nonsteroidal anti-inflammatory drugs [NSAIDs]/acetaminophen and odds ratio = 0.6; 95% CI, 0.46-0.85 for opioids). Overall, 86 of 252 (34%) reported the pain was acceptable because it had resolved, 47 (19%) believed the pain would eventually go away, and 47 (19%) reported they were able to tolerate the pain.
  
  
  CONCLUSIONS
  A substantial percentage of patients reporting severe pain report this experience as acceptable. Given recent research linking high intensity pain to adverse outcomes, future studies directed at improving the management of pain need to target both pain intensity and patients' beliefs about the acceptability of severe pain.
authors.affiliation: Hertzberg Palliative Care Institute of the Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York 10029, USA.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Maroney
authors.forename: Ann
authors.initials: A
authors.lastname: Litke
authors.forename: Daniel
authors.initials: D
authors.lastname: Fischberg
authors.forename: Carlton
authors.initials: C
authors.lastname: Moore
authors.forename: R Sean
authors.initials: RS
authors.lastname: Morrison
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010146:Pain / Q000208:ethnology / Q000523:psychology*; D010147:Pain Measurement / Q000523:psychology*; D011446:Prospective Studies