title: Factors associated with high levels of patient satisfaction with pain management.
abstract: OBJECTIVE
  The objective was to determine, among emergency department (ED) patients, the factors associated with a high level of satisfaction with pain management.
  
  
  METHODS
  This was a prospective cohort study in a single ED. Consecutive adult patients, with triage pain scores of ≥4 (numerical rating scale=0 to 10), were enrolled. Variables examined included demographics, presenting complaint, pain scores, nurse-initiated analgesia, analgesia administered, time to first analgesia, specific pain communication, and whether "adequate analgesia" was provided (defined as a decrease in pain score to <4 and a decrease from the triage pain score of ≥2). The level of patient satisfaction with their pain management (six-point scale: very unsatisfied to very satisfied) was determined by a blinded investigator 48 hours post discharge. Logistic regression analyses were undertaken.
  
  
  RESULTS
  Data were complete for 476 patients: mean (±standard deviation [SD]) age was 43.6 (±17.2) years, and 237 were males (49.8%, 95% confidence interval [CI]=45.2% to 54.4%). A total of 190 (39.9%, 95% CI=35.5% to 44.5%) patients were "very satisfied" with their pain management, and 207 (43.5%, 95% CI=39.0% to 48.1%) patients received adequate analgesia. Three variables were associated with the patient being very satisfied: the provision of adequate analgesia (odds ratio [OR]=7.8, 95% CI=4.9 to 12.4), specific pain communication (OR=2.3, 95% CI=1.3 to 4.1), and oral opioid administration (OR=2.0, 95% CI=1.1 to 3.4). Notably, the provision of nurse-initiated analgesia to 211 patients (44.3%, 95% CI=39.8% to 48.9%) and the short time to analgesia (median=11.5 minutes; interquartile range [IQR]=2.0 to 85.8 minutes) were not associated with being very satisfied.
  
  
  CONCLUSIONS
  The receipt of adequate analgesia (as defined) is highly associated with patient satisfaction. This variable may serve as a clinically relevant and achievable target in the pursuit of best-practice pain management.
authors.affiliation: Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Shill
authors.forename: David McD
authors.initials: DM
authors.lastname: Taylor
authors.forename: Bryan
authors.initials: B
authors.lastname: Ngui
authors.forename: Simone E
authors.initials: SE
authors.lastname: Taylor
authors.forename: Antony M
authors.initials: AM
authors.lastname: Ugoni
authors.forename: Michael
authors.initials: M
authors.lastname: Yeoh
authors.forename: Joanna
authors.initials: J
authors.lastname: Richardson
mesh_terms: D000293:Adolescent; D000328:Adult; D000698:Analgesia / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D011446:Prospective Studies; D055815:Young Adult