title: The prevalence of pain at pressure areas and pressure ulcers in hospitalised patients.
abstract: BACKGROUND
  Patients with pressure ulcers (PUs) report that pain is their most distressing symptom, but there are few PU pain prevalence studies. We sought to estimate the prevalence of unattributed pressure area related pain (UPAR pain) which was defined as pain, soreness or discomfort reported by patients, on an "at risk" or PU skin site, reported at a patient level.
  
  
  METHODS
  We undertook pain prevalence surveys in 2 large UK teaching hospital NHS Trusts (6 hospitals) and a district general hospital NHS Trust (3 hospitals) during their routine annual PU prevalence audits. The hospitals provide secondary and tertiary care beds in acute and elective surgery, trauma and orthopaedics, burns, medicine, elderly medicine, oncology and rehabilitation. Anonymised individual patient data were recorded by the ward nurse and PU prevalence team. The analysis of this prevalence survey included data summaries; no inferential statistical testing was planned or undertaken. Percentages were calculated using the total number of patients from the relevant population as the denominator (i.e. including all patients with missing data for that variable).
  
  
  RESULTS
  A total of 3,397 patients in 9 acute hospitals were included in routine PU prevalence audits and, of these, 2010 (59.2%) patients participated in the pain prevalence study. UPAR pain prevalence was 16.3% (327/2010). 1769 patients had no PUs and of these 223 patients reported UPAR pain, a prevalence of 12.6%. Of the 241 people with pressure ulcers, 104 patients reported pain, a UPAR pain prevalence of 43.2% (104/241).
  
  
  CONCLUSIONS
  One in six people in acute hospitals experience UPAR pain on 'at risk' or PU skin sites; one in every 8 people without PUs and, more than 2 out of every five people with PUs. The results provide a clear indication that all patients should be asked if they have pain at pressure areas even when they do not have a PU.
authors.affiliation: Centre for Pain Research, Queens Square House, Leeds Metropolitan University, Leeds LS1 3HE, UK. m.i.briggs@leedsmet.ac.uk.
authors.forename: Michelle
authors.initials: M
authors.lastname: Briggs
authors.forename: Michelle
authors.initials: M
authors.lastname: Collinson
authors.forename: Lyn
authors.initials: L
authors.lastname: Wilson
authors.forename: Carly
authors.initials: C
authors.lastname: Rivers
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McGinnis
authors.forename: Carol
authors.initials: C
authors.lastname: Dealey
authors.forename: Julia
authors.initials: J
authors.lastname: Brown
authors.forename: Susanne
authors.initials: S
authors.lastname: Coleman
authors.forename: Nikki
authors.initials: N
authors.lastname: Stubbs
authors.forename: Rebecca
authors.initials: R
authors.lastname: Stevenson
authors.forename: E Andrea
authors.initials: EA
authors.lastname: Nelson
authors.forename: Jane
authors.initials: J
authors.lastname: Nixon
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