A pilot study investigating the effect of a patient-held pain assessment tool in palliative care outpatients attending a rural Kenyan hospital.

Abstract

Pain is a frequent and distressing symptom in palliative care patients worldwide. Careful assessment is the first vital step to relieve this suffering. Assessment tools form a useful adjunct to pain management, but whether they make a difference to the patient is not known. The objective of this study was to investigate whether the use of a patient-held pain assessment tool can make a difference in patient's pain control. AIC Kijabe Hospital, Kenya, has had a nurse-led Palliative Care Service since 2002, with an annual case-load of around 600 patients. Study participants were recruited from among adult palliative care patients attending the Outpatient Department. A quantitative experimental study methodology was employed. In the pre-intervention phase, pain was assessed at study entry and at 2 weeks, following 'standard' care at home; 49 patients were recruited for this phase. In the intervention phase, pain assessments were made at entry, with follow-up assessment after introduction to a patient-held pain assessment tool taken home by each patient; 50 patients were recruited for this phase. Analysis involved a comparison of baseline and 2-week pain scores between the two groups. The results demonstrated that the use of a patient-held pain assessment tool led to an increase in the number of patients reaching satisfactory pain relief, from 30% in the pre-intervention group, to 69% in the intervention group. This study has demonstrated that a simple pain assessment tool, when linked to some action, may help achieve better analgesia.