Pain and concomitant symptoms in medical and elective surgical inpatients: a point prevalence survey.

AIMS AND OBJECTIVES: This study (1) reports the prevalence of severe pain and other symptoms among both medical and elective surgical patients and (2) examines the co-occurrence of severe pain and other symptoms and symptom-related distress. BACKGROUND: As symptom burden can interfere with patients' rehabilitation, daily activities and quality of life, detection and optimal management of pain and other symptoms is important for good nursing care. DESIGN: Cross-sectional point prevalence survey. METHODS: Data were collected by self-report on 10 predetermined screening days from medical and surgical patients admitted to a local hospital in Oslo, Norway. Patients rated their average level of pain on movement during the last 24 hours on a 0-10 numeric rating scale (severe pain defined as ≥7). The occurrence of other symptoms and symptom distress were measured with 15 items from the Memorial Symptom Assessment Scale. Data on comorbidities were also collected. RESULTS: A total of 602 patients participated in the study (response rate = 71%). Medical patients had a higher incidence of symptoms than surgical patients and reported more symptom distress. Surgical patients reported higher levels of pain than medical patients, but the prevalence of severe pain did not differ between the two groups. In analyses adjusted for age, sex and comorbidities, severe pain among medical patients was associated with severe distress due to concentration difficulties, vomiting, itching and swelling, while severe pain among surgical patients was associated with the occurrence of drowsiness. CONCLUSION: Associations between severe pain and other symptoms differ for medical and elective surgical patients. RELEVANCE TO CLINICAL PRACTICE: Knowledge of concurrent symptoms and comorbidities in medical and surgical patients experiencing severe pain may help nurses to better tailor management of the patients' symptoms and improve quality of care.