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Clinical judgments in pain management.

Janice Lander1

  • 13-103 Clinical Sciences, University of Alberta, Edmonton, Alberta T6G 2G3 Canada.

Pain
|July 1, 1990
PubMed
Summary

Despite advances in pain management, moderate to severe uncontrolled pain is common in hospitalized patients. This review examines under-management, its causes, and proposes a clinical decision-making model for improved pain control education.

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Area of Science:

  • Medical Research
  • Pain Management Science

Background:

  • Despite advancements in pain management, moderate to severe uncontrolled pain remains prevalent among hospitalized patients over the last two decades.
  • Existing research indicates a significant issue with the under-management of pain in clinical settings.

Purpose of the Study:

  • To examine and summarize research on the extent of pain under-management in hospitalized patients.
  • To identify factors contributing to the under-management of pain.
  • To review a clinical decision-making model for application in pain management.

Main Methods:

  • Systematic review and synthesis of research reports published over the last 20 years.
  • Identification and analysis of methodological imperfections in existing pain management research.
  • Review of proposed explanations for pain under-management.

Main Results:

  • Moderate to severe uncontrolled pain appears to be a common issue for hospitalized patients.
  • Methodological limitations were identified in the research reviewed.
  • Several potential explanations for the under-management of pain were reported.

Conclusions:

  • The under-management of pain in hospitals persists despite advances in pain control.
  • A clinical decision-making model shows promise for addressing pain management challenges.
  • This model could be instrumental in developing educational interventions to enhance healthcare practitioners' pain management skills.

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