Smärtbedöming inom ambulanssjukvården : Hur sjuksköterskor bedömer patientens och vilka faktorer som påverkar bedömningen

Sammanfattning: Background: The majority of patients requiring medical attention experience some degree of pain. The nurses´ assessment of pain is crucial in reducing the patients suffering in a proper and timely manner. Previous studies have shown that the treatment of pain in a emergency situation is poorly managed. The patients´ pain experience is often under assessed and undertreated which leads to increased suffering for the patient. This results in higher costs for the health care system due to prolonged hospitalization. Aim: The purpose of this study is to define the ambulance nurse´s pain assessment of patient in the field and the affecting factors their evaluation. Method: A qualitative interview study with a descriptive design was conducted including seven emergency services nurses. Both male and female participants were involved with varying degrees of education as well as durations of employment. Result: Pain assessment by emergency personnel in the field was broken down into four categories for analysis as follow: communication (both verbal and nonverbal), measurable components, environment and evaluation of diversities. Verbal communication with appraisal of patients´ body language and facial expression was the most frequent factors in assessing pain. Measurable components such as vital signs and generalized symptoms were also accounted. VAS and NRS scales where most frequently used by nurses in rating pain among patients. The result suggested differences in pain assessment with respect to gender, age and cultural background. Conclusion: The participating nurses in this study describe verbal and nonverbal communication as the most influential factors in pain assessment of patients. In rating pain, the most frequently used tool was the NRS scale providing the nurses with what they consider to give the best understanding of patients´ pain experience. A risk has been identified in the analysis of patients´ vital signs which could lead to an under assessment and restrictive treatment of pain. The authors of this study believe that lack of knowledge in pain assessment and how to implement pain rating tools could contribute to this fact, and would therefore appreciate an improvement in skills assessing pain and a better understanding in the use of pain tools for emergency service nurses. This could lead to a better caliber of patient care for those suffering with pain.