• Kerstin Wickström Ene, Gunnar Nordberg, Ingrid Bergh, Fannie Gaston Johansson, and Björn Sjöström.
• The Sahlgrenska Academy at Gothenburg University, Institute of Health and Care Sciences and Department of Anesthesiology, Sahlgrenska University Hospital, Gothenburg, Sweden. kerstin.wickstrom.ene@vgregion.se
• J Clin Nurs. 2008 Aug 1;17(15):2042-50.

AimTo compare pain levels reported by patients with those documented by ward nurses and to find out to what extent the amount of opioids given correlated with the pain level. Secondly, to study if pain management and nurses' approaches to this task had improved during a two-year period, including an educational pain treatment program for ward staff.BackgroundThe management of postoperative pain continues to remain problematic and unsatisfactory and ward nurses play an important role for this task.DesignThe study was a cross-sectional, descriptive, two-part study based on survey data from both patients and nurses on two urology surgical wards.MethodsPart I of the study included 77 patients and 19 nurses. Part II took place approximately two years later and included 141 patients and 22 nurses. Data were collected the day after surgery by asking patients about 'worst pain' experienced. The pain scores given by the patients were compared with those documented in the patients' records and with the doses of opioids administered. Nurses' approaches to pain management were sought after, by using a categorical questionnaire.ResultsThe nurses' ability to assess pain in accordance with the patients' reports had increased slightly after two years even if and the number of documented pain scores had decreased. Forty per cent of the nurses reported that they did not use visual analogue scale and that they did not assess pain at both rest and activity, neither did one fourth evaluate the effect of given analgesics.ConclusionThe study showed a discrepancy in pain scoring between nurses and patients, where active treatment was related to nurses' documentation rather than to patients' scoring.Relevance To Clinical PracticeThe study shows a need for more accurate pain assessment, since the patient experiences and suffers pain and the nurse determines upon treatment.

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