Abstract
Evaluating the absolute difference in pain intensity and the percentage difference in pain intensity could facilitate an understanding of pain reduction among cancer patients during repeated hospitalizations. Examinations of the absolute differences in pain intensity and the percentage differences in pain intensity according to the worst pain intensity and last evaluated pain intensity before discharge are lacking. The aim of this study was to evaluate the absolute and percentage difference in pain intensities among cancer patients with moderate or severe pain from their 1st to 18th hospitalizations from 2011–2013. A population-based retrospective cohort study was conducted. Pain intensity was assessed using scales and was recorded in a nursing information system. The absolute and percentage difference in pain intensities were examined via the one-sample Kolmogorov-Smirnov test, and group differences in moderate or severe pain were evaluated with the Mann-Whitney U test. For moderate pain patients, the mean absolute difference in pain intensity was 1.52, and the percentage difference in pain intensity was 29.0%; both these values were significant. More significant changes in the absolute and percentage difference in pain intensities were associated with severe pain patients. Both the average absolute difference in pain intensity (3.09) and the percentage difference in pain intensity (38.5%) in patients with severe pain were significantly higher than the average absolute difference in pain intensity (1.52) and the percentage difference in pain intensity (29.0%) in patients with moderate pain. Cancer patients with moderate and severe pain experienced pain reductions of approximately 30% and 40%, respectively. Early pain management intervention in patients with severe pain is necessary to achieve an obvious analgesic effect, and the formula of the percentage difference in pain intensity should be incorporated into the nursing information system to alert clinicians for early detection of the effectiveness of cancer pain management.
Highlights
The absolute pain intensity difference (PID) and the percentage difference in pain intensity (%PID) are common methods for evaluating the magnitude of pain reduction [1]
Significant changes were observed in the PID and %PID values associated with the severe pain group; for this category, the mean PID was 3.09, and the average %PID was 38.5% (Table 1)
Based on the patient-reported pain score at different time points, this study showed that the ranges of the PID and %PID were 1.13–1.74 and 21.8%-33.9%, respectively, in the moderate pain group; the ranges of the PID and %PID were 2.84–3.36 and 35.5%-42.5%, respectively, in the severe pain group from the 1st to the 18th hospitalizations
Summary
The absolute pain intensity difference (PID) and the percentage difference in pain intensity (%PID) are common methods for evaluating the magnitude of pain reduction [1]. The raw PID data is easy to calculate but may lead to inconsistent results, especially when variations in baseline pain intensity occur. The %PID was calculated as a percentage difference to adjust for the baseline pain intensity to provide a more consistent and clinically relevant measure of pain intensity and has the potential to increase comparability between studies [2]. When pain intensity is greater than 7 points, pain is considered severe. Pain intensities between 4 and 6 points are defined as moderate pain [6]. More than one-third of cancer patients experience moderate or severe pain [7]. Despite clear recommendations from the World Health Organization (WHO), pain is still a major problem experienced by cancer patients during repeated hospitalizations [8,9,10]
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