SummaryIntroductionEvidence on patient experiences with pain in hospitals and its impact on post‐discharge outcomes is limited. This study investigated the prevalence of pain in hospitals, patient characteristics associated with pain management adequacy, and the link between pain experiences, care ratings, readmission and emergency department visits after discharge.MethodsWe conducted a retrospective cross‐sectional analysis of the 2019 Adult Admitted Patient Survey, focusing on self‐reported pain experiences, including presence, severity and management adequacy. The outcomes included self‐reported overall care ratings; readmission; and emergency department visits within one month of discharge. Multivariable logistic regression adjusted for population weight was used to estimate adjusted odds ratios.ResultsAmong 75 large public hospitals, 21,900 patients responded (35% response rate), with 51% of patients reporting pain (mean (SD) age 57 (8.8) y; 54.9% female), 38.3% of whom classified their pain as severe. Aboriginal and/or Torres Strait Islander people and patients who spoke a language other than English were less likely to report adequate pain management (aOR (95%CI) 0.74 (0.58–0.96) and 0.82 (0.70–0.96), respectively). Pain also correlated with poor to very poor care ratings (aOR (95%CI) 2.05 (1.42–2.95)). Those patients who experienced pain were twice as likely to be readmitted (aOR (95%CI) 1.92 (1.55–2.37)) or visit the emergency department after discharge (aOR (95%CI) 1.91 (1.58–2.32)). Conversely, adequate pain management was associated with a lower likelihood of readmission (aOR (95%CI) 0.69 (0.51–0.94)) and emergency department visits (aOR (95%CI) 0.62 (0.44–0.87)). Mediation analysis suggests adequate pain management significantly mediated the relationship between pain severity and hospital rating (50.8%), readmission (11.6%) and emergency department visits (5.9%), after adjusting for all available observed confounders.DiscussionThis study highlights the importance of adequate pain management in patients' perception of care and recovery outcomes, especially among culturally and linguistically diverse patients.

中文翻译：

---

自我报告的医院疼痛经历与护理、再入院和急诊科就诊评级之间的关联：一项来自澳大利亚新南威尔士州的基于人群的研究


摘要简介关于患者在医院疼痛经历及其对出院后结果影响的证据有限。本研究调查了医院疼痛的患病率、与疼痛管理充分性相关的患者特征，以及疼痛经历、护理评级、再入院和出院后急诊科就诊之间的联系。方法我们对 2019 年成人入院患者调查进行了回顾性横断面分析，重点关注自我报告的疼痛经历，包括存在、严重程度和管理充分性。结果包括自我报告的总体护理评级;再入院;以及出院后一个月内去急诊科就诊。使用针对人群权重调整的多变量 logistic 回归来估计调整后的比值比。结果在 75 家大型公立医院中，有 21,900 名患者做出了回应 （35% 的回应率），其中 51% 的患者报告了疼痛 （平均 （SD） 年龄 57 （8.8） 岁;54.9% 为女性），其中 38.3% 的患者将疼痛归类为严重。原住民和/或托雷斯海峡岛民以及说英语以外语言的患者不太可能报告充分的疼痛管理（aOR （95%CI） 分别为 0.74 （0.58-0.96） 和 0.82 （0.70-0.96）。疼痛也与差到极差的护理评级相关 （aOR （95%CI） 2.05 （1.42–2.95））。那些经历疼痛的患者再次入院 （aOR （95% CI） 1.92 （1.55-2.37）） 或出院后去急诊科就诊的可能性是普通患者的两倍 （aOR （95%CI） 1.91 （1.58-2.32））。相反，适当的疼痛管理与再入院 （aOR （95% CI） 0.69 （0.51-0.94）） 和急诊科就诊 （aOR （95%CI） 0.62 （0.44-0.87）） 的较低可能性相关。 中介分析表明，在调整了所有可用的观察到的混杂因素后，充分的疼痛管理显着介导了疼痛严重程度与医院评级 （50.8%） 、再入院 （11.6%） 和急诊科就诊 （5.9%） 之间的关系。讨论本研究强调了充分的疼痛管理对患者对护理和康复结果的看法的重要性，尤其是在文化和语言不同的患者中。