Pain control is a key part of care for hospitalized patients. Despite calls from major health care organizations to improve provider awareness and training about pain control, pain management remains inadequate for many hospitalized patients. The quality of pain control among hospitalized patients is typically measured using retrospective reports of pain, which are often inaccurate. The experience sampling method (ESM) is a measurement tool that takes repeated, real‐time measurements of an experience and may provide more accurate measures of pain and the quality of pain control than retrospective surveys. Many ESM methodologies could be used to measure pain in hospitalized patients, including telephones, watches, diaries, and palmtop computers. Palmtop computers offer the advantage of automated data collection, but our prior work suggested that many patients, especially older ones, cannot effectively use palmtops. Bedside phones are ubiquitous in hospital rooms and are more easily used by many patients. The purpose of this study was to assess the efficacy of the palmtop computer ESM and the bedside telephone ESM in measuring pain in hospitalized patients.
Participants for this study were patients admitted to the general medicine service at the University of Chicago Hospital. If they were physically able and then agreed to participate, patients were surveyed repeatedly throughout the day for real‐time reports of pain and satisfaction with pain management. Palmtop ESM patients were given a palmtop computer during their hospital stay and surveyed 9 times per day on the computer during daytime hours. Telephone ESM patients were surveyed 5 times per day over their bedside telephone.
Patients were significantly more likely to be physically capable of participating in the telephone than the palmtop ESM study (97% vs. 72%, P < 0.001). In addition, eligible patients were more likely to consent to the telephone than to the palmtop ESM study (80% vs. 65%, P < 0.001). Multivariate logistic regressions confirmed these findings and also showed that these benefits of using telephone ESM over palmtop computer ESM were significantly greater among patients older than age 65. In addition, clustered logistic regression showed that patients enrolled in the telephone ESM study were significantly more likely to answer the ESM survey than were patients in the palmtop ESM study (OR = 3.40 for telephone vs. palmtop ESM; P = 0.026).
This study highlights the strengths of bedside telephone ESM as a technique to gather momentary pain data from hospitalized general medicine patients, particularly among older patients. Because there are bedside telephones in virtually all hospital rooms, the bedside telephone ESM might be a preferred way to assess pain and satisfaction with pain management in hospitalized patients. Because of the success and ease of this method, bedside telephone ESM could also be used to measure other momentary phenomena, such as more general features of quality of care.
J. Wortman, none; A. Chiu, none; J. Siddique, none; D. Meltzer, none.