Title : Post discharge pain experience following primary total hip or total knee arthroplasty in patients whose primary language is not English
Background: Pain following total hip or total knee arthroplasty following discharge from hospital is not well understood, especially inpatients whose primary language is not English. The objective of this study was to review how communication barrier impact the understanding of and reporting of pain levels, rather than whether non-English speaking patients actually experience different pain levels.
Purpose: The purpose of the study was:(1) To determine pain scores of the patients upon discharge from acute care; (2) Assess what level of pain scores were satisfactory; (3) Assess the number of prescribed pain tablets taken; (4)Assess the association between pain score and the number of tablets controlling for age and gender and (5) To determine whether the patients were satisfied with their ability to communicate their pain control needs, describe their satisfaction and to say how to improve pain control.
Method: Consent was obtained in the presence of a substitute decision maker. Ethics approval was obtained. Patients were presented with a Study Instruction Sheet. The sheet provided directions surrounding the completion of the Pain Self-Assessment Form (PSAF). Pain scores were measured 3 times/day with an average daily score for 5 days.
Result: Of the 22/143 patients who met the criteria, 20 consented and 2 declined. The overall response rate was 18/19 = 94.7%.Fifty-six percent of patients were satisfied with pain control. Fifty percent reported nausea; 28%reported dizziness and sweating; 22% reported constipation. Thirty-nine percent needed an interpreter.
Conclusion: Post-operative pain control is important to both patients and health care professionals. The most common recommendation was to use a translator. Impaired communication through language barriers complicates the caring process even more. Information from this study will improve discharge teachings.