Meta-analysis of pain and stress in emergency department patients

Original Article, Pol J Public Health 2016;126(4): 166-169

Renata Krzyszycha 1, Mariusz Goniewicz2, Krzysztof Goniewicz3,4,
Witold Pawłowski4, Piotr Wańkowicz1

Department of Clinical Dietetics, Medical University of Lublin, Poland

Emergency Medicine Department, Medical University of Lublin, Poland

Polish Air Force Academy, Faculty of National Security and Logistics, Poland

Department of Disaster Medicine, Medical University of Warsaw, Poland

DOI: 10.1515/pjph-2016-0034


Introduction. In Poland, among patients coming to hospital emergency departments (ED), one third require immediate surgical treatment. About one third are transferred to long-term intensive care. The remaining patients require a different type of care, e.g. consultation, healing wounds, observation in the emergency department. From there, they might either be referred to another hospital department or sent home after receiving outpatient help.

Aim. The aim of this study was to determine the prevalence of pain and stress in patients treated in the emergency department with particular emphasis on the factors that determine their level.

Material and methods. The study group consisted of 200 individuals treated in the emergency department of the Regional Hospital No. 2 in Rzeszów in 2013. The applied research method was a diagnostic survey that used a questionnaire as a research tool. The results were statistically analyzed using SPSS 20, whereas a statistically significant dependence was considered in those with level of significance p≤0.05.

Results. Most respondents reported pain and feelings of stress while staying in the ED. Women and the unemployed were significantly less likely to report pain. Factors like gender, age, education level, and the coexistence of chronic diseases significantly affected the degree of stress among patients in the ED.

Conclusion. Each patient treated at the emergency department should receive holistic care, so that the pain and stress of his injuries are reduced as soon as possible.


emergency department; hospital; pain; pain management; stress; patient satisfaction; quality of health care.


  1. Berben SA, Meijs TH, van Dongen RT, et al. Pain prevalence and pain relief in trauma patients in the Accident & Emergency department. Injury. 2008;39:578-85. [Web of Science] [Crossref]
  2. Alasad J, Tabar NA, AbuRuz ME. Patient satisfaction with nursing care: measuring outcomes in an international setting. J Nurs Adm. 2015;45:563-8. [Web of Science]
  3. Burns JW, Nielson WR, Jensen MP, et al. Specific and general therapeutic mechanisms in cognitive behavioral treatment of chronic pain. J Consult Clin Psychol. 2015;83:1-11. [Web of Science] [Crossref]
  4. Ebben R, Vloet L, Verhofstad M, et al. Adherence to guidelines and protocols in the prehospital and emergency care setting: a systematic review. Scand J Trauma Resusc Emerg Med. 2013;21:9. [Web of Science] [Crossref]
  5. Fein JA, Zempsky WT, Cravero JP, et al. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics. 2012;130(5):e1391-e405. [Web of Science] [Crossref]
  6. Berben SA, Meijs TH, van Grunsven PM, et al. Facilitators and barriers in pain management for trauma patients in the chain of emergency care. Injury. 2012;43(9):1397-402. [Crossref] [Web of Science]
  7. Karwan K. Ocena chorych po urazach wielonarządowych leczonych w szpitalnym oddziale ratunkowym. Pol Merk Lek. 2009;27(160):269-301.
  8. Papastavrou E, Andreou P, Efstathiou G. Rationing of nursing care and nurse-patient outcomes: a systematic review of quantitative studies. Int J Health Plann Manage. 2014;29:3-25. [Crossref]
  9. Stein-Parbury J. Patient and person: Interpersonal skills in nursing: Elsevier Health Sciences; 2013.
  10. Szerla MK, Ortenburger DE. Selected medical and psychological aspects of managing patients with chronic pain in Poland. Studia Medyczne. 2011;22: 55-62.
  11. Kosiński S, Siudut B. Pain treatment in the emergency department: what do patients think? Anestezjologia i Intensywna Terapia. 2010;43:234-8.
  12. Kulikowska A, Czaban SL, Jarocka I, et al. The analysis of deaths of patients requiring intensive care in the Emergency Department University Hospital in Bialystok in years: 2006-2008. Post Nauk Med. 2010;9:696-703.
  13. Sun BC, Hsia RY, Weiss RE, et al. Effect of emergency department crowding on outcomes of admitted patients. Ann Emerg Med. 2013;61:605-11. e6. [Crossref] [Web of Science]
  14. Pierik JG, IJzerman MJ, Gaakeer MI, et al. Pain management in the emergency chain: The use and effectiveness of pain management in patients with acute musculoskeletal pain. Pain Med. 2015;16:970-84. [Crossref] [Web of Science]
  15. Ista E, van Dijk M, van Achterberg T. Do implementation strategies increase adherence to pain assessment in hospitals? A systematic review. IJNS. 2013;50:552-68.
  16. McKune CM, Pascoe PJ, Lascelles BDX, Kass PH. The challenge of evaluating pain and a pre-incisional local anesthetic block. Peer J. 2014;2:e341. [Web of Science]
  17. Finan PH, Buenaver LF, Bounds SC, et al. Discordance between pain and radiographic severity in knee osteoarthritis: findings from quantitative sensory testing of central sensitization. Arthritis Rheum. 2013;65:363-72. [Web of Science] [Crossref]
  18. Janowski K, Steuden S, Kuryłowicz J. Factors accounting for psychosocial functioning in patients with low back pain. Eur Spine J. 2010;19:613-23. [Web of Science] [Crossref]
  19. Choi S, Douketis JD. Management of patients who are receiving warfarin or a new oral anticoagulant and require urgent or emergency surgery. Pol Arch Med Wewn. 2012;122:437-42.
  20. Jankowski P, Bednarek A, Surowiec S, et al. Half of coronary patients are not instructed how to respond to symptoms of a heart attack. Cardiol J. 2011;18:668-74. [Web of Science] [Crossref]
  21. Bielecka I, Osemek P, Paśnik K. The impact assessment of weight loss on an aggressive behavior and satisfaction with the connubial or cohabitation relationship in patients after Roux-en-Y gastric-by-pass surgery performed laparoscopically. Pol J Surg. 2012;84:429-36.
  22. Goulet JL, Brandt C, Crystal S, et al. Agreement between electronic medical record-based and self-administered pain numeric rating scale: clinical and research implications. Med Care. 2013;51:245-50. [Crossref] [Web of Science]
  23. Thoits PA. Stress and health major findings and policy implications. J Health Soc Behav. 2010;51(1 suppl):S41-S53. [Crossref]
  24. Kurpas D, Mroczek B, Jasinska M, et al. Health behaviors and quality of life among patients with chronic respiratory disease. In: Pokorski M (ed.) Neurobiology of Respiration: Springer Verlag; 2013. p. 401-6.
  25. Wloszczak-Szubzda A, Jarosz MJ, Goniewicz M. Professional communication competences of paramedics-practical and educational perspectives. Ann Agr Env Med. 2013;20:366-72.
  26. Chan C-L, Lin W, Yang N-P, et al. Pre-emergency-department care-seeking patterns are associated with the severity of presenting condition for emergency department visit and subsequent adverse events: A timeframe episode analysis. PloS One. 2015;10:e0127793.
  27. Forrestal B, Hynes T, Clarke-Moloney M, et al. Patient satisfaction following emergency admission via a surgical assessment unit and an emergency department. Ir J Med Sci. 2013;182:261-6. [Crossref] [Web of Science]
  28. Pilote L, Dasgupta K, Guru V, et al. A comprehensive view of sex-specific issues related to cardiovascular disease. Can Med Assoc J. 2007;176:S1-S44. [Crossref] [Web of Science]
  29. Hady HR, Łuba M, Myśliwiec P, et al. Surgical management in parenchymatous organ injuries due to blunt and penetrating abdominal traumasthe authors’ experience. Adv Clin Exp Med. 2012;21:193-200.
  30. Tait RC, Chibnall JT, Kalauokalani D. Provider judgments of patients in pain: seeking symptom certainty. Pain Med. 2009;10:11-34. [Web of Science] [Crossref]
  31. Lecomte F, Gault N, Koné V, et al. Prevalence of neuropathic pain in emergency patients: an observational study. Am J Emerg Med. 2011;29:43-9. [Crossref] [Web of Science]
  32. Finn J, Rae A, Gibson N, et al. Reducing time to analgesia in the emergency department using a nurse-initiated pain protocol: a before-and-after study. Contemp Nurs. 2012;43:29-37. [Crossref]
  33. Graham CA. Pain relief in the emergency department. Eur J Emerg Med. 2010;17:1. [Web of Science] [Crossref]
  34. Karwowski-Soulié F, Lessenot-Tcherny S, Lamarche-Vadel A, et al. Pain in an emergency department: an audit. Eur J Emerg Med. 2006;13:218-24. [Crossref]
  35. Flores-Mateo G, Violan-Fors C, Carrillo-Santisteve P, et al. Effectiveness of organizational interventions to reduce emergency department utilization: a systematic review. PloS ONE. 2012;7:e35903.
  36. Dudek D, Sobański JA. Mental disorders in somatic diseases. Psychopathology and treatment. Pol Arch Med Wewn. 2012;122:624-9.
  37. Cepuch G, Wordliczek J, Golec A. Selected scales for pain intensity examination in adolescents-assessment of their usefulness. Adv Palliat Med. 2006;5:108-13.
  38. Singer AJ, Garra G, Chohan JK, et al. Triage pain scores and the desire for and use of analgesics. Ann Emerg Med. 2008;52:689-95. [Crossref] [Web of Science]
  39. Rybojad B, Goniewicz M, Sieniawski D. Pediatric pain management - hwat are we able to do in Polish emergency medical services? Wiad Lek. 2016;69:548-54.


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