Assessing Post-operative Pain with Self-reports via the Jerrycan Pain Scale in Rural Kenya
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SURGERY IN LOW AND MIDDLE INCOME COUNTRIES
Assessing Post-operative Pain with Self-reports via the Jerrycan Pain Scale in Rural Kenya Michael Mwachiro1 • Elizabeth Mwachiro1 • MaryAnne Wachu2 • Wilter Koske2 Linda Thure1 • Robert K. Parker1,3 • Russell E. White1,3
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Accepted: 3 July 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background Perioperative pain management is an essential component to improving patient outcomes. Measurement and description of pain are challenging and vary in different contexts. The objective of this study was to assess the utility of self-reporting via visual analogue scales using the Jerrycan visual analogue scale in the assessment of postoperative pain and to validate the use of this novel scale compared to standard pain scales. Materials and methods Two hundred and forty-one inpatients who underwent surgical procedures were prospectively assessed for post-operative pain over a 12-month period from February 2016 to January 2017. Participants included patients who underwent general surgery, orthopedic and obstetrics/gynecology procedures. On post-operative day one, four scales were assessed: Verbal scale, Hands scale, Faces scale and Jerrycan scale, each ranging from 0–5. Scores for each scale were recorded, and agreements between scales were calculated using kappa values and Spearman’s rank coefficients. Results The mean age was 34.8 years and more female subjects were evaluated (68%). The majority received spinal anesthesia (61%). The mean pain score was 2.5 for all scales. The Jerrycan (0.50) and Faces scales (0.43) had moderate agreements with the Verbal scale. Participants preferred the Jerrycan Pain Scale. Conclusion The Jerrycan pain scale had comparable scores and reasonable agreement with 3 other pain scales among a cohort of post-operative patients. Patient preference and ease of use of the Jerrycan scale may impact assessment and management of pain in a rural African setting. This scale may be adapted for use in similar resource settings for post-operative pain management.
Introduction Appropriate post-operative pain management is associated with faster recoveries, shorter hospital stays and better outcomes. Pain management has been the subject of & Michael Mwachiro [email protected] 1
Department of Surgery, Tenwek Hospital, Bomet, P.O Box 39, Bomet 20400, Kenya
2
Longisa County Referral Hospital, Bomet, Kenya
3
Department of Surgery, Alpert Medical School of Brown University, Providence, RI, USA
multiple studies, especially among patients with chronic or terminal diseases [1]. There have been several studies across Africa specifically reporting assessment of postoperative pain [2–5]. Pain reporting is a function of socialization, and it varies among different cultures and different contexts. Post-operative pain management has been shown to have challenges from prior studies in the region. The use of pain scales is ubiquitous in many highincome countries but has not been fully implemented in many low-resource settings. Several scales have been devel
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