Determining the accuracy of pain assessment of senior student nurses: a clinical vignette approach.

Pain is a commonly identified clinical problem and if not relieved, patients will suffer. Accurate pain assessment is essential for effective pain management. A theoretical model of factors has been constructed for this study, indicating how clinical signs can affect the accuracy of pain assessment by student nurses. The purpose of this study is to determine the accuracy of pain assessment, using a clinical vignette approach, by a group of senior student nurses. A survey design with two clinical vignettes and question method was used to collect data. Convenience sampling was used to seek voluntary participation from 198 senior student nurses with degree and diploma programs in Hong Kong. The results indicated that the pain assessment of the two patients in each clinical vignette documented by the senior student nurses differed significantly (P<0.01). Of all the student nurses, 40.8% (69/169) considered the subjective report of patients as the most reliable indicator of pain. The remaining senior student nurses (100/169 (59.2%)) tended to ignore this subjective sign of pain and relate the objective signs for pain assessment. It is recommended that the undergraduate curriculum in the aspect of pain assessment needs to be reviewed for a sound theoretical foundation of pain, and that the bias in pain assessment be corrected.