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Background: Abdominal pain is one of the most frequent reasons for seeking care in an emergency department. Surveys have shown that patients are not satisfied with the pain management they receive. Reasons for giving inadequate pain management may include poor knowledge about pain assessment, myths concerning pain, lack of communication between the patient and healthcare professional, and organizational limitations., Objectives: The aim of the study was to investigate the outcome of nursing assessment, pain assessment and nurse-initiated intravenous opioid analgesic compared to standard procedure for patients seeking emergency care for abdominal pain. Outcome measures were: (a) pain intensity, (b) frequency of received analgesic, (c) time to analgesic, (d) transit time, and (e) patients' perceptions of the quality of care in pain management., Design: A quasi-experimental design with ABA phases was used., Setting: The study was conducted in an emergency department at a Swedish university hospital., Participants: Patients with abdominal pain seeking care in the emergency department were invited to participate. A total of 50, 100 and 50 patients, respectively, were included for the three phases of the study. The inclusion criteria were: ongoing abdominal pain not lasting for more than 2 days, ≥18 years of age and oriented to person, place and time. Exclusion criteria were: abdominal pain due to trauma, in need of immediate care and pain intensity scored as 9-10., Methods: The patients' perceptions of the quality of care in pain management in the emergency department were evaluated by means of a patient questionnaire carried out in the three study phases. The intervention phase included education, nursing assessment protocol and a range order for analgesic., Results: The nursing assessment and the nurse-initiated intravenous opioid analgesic resulted in significant improvement in frequency of receiving analgesic and a reduction in time to analgesic. Patients perceived lower pain intensity and improved quality of care in pain management., Conclusions: The intervention improved the pain management in the emergency department. A structured nursing assessment could also affect the patients' perceptions of the quality of care in pain management in the emergency department., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

International guidelines promote patient participation in health care. When patients participate in their care they experience greater satisfaction. Studies have shown that patients in emergency departments express dissatisfaction with their care, and it was therefore important to study how patients understand and conceptualize their participation. The aim of this study was to describe patients' qualitatively different conceptions of patient participation in their care in an emergency department. Based on a lifeworld perspective, nine interviews were performed with patients in an emergency department. The phenomenographic analysis shows that participation by patients means contact with the emergency department staff in three categories of conceptions: being acknowledged; struggling to become involved; and having a clear space. The different conceptions of patient participation give us a deeper understanding of how patients may experience their care, and this result may provide a foundation for developing nursing practice and the quality of health care in line with international guidelines.

This follow-up study of consecutive traffic accident victims aimed to characterize the variation in recuperation time, to estimate the incidence of delayed recovery, and to identify predictors of nonrecovery 1 and 6 months after the accident. This study included 318 of 811 consecutive patients. Whiplash type neck injuries (48%) were the most common, followed by other minor injuries (38%). Self-perceived recovery was reported by 31% and 56% of the patients at 1 and 6 months, respectively. With control for mutual confounding variables in a multivariate model, injury severity, working status, and education were associated, respectively, with 4.5-fold, 3.2-fold and 2.3-fold gradients in odds of recovery not reported at 1 month. At 6 months, only working status (odds ratio [OR], 3.2) and education (OR, 2.3) were associated with the risk of reporting nonrecovery. The authors concluded that social factors are important predictors of outcome 1 and 6 months after minor traffic accidents.