| dc.description.abstract |
<p>Background: </p><p>Injury is a leading cause of morbidity and mortality globally,
accounting for 11% of global disability-adjusted life years (DALYs) and 6% of global
years lived with disability (YDLs). The burden of injury is disproportionately high
in low- and middle-income countries (LMICs), including Tanzania. Early and effective
pain management for injury patients is essential to ensure proper physical, psychological,
and emotional outcomes and recovery, yet few studies have examined emergency department
analgesic strategies in Tanzania. This study aimed to analyze the sociodemographic
and injury characteristics associated with severe pain of injury patients admitted
to the Kilimanjaro Christian Medical Centre (KCMC) emergency department, and qualitatively
describe analgesic practices and challenges in the KCMC ED.</p><p>Methods:</p><p>Self-reported
sociodemographic and pain data (score 0-100) data were collected from a prospective
trauma registry of adult patients (n=1181) admitted to KCMC ED for acute injury. Injury
severity data were determined by the Kampala Trauma Score (KTS). Descriptive statistics
were performed and multivariable linear regressions assessed the association between
sociodemographic and injury characteristics with severe pain. KCMC ED physicians and
nurses (n=11) were recruited to participate in qualitative interviews aimed at understanding
common analgesic practices and challenges in the ED setting.</p><p>Results:</p><p>Mean
pain level decreased across all sociodemographic characteristics between ED admittance
and ED discharge. Participants who were either separated or widowed were likely to
experience higher reduction in pain level during ED treatments than those who reported
living with a partner. Participants who were admitted to the KCMC ED for road traffic
injury or fall were more likely to experience lower reduction in pan level than participants
with assault injuries. Interviewed KCMC ED physicians and nurses described high usage
of pharmacological analgesic methods for traumatic injury patients.</p><p>Conclusion:</p><p>It
is important to understand effective analgesic treatments that can be administered
as early as possible post-injury. KCMC ED pain management modalities are generally
effective at reducing pain of traumatic injury patients. Adjustments to strategies
for road traffic accident and fall injury patients may be made so that higher levels
of pain reduction are achieved.</p>
|
|
