Abstract

BARUTELL, C. de. Pain units in Spain: Survey of the Spanish Society of Pain, Pain Day 2007. Rev. Soc. Esp. Dolor [online]. 2009, vol.16, n.8, pp.421-428. ISSN 1134-8046.

Objective: To determine the real situation of pain units in the hospitals of all the autonomous regions of Spain, Ceuta and Melilla, concerning their staffing, facilities, and the clinical work carried out in 2006. Material and methods: We performed an observational cross-sectional study through hand delivery and collection of a questionnaire to the heads or coordinators of pain units. The questionnaires consisted of three sections. The first contained items on the staff working in the units and their hours of work. The second set of items concerned the facilities available and the third concerned the clinical work performed in 2006. Two final items were related to whether the units held clinical sessions or not and the waiting time for consultations. Results: Completed questionnaires were received by 95 hospitals. Of these, 94 had a pain unit, while one did not. There were 356 physicians working in pain units: most were anesthesiologists, followed by a much smaller number of neurosurgeons and family physicians. Most staff worked part-time in the units. There were few clinical psychologists, working very few hours. Staffing levels for nurses, auxiliaries and secretaries were acceptable. The results on the available facilities were discouraging. Most units lacked spaces of their own and used the hospital's general consulting rooms and operating rooms. A not inconsiderable percentage was unable to use any operating room. Despite these limitations, substantial clinical work was performed in terms of the number of both first and follow-up consultations. Conclusions: Despite the difficulties and lack of resources encountered, pain units perform considerable clinical work and a fair number also carry out teaching and research. National and regional health authorities should take a census, which should then be used to provide all the hospitals in the country with a pain unit suitable to each type of hospital. Level IV pain units should be created in level I and regional hospitals. Some family physicians should receive training in pain in order to improve coordination and provide optimal patient care. Equally, closer links with palliative care units are also desirable, since a not inconsiderable percentage of cancer patients could benefit from such a collaboration. The Comprehensive National Plan for the Treatment of Pain, much heralded by the Ministry of Health, should urgently be implemented, as has occurred with other prevalent disorders.

Keywords : Pain unit survey; Staff; Hours of work; Facilities; Clinical work 2006.

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