Open Access Research article

The prevalence of pain at pressure areas and pressure ulcers in hospitalised patients

Michelle Briggs1*, Michelle Collinson2, Lyn Wilson2, Carly Rivers3, Elizabeth McGinnis4, Carol Dealey5, Julia Brown2, Susanne Coleman2, Nikki Stubbs6, Rebecca Stevenson2, E Andrea Nelson7 and Jane Nixon2

Author Affiliations

1 Centre for Pain Research, Queens Square House, Leeds Metropolitan University, Leeds LS1 3HE, UK

2 Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS2 9JT, UK

3 Rick Hansen Institute, 6400-818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada

4 Leeds Teaching Hospital NHS Trust, Leeds, UK, Great George Street, Leeds LS1 3EX, UK

5 Clinical Research Unit, Old Nuclear Medicine, Research & Development - University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, 1st Floor Pharmacy Building, Room 3, Birmingham B15 2TH, UK

6 Tissue Viability, St Mary’s Hospital, Greenhill Road, Armley LS12 3QE, UK

7 School of Healthcare, University of Leeds, Room 1.25, Baines Wing, Leeds LS2 9JT, UK

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BMC Nursing 2013, 12:19  doi:10.1186/1472-6955-12-19

Published: 31 July 2013



Patients with pressure ulcers (PUs) report that pain is their most distressing symptom, but there are few PU pain prevalence studies. We sought to estimate the prevalence of unattributed pressure area related pain (UPAR pain) which was defined as pain, soreness or discomfort reported by patients, on an “at risk” or PU skin site, reported at a patient level.


We undertook pain prevalence surveys in 2 large UK teaching hospital NHS Trusts (6 hospitals) and a district general hospital NHS Trust (3 hospitals) during their routine annual PU prevalence audits. The hospitals provide secondary and tertiary care beds in acute and elective surgery, trauma and orthopaedics, burns, medicine, elderly medicine, oncology and rehabilitation. Anonymised individual patient data were recorded by the ward nurse and PU prevalence team. The analysis of this prevalence survey included data summaries; no inferential statistical testing was planned or undertaken. Percentages were calculated using the total number of patients from the relevant population as the denominator (i.e. including all patients with missing data for that variable).


A total of 3,397 patients in 9 acute hospitals were included in routine PU prevalence audits and, of these, 2010 (59.2%) patients participated in the pain prevalence study. UPAR pain prevalence was 16.3% (327/2010). 1769 patients had no PUs and of these 223 patients reported UPAR pain, a prevalence of 12.6%. Of the 241 people with pressure ulcers, 104 patients reported pain, a UPAR pain prevalence of 43.2% (104/241).


One in six people in acute hospitals experience UPAR pain on ‘at risk’ or PU skin sites; one in every 8 people without PUs and, more than 2 out of every five people with PUs. The results provide a clear indication that all patients should be asked if they have pain at pressure areas even when they do not have a PU.

Pain; Pressure ulcers; Risk assessment; Prevalence