Predictors of Pain During Nasopharyngeal Swab among Covid-19 Suspected Cases in Central Malacca, Malaysia
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Abstract
Introduction: Nasopharyngeal swab (NPS) is the screening tool for Coronavirus Disease 2019 (COVID-19). It is a painful procedure that leads people to refuse it. Since there was no pain evaluation conducted, this study is to examine the pain prevalence and its predictors during NPS among COVID-19 suspected cases at Central Malacca drive-through screening centre. Materials and methods: A cross-sectional study was conducted among 365 screened respondents, selected through simple random sampling in May 2021. The pain category was divided into clinically significant pain (CSP) and Non-CSP using the Ministry of Health Pain Scale. Independent variables were the socio demographic factors, frequency of NPS, operators’ experience score and swab tip type. Data was collected using validated, self-administered Google form questionnaire, blasted via WhatsApp and the analysis was done using IBM SPSS software version 26. Results: The response rate was 86.4% with 53.5% reported having CSP. Binary Logistic Regression revealed frequent NPS procedures (OR= 1.18, 95% CI 1.01-1.38, p=0.040) and the nylon-flocked swab tip (OR= 2.08, 95% CI 1.24-3.49, p=0.006) have higher odds of CSP. Operator with more experience score is less likely to cause CSP to respondents (OR = 0.94, 95% CI 0.89-0.99, p <0.048). The predictors of CSP during NPS among COVID-19 suspected cases are of higher frequency of NPS and nylon-flocked swab tip. Increase operators’ experience score is the protective factor for CSP. Conclusion: The painless saliva self-testing modality screening for COVID-19 is highly recommended.
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Piras A, Rizzo D, Longoni E, Turra N, Urru S, Saba PP, et al. Nasopharyngeal swab collection in the suspicion of Covid-19. Am J Otolaryngol - Head Neck Med Surg [Internet]. 2020;41(5):102551. Available from: https://doi.org/10.1016/j.amjoto.2020.102551
Yoon JG, Yoon J, Song JY, Yoon SY, Lim CS, Seong H, et al. Clinical significance of a high SARS-CoV-2 viral load in the Saliva. J Korean Med Sci. 2020;35(20):1–6. 10.3346/jkms.2020.35.e195
CDC Respiratory. Overview of Testing for SARS-CoV-2, the virus that causes COVID-19. Centre for Disease Control and Prevention. 2020.
IASP. IASP Announces Revised Definition of Pain. 2021.
Gupta K, Bellino PM, Charness ME. Adverse effects of nasopharyngeal swabs: Three-dimensional printed versus commercial swabs. Infect Control Hosp Epidemiol. 2021;42(5):641–2. 10.1017/ice.2020.297
Clark JH, Pang S, Naclerio RM, Kashima M. Complications of nasal SARS-CoV-2 testing: a review. J Investig Med. 2021;69(8):1399–403. DOI: 10.1136/jim-2021-001962
Nagaya T, Miyahara R, Funasaka K, Furukawa K. Nasal patency as a factor for successful transnasal endoscopy. 2019;81:587–95. doi: 10.18999/nagjms.81.4.587
Sommer M, Geurts JWJM, Stessel B, Kessels AGH, Peters ML, Patijn J, et al. Prevalence and predictors of postoperative pain after ear, nose, and throat surgery. Arch Otolaryngol - Head Neck Surg. 2009;135(2):124–30. DOI: 10.1001/archoto.2009.3
Kinloch NN, Shahid A, Ritchie G, Dong W, Lawson T, Montaner JSG, et al. Evaluation of Nasopharyngeal Swab Collection Techniques for Nucleic Acid Recovery and Participant Experience : Recommendations for COVID-19 Diagnostics. Open Forum Infect Dis [Internet]. 2020;7(11):1–6. Available from: https://pubmed.ncbi.nlm.nih.gov/33235889/
Fabbris C, Cestaro W, Menegaldo A, Spinato G, Frezza D, Vijendren A, et al. Is oro/nasopharyngeal swab for SARS-CoV-2 detection a safe procedure? Complications observed among a case series of 4876 consecutive swabs. Am J Otolaryngol - Head Neck Med Surg [Internet]. 2020;42(1):102758. Available from: https://doi.org/10.1016/j.amjoto.2020.102758
Petruzzi G, De Virgilio A, Pichi B, Mazzola F, Zocchi J, Mercante G, et al. COVID-19: Nasal and oropharyngeal swab. Head Neck. 2020;42(6):1303–4. doi: 10.1002/hed.26212.
Chapman CR, Gavrin J. Suffering : the contributions of persistent pain. 1999;353:2233–7. Available from: http://dx.doi.org/10.1016/S0140-6736(99)01308-2
Das SK, Dhar SS, Panigrahi A. Prevalence of Pain and Its Characteristics in Hospitalized Patients in an Indian Teaching Hospital. Pain Manag Nurs [Internet]. 2020;21(3):299–303. Available from: https://doi.org/10.1016/j.pmn.2019.06.005
Linton SJ, Shaw WS. Impact of psychological factors in the experience of pain. Phys Ther. 2011;91(5):700–11. doi: 10.2522/ptj.20100330
Oran DP, Topol EJ. Prevalence of Asymptomatic SARS-CoV-2 Infection : A Narrative Review. Ann Intern Med. 2020;173(5):362–7. doi: 10.7326/M20-3012.
Elashoff JD, Lemeshow S. Sample size determination in epidemiologic studies. In: In: Ahrens W, Pigeot I (eds) Handbook of Epidemiology. Springer, Berlin, Heidelberg; 2005. p. 311–37. DOI:10.1007/3-540-26577-5_15
Ministry of Health Malaysia. Pain as the 5 Th Vital Sign [Internet]. 3rd Editio. Ministry of Health Malaysia. Malaysia: Ministry of Health Malaysia; 2018. 31–44 p. Available from: www.moh.gov.my
Guido D, Leonardi M, Mellor-Marsá B, Moneta M V., Sanchez-Niubo A, Tyrovolas S, et al. Pain rates in general population for the period 1991-2015 and 10-years prediction: Results from a multi-continent age-period-cohort analysis. J Headache Pain. 2020;21(52):1–12. doi: 10.1186/s10194-020-01108-3
Eltumi HG, Tashani OA. Effect of Age , Sex and Gender on Pain Sensitivity : A Narrative. Open Pain J. 2017;10:44–55. DOI: 10.2174/1876386301710010044
Gupta E Das, Zailinawati AH, Lim AW, Chan JB, Yap SH, Hla YY. Are Indians and Females Less Tolerant to Pain ? An Observational Study Using a Laboratory Pain Model. 2009;64(2):111–3. PMID: 20058568
Lue YJ, Wang HH, Cheng KI, Chen CH, Lu YM. Thermal pain tolerance and pain rating in normal subjects: Gender and age effects. Eur J Pain (United Kingdom). 2018;22(6):1035–42. doi: 10.1002/ejp.1188
Adam KW. Depression and anxiety in pain. Rev Pain. 2010;4(1):326–326. doi: 10.1177/204946371000400103
Rogers AH, Bakhshaie J, Lam H, Langdon KJ. Pain-related anxiety and opioid misuse in a racially / ethnically diverse young adult sample with moderate / severe pain. 2018;47(5):372–82. DOI: 10.1080/16506073.2018.1436085
Gendron N, Chahabi SZ, Poenou G, Rivet N, Belleville-Rolland T, Lemaire P, et al. Pain assessment and factors influencing pain during bone marrow aspiration : A prospective study. PLoS One. 2019;14(8):e0221534. https://doi.org/10.1371/journal.pone.0221534
Cimpean A, David D. The mechanisms of pain tolerance and pain-related anxiety in acute pain. 2019;(37). doi: 10.1177/2055102919865161
Seely JM, Hill F, Peddle S, Lau J, Hill F, Lau J. An evaluation of patient experience during percutaneous breast biopsy. Eur Radiol. 2017;27:4804–11. doi: 10.1007/s00330-017-4872-2
Cadranel JF, Rufat P, Degos F. Practices of Liver Biopsy in France : Results of a Prospective Nationwide Survey. HEPATOLOGY. 2000;477–81. doi: 10.1053/jhep.2000.16602
Farrington EA, Maskell G, Hussaini HS, Farrington EA. percutaneous liver biopsy. Frontline Gastroenterol. 2012;3:187–90. DOI: 10.1136/flgastro-2012-100154
McDonald RJ, Gray LA, Cloft HJ, Thielen KR, Kallmes DF. The effect of operator variability and experience in vertebroplasty outcomes. Radiology. 2009;253(2):478–85. doi: 10.1148/radiol.2532081370
Westheim et al. Effect of Operator Experience and Frequency. Hepatol Nutr. 2013;57(5):638–43. DOI:10.1097/MPG.0b013e3182a0c7a5
Daley P, Castriciano S, Chernesky M, Smieja M. Comparison of Flocked and Rayon Swabs for Collection of Respiratory Epithelial Cells from Uninfected Volunteers and Symptomatic Patients. J Clin Microbiol. 2006;44(6):2265–7. doi: 10.1128/JCM.02055-05
Apoola A, Herrero-diaz M, Fitzhugh E, Rajakumar R, Fakis A, Oakden J. A randomised controlled trial to assess pain with urethral swabs. Sex Transm Infect. 2010;87:110–4. doi: 10.1136/sti.2010.042861
Galai T, Yerushalmy-Feler A, Heller NP, Ben-Tov A, Weintraub Y, Amir A, et al. Age and pain score before gastrointestinal endoscopies in children are predictors for post procedure pain. BMC Gastroenterol [Internet]. 2020;20(400):1–7. Available from: https://doi.org/10.1186/s12876-020-01546-y
Puritan. Medical Swabs: How to Choose the Right Tools. 2021.
Nacher M, Mergeay-fabre M, Blanchet D, Benoit O, Pozl T, Mesphoule P, et al. Prospective Comparison of Saliva and Nasopharyngeal Swab Sampling for Mass Screening for COVID-19. Front Med. 2021;8(February):1–6. https://doi.org/10.3389/fmed.2021.621160