{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T12:15:56Z","timestamp":1774527356933,"version":"3.50.1"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Program against Pain of the Directorate-General for Health and Central Administration of the Health System"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The assessment of pain as the fifth vital sign (P5VS) is of paramount importance since it leads to the management of undertreated pain, consequently reducing suffering, readmissions and emergency department visits after hospital discharge.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To evaluate the implementation of P5VS in public and private hospitals.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Data analysis on validated questionnaires was sent to all 171 Portuguese hospitals via an official letter.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>When compared to private hospitals, public hospitals presented a higher adherence to the process related to the P5VS. It has demonstrated superiority in the charts properly placed to record P5VS, in the number of emergency departments recording P5VS, in the regularity of audits, and in the existence of guidelines and staff training on pain assessment and management.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The standardization of both evaluation and recording of pain intensity constitutes a measure of good clinical practice. Public hospitals demonstrated better commitment to these procedures that should be properly carried out in all health care institutions.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0259535","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T17:29:29Z","timestamp":1635960569000},"page":"e0259535","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["Pain as the fifth vital sign\u2014A comparison between public and private healthcare systems"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2119-4479","authenticated-orcid":true,"given":"Daniel Humberto","family":"Pozza","sequence":"first","affiliation":[]},{"given":"Lu\u00eds Filipe","family":"Azevedo","sequence":"additional","affiliation":[]},{"given":"Jos\u00e9 Manuel","family":"Castro Lopes","sequence":"additional","affiliation":[]}],"member":"340","published-online":{"date-parts":[[2021,11,3]]},"reference":[{"key":"pone.0259535.ref001","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1741-7015-8-8","article-title":"Access to pain treatment as a human right","volume":"8","author":"D Lohman","year":"2010","journal-title":"BMC Med"},{"issue":"5","key":"pone.0259535.ref002","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1097\/ACO.0000000000000225","article-title":"Acute pain assessment tools: let us move beyond simple pain ratings","volume":"28","author":"DB Gordon","year":"2015","journal-title":"Curr Opin Anaesthesiol"},{"issue":"14","key":"pone.0259535.ref003","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1001\/archinte.165.14.1574","article-title":"American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force","volume":"165","author":"DB Gordon","year":"2005","journal-title":"Arch Intern Med"},{"key":"pone.0259535.ref004","unstructured":"Directorate-General for Health. 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