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Visintini C, Palese A. What Nursing-Sensitive Outcomes Have Been Investigated to Date among Patients with Solid and Hematological Malignancies? A Scoping Review. NURSING REPORTS 2023; 13:1101-1125. [PMID: 37606464 PMCID: PMC10443292 DOI: 10.3390/nursrep13030096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/23/2023] Open
Abstract
Nursing-sensitive outcomes are those outcomes attributable to nursing care. To date three main reviews have summarized the evidence available regarding the nursing outcomes in onco-haematological care. Updating the existing reviews was the main intent of this study; specifically, the aim was to map the state of the art of the science in the field of oncology nursing-sensitive outcomes and to summarise outcomes and metrics documented as being influenced by nursing care. A scoping review was conducted in 2021. The MEDLINE, Cumulative Index to Nursing and Allied Health, Web of Science, and Scopus databases were examined. Qualitative and quantitative primary and secondary studies concerning patients with solid/haematological malignancies, cared for in any setting, published in English, and from any time were all included. Both inductive and deductive approaches were used to analyse the data extracted from the studies. Sixty studies have been included, mostly primary (n = 57, 95.0%) with a quasi- or experimental approach (n = 26, 55.3%), conducted among Europe (n = 27, 45.0%), in hospitals and clinical wards (n = 29, 48.3%), and including from 8 to 4615 patients. In the inductive analysis, there emerged 151 outcomes grouped into 38 categories, with the top category being 'Satisfaction and perception of nursing care received' (n = 32, 21.2%). Outcome measurement systems included mainly self-report questionnaires (n = 89, 66.9%). In the deductive analysis, according to the Oncology Nursing Society 2004 classification, the 'Symptom control and management' domain was the most investigated (n = 44, 29.1%); however, the majority (n = 50, 33.1%) of nursing-sensitive outcomes that emerged were not includible in the available framework. Continuing to map nursing outcomes may be useful for clinicians, managers, educators, and researchers in establishing the endpoints of their practice. The ample number of instruments and metrics that emerged suggests the need for more development of homogeneous assessment systems allowing comparison across health issues, settings, and countries.
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Affiliation(s)
- Chiara Visintini
- Division of Hematology and Stem Cell Transplantation, Clinical University Hospital of Udine, 33100 Udine, Italy;
| | - Alvisa Palese
- Department of Medical Sciences, University of Udine, 33100 Udine, Italy
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Hadjisavva IC, Papastavrou E, Kouta C. Knowledge and Attitudes of Home Care Nurses in Cyprus in the Management of Cancer Pain. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2021. [DOI: 10.1177/1084822320957287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pain is a common symptom for cancer patients. It is a problem for themselves and their relatives. Nurses are confronted with the treatment of cancer pain in their everyday clinical practice. Efficient management requires accurate and appropriate knowledge, positive attitudes, and competent evaluation skills. The aim is to explore the knowledge and attitudes of Cypriot home care nurses in pain management of cancer patients. Regarding methodology, a quantitative descriptive design was used and the data were collected with the Greek version of the McCaffery and Ferrell Nurses’ Knowledge and Attitudes Survey Regarding Pain questionnaire along with a demographic questionnaire. The sample of the study consisted of home care nurses working in non-profit organizations in Cyprus ( n = 31). For the analysis of data, the SPSSv.21. was used and the statistical significance was set to the p = .05. Results revealed of the total of 35 questions only 13 were answered correctly by the 80% of the participants. Limited knowledge was reported mainly on the duration of action, the effect and dosage of Pethidine, the risk of addiction and the use of non-medication interventions. Significant differences were found to the level of knowledge as regards the age and the experience of nurses. In the case study exercise, it was found that false assessment of pain was related to wrong decisions. Nurses’ attitudes seemed to be positive. In conclusion, the study revealed the knowledge deficits and need for continuous education of home care nurses on the assessment and management of pain for patients with cancer. Empowering nurses with better skills to deal with pain, a most distressing symptom of cancer, will result in a better quality of life for patients. However, the integration of pain management within the national cancer strategies is also very important.
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Chen J, Tong Y, Cheng Y, Xue Z, Liu M. Establishment and Empirical Evaluation of a Quality Indicator System for Postoperative Pain Management. PAIN MEDICINE 2020; 21:3270-3282. [PMID: 33040153 DOI: 10.1093/pm/pnaa221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES This study aimed to establish a quality indicator system for postoperative pain management and test its reliability, validity, and discrimination in China. METHODS We established a quality indicator system using the Delphi method. Further, we designed and administered a survey questionnaire in the orthopedic departments of nine hospitals, located in the Zhejiang and Jiangsu Provinces, through purposive and convenience sampling methods to examine the reliability, validity, and discrimination of the quality indicator system. RESULTS We established a quality indicator system to assess structure, process, and outcome measures of postoperative pain management using three first-level, eight subordinate second-level, and 32 subordinate third-level quality indicators. The scale-level content validity indexes of the three sections of the questionnaire, assessing structure, process, and outcomes measures, were 0.99, 0.98, and 0.98, respectively. We identified two common factors from the third section that demonstrated a cumulative variance contribution rate of 80.38% and a Cronbach's α coefficient of 0.95. The total scores and scores of the structure, process, and outcome quality indicators demonstrated statistically significant differences (P < 0.05) between the wards (N = 4) that participated in the "Painless Orthopedics Ward" quality improvement program and those (N = 5) that did not. CONCLUSIONS This quality indicator system highlights the need for multidisciplinary cooperation and process characteristics of postoperative pain management, along with interdepartmental quality comparisons. And it demonstrates acceptable reliability, validity, and discrimination; thus it may be completely or partially employed in Chinese hospitals.
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Affiliation(s)
- Jiajia Chen
- Medical College, Hangzhou Normal University, Hangzhou, China.,Department of Anesthesiology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yingge Tong
- Medical College, Hangzhou Normal University, Hangzhou, China
| | - Yan Cheng
- Zhejiang Provincial People's Hospital, Hangzhou, China
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Erol O, Unsar S, Yacan L, Pelin M, Kurt S, Erdogan B. Pain experiences of patients with advanced cancer: A qualitative descriptive study. Eur J Oncol Nurs 2018; 33:28-34. [DOI: 10.1016/j.ejon.2018.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/22/2017] [Accepted: 01/08/2018] [Indexed: 01/09/2023]
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Golas M, Park CG, Wilkie DJ. Patient Satisfaction with Pain Level in Patients with Cancer. Pain Manag Nurs 2017; 17:218-25. [PMID: 27283267 DOI: 10.1016/j.pmn.2016.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/15/2016] [Accepted: 04/14/2016] [Indexed: 11/17/2022]
Abstract
Interest in satisfaction with pain management as a pain-related outcome variable wavered when investigators found poor correlations with pain intensity when they measured satisfaction with pain management rather than satisfaction with pain level. The aim was to explore the relationship between satisfaction with pain level and pain intensity among patients receiving ongoing outpatient cancer care. In a comparative, secondary data analysis of a cross-sectional sample of 806 cancer patients (57% male, mean age 56 ± 13 years, 77% Caucasian), the authors measured satisfaction with pain level as a single item (yes, no, not sure) and pain intensity as an average of current, least, and worst pain intensity (all 0-10 scales) in the past 24 hours. Of the 806 participants, 447 (56%) subjects were satisfied with their pain level, 291 (36%) were not satisfied and 68 (8%) were not sure. Satisfaction was moderately correlated with API (rho = -0.43, p < .001). Patients satisfied with their pain levels reported statistically lower mean API scores (2.26 ± 1.70) than those who were not satisfied (4.68 ± 2.07) or not sure (4.21 ± 2.2.1), p < .001. With pair wise post hoc comparisons, mean API scores of satisfied patients were significantly lower than those who were not satisfied or not sure. In contrast with other researchers who have not found associations between satisfaction with pain management and pain intensity, the authors demonstrated that when satisfaction is measured specifically, patients with higher pain intensity are not satisfied. The authors recommend that researchers use "satisfaction with pain level" instead of "satisfaction with pain management" as the pain satisfaction outcome.
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Affiliation(s)
- Mary Golas
- University of Illinois College of Nursing, Chicago, Illinois; Jesse Brown Veterans Administration Medical Center, Chicago, Illinois
| | - Chang Gi Park
- University of Illinois College of Nursing, Chicago, Illinois
| | - Diana J Wilkie
- University of Illinois College of Nursing, Chicago, Illinois; College of Nursing, University of Florida, Gainesville, Florida.
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Wang H, Sherwood GD, Gong Z, Ren L, Liu H. Reliability and Validity of the Chinese Version of the Revised American Pain Society Patient Outcome Questionnaire in Postoperative Patients. Pain Manag Nurs 2017; 18:110-120. [PMID: 28259638 DOI: 10.1016/j.pmn.2017.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 11/30/2022]
Abstract
The American Pain Society Patient Outcome Questionnaire and the subsequent revised version are the most frequently reported measures of the quality of pain management. However, the reliability and validity of the revised questionnaire have not been reported in Chinese patients. This study sought to evaluate the psychometric properties of the Chinese version of the revised questionnaire in postoperative patients in China. The study was a descriptive, cross-sectional psychometric study. The revised questionnaire was translated into Chinese according to international guidelines and then administered to participants. The patients' present, average, and worst pain intensity were evaluated in face-to-face interviews. The Pain Management Index was calculated according to the worst pain intensity and the classification of analgesic drugs used by the patients. The continuous items in the revised questionnaire demonstrated excellent construct validity and acceptable internal consistency reliability (0.732). Cronbach's alpha coefficients for the following subscales were acceptable: pain severity and sleep interference (0.773), activity interference (0.812), affective (0.824), and adverse effects (0.636); the exception was for the perception of pain care subscale (0.492). Patients with different anticipated pain management outcomes were differentiated as expected. Satisfaction could be predicted (31.3% of the variance) using subscales and items in the questionnaire. Although our evidence supports the psychometric properties of the Chinese version of the revised questionnaire when tested with postoperative patients, further study is needed, especially on the subscale perception of pain care.
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Affiliation(s)
- Hui Wang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Gwen D Sherwood
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Zhiyi Gong
- Department of Anesthesia, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Liying Ren
- Operation Room, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Huaping Liu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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The Influence of Pain Severity and Interference on Satisfaction with Pain Management among Middle-Aged and Older Adults. Pain Res Manag 2016; 2016:9561024. [PMID: 28100956 PMCID: PMC5215497 DOI: 10.1155/2016/9561024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 11/10/2016] [Indexed: 11/25/2022]
Abstract
Background. Health outcomes are often contingent on how effective the individual is able to manage existent illness-related symptoms. This is all the more relevant among chronic pain patients. Objective. This study aimed to identify indicators of pain treatment satisfaction among middle-aged and older adults (N = 150) receiving outpatient treatment from a comprehensive cancer center. Methods. Patients were surveyed on questions assessing pain treatment satisfaction, pain severity, and additional social characteristics. Results. Descriptive data showed that middle-aged adults reported more pain locations, greater pain severity, and less satisfaction with pain treatment. A multivariate model was specified, showing older adults being more satisfied with their pain treatment. For the middle-aged adults, treatment satisfaction was generally lower with greater pain severity. This counters that for the older adults, where treatment satisfaction remained consistent despite increased levels of pain severity. Conclusion. These findings address an important issue regarding how pain is experienced across the life course. This suggests that general assumptions cannot be made about the health outcomes of older adults. Beyond the descriptive definitions of pain, there remains the need to develop models that account for determinants that may account for the pain experience among a diverse adult population.
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Dueñas M, Ojeda B, Salazar A, Fernández-Palacín F, Micó JA, Torres LM, Failde I. Use and satisfaction with the Healthcare System of the chronic pain patients in Spain: results from a nationwide study. Curr Med Res Opin 2016; 32:1813-1820. [PMID: 27400416 DOI: 10.1080/03007995.2016.1211519] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To analyze the use of healthcare resources by chronic pain (CP) patients in Spain and their satisfaction with them. RESEARCH DESIGN AND METHODS A nationwide, cross-sectional study was carried out on a representative sample of 1957 Spanish adults. A telephone survey was conducted with the aim of analyzing the prevalence of CP, the characteristics and consequences of pain, the use of healthcare resources and patients' satisfaction with them. Descriptive, bivariate and multivariate analyses were performed. RESULTS Of the 1957 subjects interviewed, 325 suffered CP. The mean duration of CP was 10 years (SD: 11.3) and 48.9% of the CP sufferers reported severe/unbearable pain. Moreover, about 30% felt sad/very sad or anxious/very anxious, 24.4% had been on sick leave, 12% had left/lost their jobs and 47.2% considered their pain affected their families. Likewise, 92.9% had consulted a healthcare professional due to their CP, on average 3.49 times (SD: 3.9), and 69.2% took medication. In addition, 67.3% and 63.8% were satisfied/very satisfied with the care and the healthcare information they received, respectively. Individuals who reported headache (OR = 0.34) and feeling sad (OR =0.38) were least satisfied with the care they received. In addition, CP sufferers who made greater use of consultations were those who had left/lost their jobs (β = 1.44), those who took medication (β = 1.67), those who considered their pain affected their families (β = 0.97) and those with a shorter duration of pain (β = -0.003). CONCLUSIONS CP produces relevant demands on healthcare resources, conditioned by the consequences within the family and the effects on their employment. To achieve greater patient satisfaction, professionals need to pay particular attention to certain sites of pain and to patients' mental health.
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Affiliation(s)
- María Dueñas
- a Salus Infirmorum Faculty of Nursing , University of Cádiz , Cádiz , Spain
| | - Begoña Ojeda
- b Preventive Medicine and Public Health Area, Faculty of Nursing and Physiotherapy , University of Cádiz , Cádiz , Spain
| | - Alejandro Salazar
- b Preventive Medicine and Public Health Area, Faculty of Nursing and Physiotherapy , University of Cádiz , Cádiz , Spain
| | - Fernando Fernández-Palacín
- c Department of Statistics and Operations Research, Faculty of Sciences , University of Cádiz , Cádiz , Spain
| | - Juan Antonio Micó
- d Department of Neuroscience, Pharmacology and Psychiatry , University of Cádiz, CIBER of Mental Health, CIBERSAM, Instituto de Salud Carlos III , Cádiz , Spain
| | - Luis Miguel Torres
- e Department of Anesthesiology - Critical Care and Pain Management , University Hospital "Puerta del Mar" , Cádiz , Spain
| | - Inmaculada Failde
- b Preventive Medicine and Public Health Area, Faculty of Nursing and Physiotherapy , University of Cádiz , Cádiz , Spain
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Baker TA, Roker R, Collins HR, Johnson-Lawrence V, Thorpe RJ, Mingo CA, Vasquez E. Beyond Race and Gender: Measuring Behavioral and Social Indicators of Pain Treatment Satisfaction in Older Black and White Cancer Patients. Gerontol Geriatr Med 2016; 2:2333721415625688. [PMID: 28138486 PMCID: PMC5119862 DOI: 10.1177/2333721415625688] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 12/10/2015] [Accepted: 12/14/2015] [Indexed: 11/16/2022] Open
Abstract
There are a number of factors that influence compliance with prescribed plans of care. However, there remains a need to identify the collective source health, behavioral, and social constructs have on treatment satisfaction. This study aimed to identify indicators of pain treatment satisfaction among older adults receiving outpatient treatment from a comprehensive cancer center in the southeast region of the United States. Data included a sample of 149 Black and White patients diagnosed with cancer, with the majority being White (85%) and female (57%). Patients were surveyed on questions assessing pain treatment satisfaction, pain severity, and additional social characteristics. A series of multivariate models were specified, whereby patients reporting multiple chronic conditions, poor communication, and perceived discrimination were less satisfied with treatment. Positive communication, higher self-efficacy, and fewer perceived discriminatory acts were significant among the female patients only. These findings suggest the need to develop clinical models that assess how these factors influence the degree of treatment satisfaction, while providing a comprehensive mechanism by which to service the long-term needs of older adults.
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10
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D’emeh WM, Yacoub MI, Darawad MW, Al-Badawi TH, Shahwan B. Pain-Related Knowledge and Barriers among Jordanian Nurses: A National Study. Health (London) 2016. [DOI: 10.4236/health.2016.86058] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ambrogi V, Tezenas du Montcel S, Collin E, Coutaux A, Bourgeois P, Bourdillon F. Care-related pain in hospitalized patients: severity and patient perception of management. Eur J Pain 2015; 19:313-21. [PMID: 25055764 DOI: 10.1002/ejp.549] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hospitalized patients commonly undergo painful procedures, but little is known about care-related pain (CRP) in the overall population of inpatients. We conducted a cross-sectional 1-day survey to assess the prevalence and characteristics of CRP and its management in all units of a university hospital in Paris and determined the factors linked to severe CRP. METHODS All patients who were able to communicate and were hospitalized for at least 24 h but not in a day-care or neonatal unit were included. RESULTS From 938 patients who completed the questionnaire, 554 patients reported pain within the previous 24 h, for a 59% prevalence of pain, and 540 (58%) had experienced CRP in the previous 15 days (51% males; mean [SD] age 54 [18] years). Of 907 procedures, 330 (37%) resulted in severe pain. The most-often reported painful procedures were vascular punctures and patient mobilization. Severe CRP was associated with long hospitalization; non-vascular invasive punctures, catheterization, mobilization or radiological examination; or pain during the previous 24 h due to surgery or treatment. Only half of the patients declared that they had received information regarding the painful procedure. Treatment for pain was proposed and delivered in less than one quarter of cases. CONCLUSIONS Our results of a survey of pain management in hospitalized patients relate to a wide variety of medical conditions and procedures. Health-care workers should be more systematic in managing CRP, and attention should be paid to patients at greatest risk of severe CRP.
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Affiliation(s)
- V Ambrogi
- Public Health Department, Pitié-Salpêtrière Hospital, Paris, France
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Darawad MW, Al-Hussami M, Saleh AM, Al-Sutari M, Mustafa WM. Predictors of ICU patients’ pain management satisfaction: A descriptive cross-sectional survey. Aust Crit Care 2015; 28:129-33. [DOI: 10.1016/j.aucc.2014.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 07/06/2014] [Accepted: 07/22/2014] [Indexed: 11/25/2022] Open
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Maher DP, Wong W, Woo P, Padilla C, Zhang X, Shamloo B, Rosner H, Wender R, Yumul R, Louy C. Perioperative Factors Associated with HCAHPS Responses of 2,758 Surgical Patients. PAIN MEDICINE 2015; 16:791-801. [DOI: 10.1111/pme.12651] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jabusch KM, Lewthwaite BJ, Mandzuk LL, Schnell-Hoehn KN, Wheeler BJ. The pain experience of inpatients in a teaching hospital: revisiting a strategic priority. Pain Manag Nurs 2014; 16:69-76. [PMID: 25439113 DOI: 10.1016/j.pmn.2014.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 05/21/2014] [Accepted: 05/27/2014] [Indexed: 11/28/2022]
Abstract
For hospital executives and clinicians to improve pain management, organizations must examine the current pain experience of in-patients beyond simply measuring patient satisfaction. The aim of this study was to quantify the prevalence of pain among adult in-patients and the degree of interference pain had on daily activities. A descriptive, cross-sectional study was undertaken in a 530 bed tertiary care, teaching hospital in central Canada. A convenience sample (N = 88) of adult medical-surgical patients completed the Short Form-Brief Pain Inventory survey. Pain prevalence was 70.4%. The mean pain severity score was 3.76 (standard deviation, SD = 2.88) and mean pain interference score on daily activities was 4.56 (SD = 3.93). The most frequently identified site of pain was the lower extremities (n = 15, 28%). Women had higher mean scores on pain "right now" compared to men (p < 0.05). The sample majority (n = 81) indicated hospital staff asked about the presence of pain. Seventy-nine percent (n = 57) reported hospital staff "always" did everything they could to help manage pain. Eighty-four percent (n = 61) selected "always" or "usually" to describe their ability to be involved in deciding pain treatments. The mean pain relief score from treatments was 61% (SD = 34.79). Significant positive correlations were found between pain intensity ratings and pain interference on all daily activities (p < 0.001). Pain prevalence remains high with a significant relationship between pain and activities of daily living. The study provides baseline data to direct future initiatives at improving pain management.
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Affiliation(s)
| | | | - Lynda L Mandzuk
- Rehabilitation and Geriatrics Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | | | - Barbara J Wheeler
- Woman & Child Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada
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Abstract
OBJECTIVE Despite treatment availability, many cancer patients experience severe pain. Although patient assessments of care are increasingly employed to evaluate quality of care, little is known about its association with cancer symptom burden. The objective of our study was to examine the association between patient-reported quality of care and pain severity in a nationally representative cohort of cancer patients. METHOD Quality of care was measured in three domains: physician communication, care coordination/responsiveness, and nursing care. Quality scores were dichotomized as optimal versus nonoptimal. Pain was measured on a scale of 0 (least) to 100 (worst). We utilized multivariable linear regression to examine the association between patient-reported quality of care and pain severity. RESULTS The analytic sample included 2,746 individuals. Fifty and 54% of patients, respectively, rated physician communication and care coordination/responsiveness as nonoptimal; 28% rated nursing care as nonoptimal. In adjusted models, rating physician communication as nonoptimal (versus optimal) was associated with a 1.8-point higher pain severity (p = 0.018), and rating care coordination/responsiveness as nonoptimal was associated with a 2.2-point higher pain severity (p = 0.006). SIGNIFICANCE OF RESULTS Patient-reported quality of care was significantly associated with pain severity, although the differences were small. Interventions targeting physician communication and care coordination/responsiveness may result in improved pain control for some patients.
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Phillips S, Gift M, Gelot S, Duong M, Tapp H. Assessing the relationship between the level of pain control and patient satisfaction. J Pain Res 2013; 6:683-9. [PMID: 24049457 PMCID: PMC3775677 DOI: 10.2147/jpr.s42262] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The primary assessment tool used by hospitals to measure the outcomes of pain management programs is the 0–10 numerical pain rating scale. However, it is unclear if this assessment should be used as the sole indicator of positive outcomes by pain management programs. Although it is assumed that pain intensity scores would be correlated with patient satisfaction, few studies have evaluated the association between pain intensity scores and patient satisfaction. Methods In this pilot study, we investigated the relationship between pain intensity and patient satisfaction by evaluating 88 patients who received opioid analgesics at a 1018-bed acute care institution. A 14-question survey was adapted from a questionnaire developed by the American Pain Society to assess patient pain control and overall satisfaction with our institution’s pain management strategies. Results This study found no association between pain intensity score and patient satisfaction with overall pain management (Spearman’s rank correlation coefficient = −0.31; 95% confidence interval = −0.79 to 0.39). The majority of the surveyed patients were satisfied or very satisfied with their overall pain management, regardless of their pain intensity score. Conclusion These findings contribute to the general understanding that institutions should use pain intensity scores together with a measure of patient pain satisfaction when assessing regulatory and quality control programs.
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Affiliation(s)
- Shay Phillips
- Carolinas Medical Center, Department of Family Medicine, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA
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Luckett T, Davidson PM, Green A, Boyle F, Stubbs J, Lovell M. Assessment and management of adult cancer pain: a systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care. J Pain Symptom Manage 2013; 46:229-53. [PMID: 23159681 DOI: 10.1016/j.jpainsymman.2012.07.021] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 07/23/2012] [Accepted: 07/28/2012] [Indexed: 11/26/2022]
Abstract
CONTEXT Cancer pain is a common, burdensome problem, which is not well managed despite evidence-based guidelines. OBJECTIVES To develop insights for managing barriers and optimizing facilitators to adult cancer pain assessment and management within a comprehensive framework of patient care. METHODS We undertook a systematic review and synthesis of qualitative studies. Medline, PsycINFO, Embase, AMED, CINAHL, and Sociological Abstracts were searched from May 20 to 26, 2011. To be included, the articles had to be published in a peer-reviewed journal since 2000; written in English; and report original qualitative studies on the perspectives of patients, their significant others, or health care providers. Article quality was rated using the checklist of Kitto et al. Thematic synthesis followed a three-stage approach using Evidence for Policy and Practice Information and Co-ordinating Centre-Reviewer 4 software: 1) free line-by-line coding of "Results," 2) organization into "descriptive" themes, and 3) development of "analytical" themes informative to our objective. At Stage 3, a conceptual framework was selected from the peer-reviewed literature according to prima facie "fit" for descriptive themes. RESULTS Of 659 articles screened, 70 met the criteria, reporting 65 studies with 48 patient, 19 caregiver, and 21 health care provider samples. Authors rarely reported reflexivity or negative cases. Mead and Bower's model of patient-centered care accommodated 85% of the descriptive themes; 12% more related to the caregiver and service/system factors. Three themes could not be accommodated. CONCLUSION Findings highlight the need to integrate patient/family education within improved communication, individualize care, use more nonpharmacological strategies, empower patients/families to self-manage pain, and reorganize multidisciplinary roles around patient-centered care and outcomes. These conclusions require validation via consensus and intervention trials.
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Affiliation(s)
- Tim Luckett
- Improving Palliative Care through Clinical Trials, New South Wales Palliative Care Clinical Trials Collaborative, Sydney, NSW 2007, Australia.
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18
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Yang P, Sun LQ, Pang D, Ding Y. Quality of life in cancer patients with pain in beijing. Chin J Cancer Res 2013; 24:60-6. [PMID: 23359351 DOI: 10.1007/s11670-012-0060-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 12/13/2011] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the quality of life (QOL) of cancer pain patients in Beijing, and explore the effect of cancer pain control on patients' QOL. METHODS Self-developed demographic questionnaire, numeric rating scale and SF-36 questionnaire were used together among 643 cancer pain patients in 28 Grade 2nd to 3rd general hospitals and 2 Grade 3rd cancer hospitals. RESULTS The SF-36 eight dimensions scores ranged from 31.75 to 57.22 in these cancer pain patients. The t test and Wilcoxon rank sum test were used to compare the QOL between pain controlled (PC) group and pain uncontrolled (PUC) group, and the results showed that patients in PC group had the higher QOL scores in 6 areas of SF-36 (P<0.05). Binary logistic regression results found that pain management satisfaction scores (P<0.001), family average personal monthly income (P=0.029), current receiving chemotherapy (P=0.009) and cancer stage (P<0.001) were the predictors to cancer pain controlled results. CONCLUSION Cancer patients with pain in Beijing had poor QOL. Pain control will improve the QOL of cancer pain patients.
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Affiliation(s)
- Ping Yang
- Department of Medical & Surgical Nursing, Peking University School of Nursing, Beijing 100191, China
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Jordanian patients' satisfaction with pain management. Pain Manag Nurs 2012; 15:116-25. [PMID: 23273825 DOI: 10.1016/j.pmn.2012.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 06/19/2012] [Accepted: 07/09/2012] [Indexed: 11/22/2022]
Abstract
Pain is still undertreated among hospitalized patients. Recently, patient satisfaction with pain management has received significant attention. This field has not yet been explored among Jordanian patients. The purpose of this study was to determine the knowledge regarding pain characteristics, beliefs, and satisfaction that can be included in planning pain management strategies and protocols within Jordanian hospitals. Using descriptive cross-sectional methodology, the American Pain Society Patient Outcome Questionnaire (APS-POQ) was used to survey 375 inpatients from Jordanian hospitals. Participants reported relatively severe pain and pain interferences while being hospitalized and seemed to be well informed regarding pain and pain management. Participants reported high levels of pain management satisfaction. Also, the Arabic version of the APS-POQ was found to be reliable among the Jordanian population. Findings of this study are similar to those reported by earlier studies in other countries and support the need for applying the caring attitude in managing patients' reports of having pain. This study is the first in Jordan, opening the door for future studies to be conducted in this important field.
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Palese A, Romano A, Moreale R, Magee J. Do nurses risk underestimating the problems of patients with frontal lobe neoplasms? Eur J Oncol Nurs 2012; 16:158-64. [DOI: 10.1016/j.ejon.2011.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 04/25/2011] [Accepted: 04/27/2011] [Indexed: 10/18/2022]
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Antón A, Montalar J, Carulla J, Jara C, Batista N, Camps C, Cassinello J, Sanz-Ortiz J, Díaz-Rubio E, Martínez C, Ledesma F, Zubillaga E. Pain in clinical oncology: patient satisfaction with management of cancer pain. Eur J Pain 2011; 16:381-9. [PMID: 22337158 DOI: 10.1002/j.1532-2149.2011.00036.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2011] [Indexed: 11/06/2022]
Abstract
BACKGROUND Despite effective analgesic therapy, inadequate pain control is frequently perceived by patients and caregivers. AIMS To assess satisfaction with management of pain in cancer patients. METHODS Between January and May 2007, a cross-sectional multicentre study was conducted in 64 Medical Oncology Departments throughout Spain. A total of 525 outpatients with oncological diseases completed a questionnaire with demographic data, characteristics and intensity of pain, and perceptions and attitudes towards pain management at the time of a routine clinical visit. Physicians also completed a questionnaire with tumour-related and treatment-related data. Cluster analysis was used to classify patients into three groups (satisfied, neither satisfied nor dissatisfied or neutral, dissatisfied) according to pain intensity and satisfaction with treatment. RESULTS Patients satisfied with their analgesic treatment (33%) had lower pain intensities and, when regularly asked about their pain, considered their physicians to be more involved in their treatment. Neither satisfied nor dissatisfied patients (neutral) (44%) had higher mean pain intensities. Two-thirds of them achieved marked relief of their pain and also thought that physicians were aware of their situation. Dissatisfied patients (23%) had moderate to severe pain intensities, and said that they were asked less frequently about their pain, and thought that their physicians were less involved in their analgesic treatment. CONCLUSION Physician-patient communication and information provided to patients are essential aspects of patient perceptions and attitudes towards control of cancer-related pain. Pain is seen as a condition that may be controlled but affects the capacity to lead a normal life.
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Affiliation(s)
- A Antón
- Service of Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
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Alexopoulos EC, Koutsogiannou P, Moratis E, Mestousi A, Jelastopulu E. Pain in cancer patients: The Greek experience. Eur J Oncol Nurs 2011; 15:442-6. [DOI: 10.1016/j.ejon.2010.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 10/19/2010] [Accepted: 10/21/2010] [Indexed: 10/18/2022]
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Naveh P, Leshem R, Dror YF, Musgrave CF. Pain Severity, Satisfaction With Pain Management, and Patient-Related Barriers to Pain Management in Patients With Cancer in Israel. Oncol Nurs Forum 2011; 38:E305-13. [DOI: 10.1188/11.onf.e305-e313] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Chou PL, Lin CC. A pain education programme to improve patient satisfaction with cancer pain management: a randomised control trial. J Clin Nurs 2011; 20:1858-69. [DOI: 10.1111/j.1365-2702.2011.03740.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rustøen T, Gaardsrud T, Leegaard M, Wahl AK. Nursing Pain Management—A Qualitative Interview Study of Patients with Pain, Hospitalized for Cancer Treatment. Pain Manag Nurs 2009; 10:48-55. [DOI: 10.1016/j.pmn.2008.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2008] [Revised: 09/06/2008] [Accepted: 09/23/2008] [Indexed: 10/21/2022]
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Patient satisfaction measurement for in-hospital services: A pilot study in Greece. ACTA ACUST UNITED AC 2008. [DOI: 10.1057/jmm.2008.21] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Efstathiou N, Ameen J, Coll AM. A Delphi study to identify healthcare users’ priorities for cancer care in Greece. Eur J Oncol Nurs 2008; 12:362-71. [DOI: 10.1016/j.ejon.2008.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Revised: 04/22/2008] [Accepted: 04/25/2008] [Indexed: 11/16/2022]
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