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Samara H, O’Hara L, Singh K. Nurses' Knowledge and Attitudes about Adult Post-Operative Pain Assessment and Management: Cross Sectional Study in Qatar. NURSING REPORTS 2024; 14:2061-2071. [PMID: 39189283 PMCID: PMC11348211 DOI: 10.3390/nursrep14030153] [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: 08/30/2023] [Revised: 12/06/2023] [Accepted: 12/22/2023] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Pain is a complex and challenging phenomenon. People have different pain experiences, but everyone has the right to effective pain management. Pain assessment and management are integral components of a nurse's role. AIM To assess the knowledge and attitudes of nurses in Qatar about adult post-operative patients' pain assessment and management, and the factors that may be associated with such knowledge and attitudes. METHODS Post-operative registered nurses from all peri-operative areas at Hamad Medical Corporation participated in a cross-sectional online survey using a self-administered questionnaire. A knowledge and attitudes (K&A) score was calculated. Associations between K&A and potential explanatory variables were assessed using t-tests and one-way ANOVA. RESULTS A total of 151 post-operative nurses participated in the study. The mean knowledge and attitudes (K&A) score was 19.6 ± 4.5 out of 41 (48%), indicating a large deficit in nurses' knowledge and attitudes about adult post-operative pain. There were no statistically significant differences in the mean K&A scores of participants based on gender, nationality, education level, marital status, workplace facility, current job designation, or hours of pain education. CONCLUSIONS There is a significant deficit in post-operative nurses' knowledge and attitudes about pain across the nursing workforce in post-operative care. Implications for nursing education and policy: Evidence-based, innovative nursing education courses are needed to improve nurses' knowledge and attitudes about pain assessment and management. Health service policy is required to ensure that evidence-based in-service education on pain management is compulsory for all nurses. This study was not registered.
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Affiliation(s)
- Haya Samara
- Nursing Education Department, Hamad Medical Corporation, Doha 122014, Qatar
| | - Lily O’Hara
- Department of Public Health, QU Health, Qatar University, Doha P.O. Box 2713, Qatar;
| | - Kalpana Singh
- Department of Nursing Research, Hamad Medical Corporation, Doha 122014, Qatar;
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Korkut S, Saatçi G. The relationship between nurses' professional values and ethical attitudes to pain. Nurs Ethics 2024:9697330241263993. [PMID: 39031935 DOI: 10.1177/09697330241263993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
Background: Pain management is a fundamental human right for everyone who experiences it. The management of pain is an ethical obligation for all health professionals. Professional values have an important place in appropriate clinical decision-making. Research aim: This study was conducted to determine the relationship between nurses' ethical attitudes in pain management and their compliance with professional values. Research design: The study was conducted as a descriptive and correlational research. The study data were collected by online survey method using the Introductory Characteristics Form, Ethical Attitude Scale for Pain Management in Nursing, and Nurses Professional Values Scale - Revised. Participants and research context: The population of the study consisted of nurses working in tertiary treatment centers in a country. A total of 388 nurses participated in the study. Ethical considerations: Ethical approval was obtained from the University Ethics Committee. Consent was obtained from the nurses. Results: The mean total score of the Ethical Attitude Scale for Pain Management in Nursing was 98.96 ± 9.37, and the mean total score of the Nurses Professional Values Scale was 101.51 ± 15.20. The scores of the Ethical Attitude Scale for Pain Management in Nursing were positively and moderately correlated with the total scores of the Professional Values Scale. Compliance with professional values explained 41% of the total variance of ethical attitude for pain management. Conclusions: In this study, it was found that nurses' ethical attitudes for pain management and compliance with professional values were at a high level, compliance with professional values was associated with ethical attitudes for pain management, and ethical attitudes for pain management decreased with increasing working years. A nurse with high ethical sensitivity and compliance with professional values can easily recognize ethical problems, effectively manage the ethical decision-making process, and provide appropriate patient care.
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Yoo M, Suh EE, Jang M, Kang S. Development of a nurse navigation program for cancer pain. Asia Pac J Oncol Nurs 2024; 11:100528. [PMID: 39081550 PMCID: PMC11287076 DOI: 10.1016/j.apjon.2024.100528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 05/28/2024] [Indexed: 08/02/2024] Open
Abstract
Objective Cancer pain significantly impacts the overall quality of life of cancer patients, necessitating proactive management. The manifestations of cancer pain vary individually and require tailored interventions to address each patient's unique characteristics. Therefore, this study aims to develop a nurse navigation program for cancer pain (NNP-CP) tailored to the needs of cancer patients requiring pain control, aiming to establish evidence-based clinical nursing practices and promote effective cancer pain management. Methods This study is a methodological research into developing a pain management program led by nurses for cancer patients requiring pain control, based on a professional navigation framework. The development of the program relied on three out of the five stages of the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model. Results A literature review was conducted to select the content and rationale to be included in the intervention program. Publications within the last 10 years in English or Korean were identified and screened based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 literature selection flow, 17 articles were included. Standardized information regarding cancer pain control was based on the 7th edition of 'Cancer Pain Management Guidelines'. The initial draft of the pain management intervention program was developed by organizing and structuring the derived content based on the professional navigation framework. Subsequently, the final intervention program was confirmed through the review by six clinical experts specializing in cancer pain. Conclusions Cancer pain is a significant factor that profoundly influences the quality of life and survival duration of cancer patients. While appropriate management methods offer the prospect of control, insufficient intervention is the current reality. Through the pain management intervention program based on the expert navigation framework that promotes continuity of care and empowers the recipients, this study anticipates not only pain reduction in cancer patients but also an enhancement in their quality of life.
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Affiliation(s)
- Miyoung Yoo
- Department of Nursing, Seoul National University Hospital, Seoul, Republic of Korea
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Eunyoung E. Suh
- College of Nursing, Seoul National University, Seoul, Republic of Korea
- Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
- Center for World-leading Human-Care Nurse Leaders for the Future by Brain Korea 21 (BK 21) four Project, College of Nursing, Seoul National University, Republic of Korea
| | - Mi Jang
- Department of Nursing, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sunsil Kang
- Department of Nursing, Seoul National University Hospital, Seoul, Republic of Korea
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Peters M, Kutzko DJ, Stilos K. Continuous Ambulatory Delivery Device Use for Patients Managed by an Inpatient Palliative Care Team. Pain Manag Nurs 2024; 25:e236-e242. [PMID: 38616457 DOI: 10.1016/j.pmn.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/25/2024] [Accepted: 02/19/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND The use of Patient Controlled Analgesia (PCA) via a Continuous Ambulatory Delivery Device (CADD) is a common and effective means of pain and symptom management for hospitalized patients with a malignancy. Studies exploring the indications for starting such a device for hospitalized inpatients referred to inpatient palliative care teams are limited. AIM This retrospective chart review aims to explore indications, timing of initiation, and barriers to the use of a CADD. METHODS Over a six month period, during daily inpatient palliative care consult team rounds, patients who required a CADD were enrolled in this study. Sixty-one adult patients were identified who required a pump for symptom control. The team's database sheets were used to capture patient demographics. RESULTS The main reasons for initiating a Continuous Ambulatory Delivery Device in the above setting included: lack of efficacy of oral opioids and to increase patient autonomy of their pain management. Approximately 20% of patients required transfer to another unit that could accommodate the CADD. The median length of stay for these patients was 13 days, with a median length of half a day for a pump to be started. CONCLUSIONS This initial study provides the Palliative Care Consult Team with information on the indications for the use of a CADD. The lack of universal access to a CADD in various areas of our hospital due to differences in departmental protocols may compromise good symptom management and patient safety. These results strengthen the argument that the existing hospital policy requires revamping to improve CADD access. A CADD has been shown to provide hospitalized patients, with a malignancy, with timely access to effective symptom management, and in turn, reducing their length of stay in hospital. These findings will help inform this organization's CADD policy and support the need to broaden access to this device.
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Affiliation(s)
- Madison Peters
- Advanced Practice Nurse, Division of Palliative Care Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Dr Justin Kutzko
- Palliative Care Physician, Division of Supportive and Palliative Care, Brampton Civic Hospital, William Osler Health System, Brampton, Ontario, Canada; Senior Lecturer, University of Queensland, Brisbane, Australia
| | - Kalli Stilos
- Advanced Practice Nurse, Division of Palliative Care Sunnybrook Health Sciences Centre, Adjunct Clinical Faculty for Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
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Erfina E, Nurmaulid N, Hariati S, Andriani A, McKenna L. Effectiveness of a Multimodal Nursing Intervention on Quality of Sleep, Fatigue, and Level of Depression Among Indonesian Patients With Gynecological Cancer: A Pilot Study. Cancer Nurs 2024; 47:72-80. [PMID: 36076316 DOI: 10.1097/ncc.0000000000001158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The use of nonpharmacological modalities in managing symptoms experienced by patients with cancer is increasingly important in providing holistic care. However, limited studies have reported on integrating nonpharmacological interventions to improve physical and psychological symptoms of women with gynecological cancer. OBJECTIVE The aim of this study was to examine the effect of a multimodal nursing intervention (MNI) on sleep quality, fatigue, and level of depression among Indonesian women with gynecological cancer. METHODS The quasi-experimental nonequivalent group design involved 50 patients in 2 groups and used convenience sampling. An experimental group (n = 25) received MNI including progressive muscle relaxation and a counseling session; the control group received routine hospital care (n = 25). Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI), depression levels by the Beck Depression Inventory-II, and fatigue by the Piper Fatigue Scale (PFS). Pretest data were collected after 3 days of hospital admission; posttest data were gathered after the intervention. RESULTS The PSQI ( P = .000), Beck Depression Inventory-II ( P = .008), and PFS ( P = .000) changed significantly in the intervention group; the PSQI ( P = .000) and PFS ( P = .000) in the control group changed significantly. The PSQI ( P = .00) and PFS ( P = .000) scores differed significantly between the 2 groups before and after the intervention. The effect size of the MNI for difference scores before and after the intervention was medium effect size. CONCLUSIONS The role of nonpharmacological modalities in managing symptoms experienced by patients with cancer is increasingly important to providing holistic care. IMPLICATION FOR PRACTICE Gynecology nurses can lead the implementation of MNI to decrease patient fatigue and depression and to increase sleep quality.
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Affiliation(s)
- Erfina Erfina
- Author Affiliations: Maternity Nursing Department (Dr Erfina and Ms Nurmaulid), Pediatric Nursing Department (Dr Hariati), and Mental Health Nursing Department (Ms Andriani), Faculty of Nursing, Hasanuddin University, Makassar, Indonesia; and College of Science Health and Engineering, La Trobe University (Prof McKenna), Bundoora, Australia
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Kang M, Seo M. Factors Affecting Nurses' Performance of Cancer Pain Management in a Tertiary Hospital. JOURNAL OF HOSPICE AND PALLIATIVE CARE 2022; 25:99-109. [PMID: 37674907 PMCID: PMC10179990 DOI: 10.14475/jhpc.2022.25.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/13/2022] [Accepted: 05/22/2022] [Indexed: 09/08/2023]
Abstract
Purpose More than 60% of patients with advanced cancer experience pain, and uncontrolled pain reduces the quality of life. Nurses are the closest healthcare providers to the patient and are suitable for managing cancer pain using pharmacological and non-pharmacological interventions. This study aimed to identify factors affecting the performance of cancer pain management among nurses. Methods This study was conducted among 155 participating nurses working at a tertiary hospital who had experience with cancer pain management. Data collection was performed between October 18, 2021 and October 25, 2021. Data analysis was conducted using descriptive statistics, the independent-sample t-test, one-way analysis of variance, and hierarchical regression analysis. Results There were 110 subjects (71.0%) who had no experience of cancer pain management education. The results of regression analysis indicated that barriers included medical staff, patients, and the hospital system for cancer pain management (β=0.28, P<0.001). The performance of cancer pain management was also affected by experience of cancer pain management training (β=0.22, P=0.007), and cancer pain management knowledge (β=0.21, P=0.006). The explanatory power of the variable was 16.6%. Conclusion It is crucial to assess system-related obstacles, as well as patients and medical staff, in order to improve nurses' cancer pain management performance. A systematic approach incorporating multidisciplinary interventions from interprofessional teams is required for effective pain management. Furthermore, pain management education is required both for cancer ward nurses and nurses in other wards.
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Affiliation(s)
- Minhwa Kang
- Department of Nursing, Gyeongsang National University Hospital, Jinju, Korea
| | - Minjeong Seo
- College of Nursing, Gyeongsang National University, Jinju, Korea
- Gerontological Health Research Center in Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
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Imeraj Z, Veseli (Bego) D, Pirushi R. The Role of Nursing Staff in Pain Management of Patients with Cancer. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Nurses spend more time with patients than any other member of the healthcare team. They play a critical, active and very important part in controlling cancer patients' pain and alleviating suffering. This study aimed to explore current nursing practices in the oncology hospital and the level of knowledge they possess about pain and its management in clinical settings.
Methods: This is a transversal type study developed on the basis of cluster sampling type on nurses in the Oncology Hospital, Tirana. The study was conducted in the period 2016-2018 and the sample consisted of 119 nurses.
Results: In total, 119 questionnaires were completed by oncology hospital nurses. Regarding the gender of was seen a predominance of women nurses compared to men 78.15% and 21.85% respectively. Nurses between the age 30 until to 39 years old were 34.4% of participants. Nurses of different gender, education level, and place of birth showed statistically significant difference. Only 23.5 % of nurses had pain training and education, and less than half of nurses (43.7%) had 5-10 years in oncology hospital. In this study, knowledge and practice of nurse’s participant on non-and pharmacological pain management were more than 55%. Related to the pain assessment 36.1% were based on the information provided by the patients, while 31.1% of nurses had used the visual analogue scale for pain assessment. According to the ways of pain management, almost 76.5% of nurses think that the best ways of pain management were pharmacology and 71.4% selected opioid analgesic medication while 28.6% selected non-opioid analgesic medication. Contacting the physician for the prescription of opioids was cited as the main delaying process by 43.7% of participants.
Conclusions: The results of the study demonstrated that the nurses had limited knowledge of pain management, because of non-training courses for consequence all of it was associated with poor attitude toward pain management. Most of them did not have formal training in pain management either at the local level. Many of them are familiar with oral route of administration of opioids but still the logistics of administration is not clear to them. Nowadays training and education in pain management is a necessity for medical staff especially for nurses because the adequate knowledge is vital in the provision of quality pain management to patients.
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Manworren RCB. Nurses' management of children's acute postoperative pain: A theory of bureaucratic caring deductive study. J Pediatr Nurs 2022; 64:42-55. [PMID: 35149258 DOI: 10.1016/j.pedn.2022.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Few studies have examined the translation of nurses' knowledge of pain management into clinical practice or how nurses negotiated the bureaucracy of caring to treat patients' acute pain. PURPOSE This study describes factors that influence pediatric nurses' actions in caring for hospitalized children's acute post-surgical pain. METHOD Ray's Theory of Bureaucratic Caring provided the theoretical framework for this mixed methods study of ethnography and human factors engineering. Fourteen nurses were observed throughout their shifts (175.5 h) to elucidate humanistic and bureaucratic influences. FINDINGS Of 105 pain assessments, nurses intervened with pharmacologic (n = 45) and biobehavioral (n = 13) interventions for pediatric patients' post-surgical pain in less than 11 min; and 25 assessments revealed patients did not have pain. Pain was assessed and no intervention was provided to 4 patients who were asleep, 5 patients who refused, 2 patients who had no ordered analgesics and 10 patients who were assessed prior to peak effectiveness of their prior analgesic. Overall pain was well-controlled. Of the 28 themes identified, the interplay of 6 categorized to the social/cultural humanistic, 7 political, and 6 technologic/physiological bureaucratic dimensions most strongly influenced pain care. DISCUSSION To achieve optimal pain care outcomes, nurses' and parents' pain management knowledge was less influential for clinical practice translation than nurses' negotiation of other dimensions of bureaucratic caring.
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Affiliation(s)
- Renee C B Manworren
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 100, Chicago, IL 60611, USA; Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Box 100, Chicago, IL 60611, USA.
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Samarkandi OA. The factors affecting nurses' assessments toward pain management in Saudi Arabia. Saudi J Anaesth 2021; 15:165-173. [PMID: 34188636 PMCID: PMC8191256 DOI: 10.4103/sja.sja_2_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/13/2021] [Accepted: 03/01/2021] [Indexed: 12/03/2022] Open
Abstract
Background and Aims: Pain assessment requires an extensive practice in diagnosis coupled with proficiency in recognizing health factors that lead to its occurrence. Nurses' education and training could be the main factor influencing pain perception and diagnosis. This study aims at comparing nurses' academic qualifications and relevant training courses that may impact their assessment skills toward patients in pain. Methods: A descriptive cross-sectional design using a Knowledge and Attitudes Survey Regarding Pain questionnaire was administered to a total of 247 nurses. In this survey, the nurses were asked to answer specific questions related to correctly diagnosing and assessing patients' pain, as well as answer questions about their previous training in pain assessment. Results: A total of 247 nurses answered the questionnaire, with an overall response rate of 82%. Questionnaires revealed that more than half (50.6%) of the nurses involved in this study have not received any pain education related to pain management in the 5 years following their initial nursing licensure or supervision under a nurse supervisor. Conclusions: The results of the paper show that nurses' experiential level has the highest impact on their knowledge of pain relief management and medications necessary for treating it. Also, nurses' pain education following their initial licensure and during their professional practice has the second highest impact on their pain relief management knowledge, whereas their primary nursing education had the lowest.
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Affiliation(s)
- Osama A Samarkandi
- Department of Basic Science, Prince Sultan College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia
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Hackett J, Allsop MJ, Taylor S, Bennett MI, Bewick BM. Using information and communication technologies to improve the management of pain from advanced cancer in the community: Qualitative study of the experience of implementation for patients and health professionals in a trial. Health Informatics J 2020; 26:2435-2445. [PMID: 32133902 DOI: 10.1177/1460458220906289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In cancer care, there are emerging information and communication technology systems being developed, enabling real-time information sharing between patients and health professionals. This study explored health professionals' and patients' perceptions of their engagement with an information and communication technology system for pain management to understand the mechanisms that could support implementation into routine palliative care practice. This was a qualitative study, embedded within a randomised control trial, using semi-structured face-to-face interviews. Data were analysed using thematic analysis. The role of health professionals was a key component to patient engagement with the information and communication technology system. Where patients engaged with the information and communication technology system, both patients and health professionals reported benefits to system use in addition to usual care. Implementation issues were identified that can be used to guide future system development to support pain management in the context of routine clinical care in palliative care services. Where interventions are dependent on multiple providers, collaborative working and consideration of the context within which they are set are needed.
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Utne I, Småstuen MC, Nyblin U. Pain Knowledge and Attitudes Among Nurses in Cancer Care in Norway. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:677-684. [PMID: 29603056 DOI: 10.1007/s13187-018-1355-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The purpose of this study was to survey knowledge on, and attitudes to, pain and pain management among a cohort of Norwegian Nurses in cancer care, and to explore whether there is any association between various demographic variables and knowledge level. This is a web-based survey and nurses were recruited from the Forum for Cancer Nursing. Nurses completed the questionnaire "Nurses' Knowledge and Attitudes Survey Regarding Pain (NKAS)". Univariate and multivariate linear regression analysis were used to evaluate the association between knowledge and attitudes and demographic variables. Nurses from all over Norway answered. The majority were women and most had education above bachelor level. Mean NKAS total score was 31 points (75%). Significant associations were found between NKAS total score and pain management course (p = 0.01) and workplace (p = 0.04). Nurses in cancer care in Norway have relatively good pain knowledge. The potential for improvement is the greatest with regard to pharmacology and nurses' attitudes to how patients express pain. Our findings suggest that an extensive pain management course with patient histories may result in more theoretical knowledge being applied to the patients. In a time with large migration among nurses, our findings indicate that pain management courses should be aware of cultural differences in the educational training.
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Affiliation(s)
- Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs Plass, NO-0130, Oslo, Norway.
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs Plass, NO-0130, Oslo, Norway
| | - Ulla Nyblin
- Department of Surgery, Vestre Viken Hospital Trust, PO 800, NO-3004, Drammen, Norway
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Leung YW, Wong J, Kiteley C, Ellis J, Esplen MJ. Addressing Educational Needs in Managing Complex Pain in Cancer Populations: Evaluation of APAM: An Online Educational Intervention for Nurses. Am J Hosp Palliat Care 2019; 36:587-597. [DOI: 10.1177/1049909119832819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Yvonne W. Leung
- de Souza Institute, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jiahui Wong
- de Souza Institute, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Cathy Kiteley
- de Souza Institute, University Health Network, Toronto, Ontario, Canada
| | - Jerusha Ellis
- de Souza Institute, University Health Network, Toronto, Ontario, Canada
| | - Mary Jane Esplen
- de Souza Institute, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Phillips JL, Heneka N, Lovell M, Lam L, Davidson P, Boyle F, McCaffrey N, Fielding S, Shaw T. A phase III wait-listed randomised controlled trial of novel targeted inter-professional clinical education intervention to improve cancer patients' reported pain outcomes (The Cancer Pain Assessment (CPAS) Trial): study protocol. Trials 2019; 20:62. [PMID: 30658657 PMCID: PMC6339283 DOI: 10.1186/s13063-018-3152-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 12/18/2018] [Indexed: 11/17/2022] Open
Abstract
Background Variations in care models contribute to cancer pain being under-recognised and under-treated in half of all patients with cancer. International and national cancer pain management guidelines are achievable with minimal investment but require practice changes. While much of the cancer pain research over the preceding decades has focused on management interventions, little attention has been given to achieving better adherence to recommended cancer pain guideline screening and assessment practices. This trial aims to reduce unrelieved cancer pain by improving cancer and palliative doctors’ and nurses’ (‘clinicians’) pain assessment capabilities through a targeted inter-professional clinical education intervention delivered to participants’ mobile devices (‘mHealth’). Methods A wait-listed, randomised control trial design. Cancer and/or palliative care physicians and nurses employed at one of the six participating sites across Australia will be eligible to participate in this trial and, on enrolment, will be allocated to the active or wait-listed arm. Participants allocated to the active arm will be invited to complete the mHealth cancer pain assessment intervention. In this trial, mHealth is defined as medical or public health practice supported by mobile devices (i.e. phones, patient monitoring devices, personal digital assistants and other wireless devices). This mHealth intervention integrates three evidence-based elements, namely: the COM-B theoretical framework; spaced learning pedagogy; and audit and feedback. This intervention will be delivered via the QStream online platform to participants’ mobile devices over four weeks. The trial will determine if a tailored mHealth intervention, targeting clinicians’ cancer pain assessment capabilities, is effective in reducing self-reported cancer pain scores, as measured by a Numerical Rating Scale (NRS). Discussion If this mHealth intervention is found to be effective, in addition to improving cancer pain assessment practices, it will provide a readily transferable evidence-based framework that could readily be applied to other evidence practice gaps and a scalable intervention that could be administered simultaneously to multiple clinicians across diverse geographical locations. Moreover, if found to be cost-effective, it will help transform clinical continuing professional development. In summary, this mHealth intervention will provide health services with an opportunity to offer an evidence-based, pedagogically robust, cost-effective, scalable training alternative. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12618001103257. Registered on 3 July 2018. Electronic supplementary material The online version of this article (10.1186/s13063-018-3152-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jane L Phillips
- University of Technology Sydney, PO Box 123, Ultimo, NSW, 2007, Australia.
| | - Nicole Heneka
- University of Technology Sydney, PO Box 123, Ultimo, NSW, 2007, Australia
| | - Melanie Lovell
- University of Sydney, City Rd, Camperdown, NSW, 2006, Australia
| | - Lawrence Lam
- University of Technology Sydney, PO Box 123, Ultimo, NSW, 2007, Australia
| | - Patricia Davidson
- Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD, 21218, USA
| | - Frances Boyle
- University of Sydney, City Rd, Camperdown, NSW, 2006, Australia
| | - Nikki McCaffrey
- Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia
| | - Sally Fielding
- University of Technology Sydney, PO Box 123, Ultimo, NSW, 2007, Australia
| | - Tim Shaw
- University of Sydney, City Rd, Camperdown, NSW, 2006, Australia
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Abstract
Background: Pain control is a vitally important goal because untreated pain has detrimental impacts on the patients as hopelessness, impede their response to treatment, and negatively affect their quality of life. Limited knowledge and negative attitudes toward pain management were reported as one of the major obstacles to implement an effective pain management among nurses. The main purpose for this study was to explore Saudi nurses’ knowledge and attitudes toward pain management. Methods: Cross-sectional survey was used. Three hundred knowledge and attitudes survey regarding pain were submitted to nurses who participated in this study. Data were analyzed with the Statistical Package for the Social Sciences software (SPSS; version 17). Results: Two hundred and forty-seven questionnaires were returned response rate 82%. Half of the nurses reported no previous pain education in the last 5 years. The mean of the total correct answers was 18.5 standard deviation (SD 4.7) out of 40 (total score if all items answered correctly) with range of 3–37. A significant difference in the mean was observed in regard to gender (t = 2.55, P = 0.011) females had higher mean score (18.7, SD 5.4) than males (15.8, SD 4.4), but, no significant differences were identified for the exposure to previous pain education (P > 0.05). Conclusions: Saudi nurses showed a lower level of pain knowledge compared with nurses from other regional and worldwide nurses. It is recommended to considered pain management in continuous education and nursing undergraduate curricula.
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Taylor S, Allsop MJ, Bekker HL, Bennett MI, Bewick BM. Identifying professionals' needs in integrating electronic pain monitoring in community palliative care services: An interview study. Palliat Med 2017; 31:661-670. [PMID: 27836943 DOI: 10.1177/0269216316677470] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Poor pain assessment is a barrier to effective pain control. There is growing interest internationally in the development and implementation of remote monitoring technologies to enhance assessment in cancer and chronic disease contexts. Findings describe the development and testing of pain monitoring systems, but research identifying the needs of health professionals to implement routine monitoring systems within clinical practice is limited. AIM To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals' needs when integrating PainCheck into routine clinical practice. DESIGN Qualitative study using face-to-face interviews. Data were analysed using framework analysis Setting/participants: Purposive sample of health professionals managing the palliative care of patients living in the community Results: A total of 15 interviews with health professionals took place. Three meta-themes emerged from the data: (1) uncertainties about integration of PainCheck and changes to current practice, (2) appraisal of current practice and (3) pain management is everybody's responsibility Conclusion: Even the most sceptical of health professionals could see the potential benefits of implementing an electronic patient-reported pain monitoring system. Health professionals have reservations about how PainCheck would work in practice. For optimal use, PainCheck needs embedding within existing electronic health records. Electronic pain monitoring systems have the potential to enable professionals to support patients' pain management more effectively but only when barriers to implementation are appropriately identified and addressed.
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Affiliation(s)
- Sally Taylor
- 1 Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Matthew J Allsop
- 1 Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Hilary L Bekker
- 2 Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Michael I Bennett
- 1 Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Bridgette M Bewick
- 2 Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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