"FastSchool": A single session of an interprofessional pain management program for chronic pain patients inspired by cognitive behavioral therapy

OBJECTIVES

Multidisciplinary approaches to treating chronic pain have been proven effective. Currently, chronic pain patients face lengthy waitlists in pain medicine departments. To overcome this problem, we developed the "FastSchool" program to educate patients about pain management and treatment. In this study, we evaluated the benefit of a "FastSchool" session on pain and catastrophizing in chronic pain patients.

METHODS

Included patients had chronic non-cancer pain, no more than 2 visits to a pain medicine department. Patients attended a single 3-hour session, conducted by an interprofessional team. Four topics were addressed: chronic pain mechanisms, pharmacological therapies, physical activity, and the management of analgesics. Patients completed questionnaires at baseline and at 3 months post-session to assess pain interference, pain intensity, and catastrophizing.

RESULTS

The study population included 88 patients; 71 completed the follow-up questionnaires. Pain interference (p = 0.002), average pain intensity (p = 0.013), and catastrophizing (p < 0.001) decreased 3 months after FastSchool. At M3, 35 % of patients felt their pain had improved based on the Patient Global Impression of Change.

CONCLUSION

FastSchool, an innovative short-term educational program inspired by cognitive behavioral therapy, showed positive results in reducing pain impact.

PRACTICE IMPLICATIONS

Implementation of FastSchool in pain medicine departments would reduce waitlist times for non-pharmacological treatment.

Accuracy and Readability of Websites on Kidney and Bladder Cancers

The aim of this study was to assess the scientific accuracy and the readability level of websites on kidney and bladder cancers. The search engines Google™, Yahoo™ and Bing™ were searched independently by assessors in November 2014 using the following keywords: "bladder cancer", "kidney cancer", "patient bladder cancer", "patient kidney cancer" and "bladder and kidney cancer". Only English-language websites were selected on the bases of predetermined inclusion and exclusion criteria. Assessors independently reviewed the findings and evaluated the accuracy and quality of each website by using the DISCERN and the LIDA instruments. The readability of the websites was calculated using the Flesch-Kincaid Grade Level Index and the Coleman-Liau Readability Index. Sixty-two websites were finally included in the study. The overall accuracy scores varied; for the DISCERN, the range was 28 to 76; out of 80 (mean ± SD, 47.1 ± 12.1; median = 46.0, interquartile range (IQR) = 19.2), and for the LIDA, the range was 52 to 125; out of 144 (mean ± SD, 101.9 ± 15.2; median, 103; IQR, 16.5). The creators of these websites were universities and research centres (n = 25, 40%), foundations and associations (n = 10, 16%), commercial and pharmaceutical companies (n = 13, 21%), charities and volunteer work (n = 4, 6%) and non-university educational bodies (n = 10, 16%). The readability scores (mean ± SD) were 11.2 ± 2.2 for the Flesch-Kincaid Grade Level Index and 11.2 ± 1.6 for the Coleman-Liau Readability Index. The accuracy and the quality of the websites on kidney and bladder cancers varied. In most websites, there were deficiencies in clarity of aims, presenting symptoms, investigations and treatment options. The readability matched grades 10-11 literacy levels-a level above the public readability level. The study highlights the needs for further improvement of the online information created for public and patients with kidney and bladder cancers.

Surgical patients' perspectives on nurses' education on post-operative care and follow up in Northern Ghana

Background

The purpose of the study was to explore surgical patients' experiences of discharge planning and home care in the Northern part of Ghana.

Methods

The study was conducted at a referral hospital located at the Northern part of Ghana. A qualitative explorative descriptive design was adopted for the study. Purposive sampling technique was used to recruit participants. Data was saturated with 15 participants aged between 23 and 65 years. All the interviews were audio-taped and transcribed verbatim. Data analysis was done using the processes of content analysis.

Results

Nurses educated surgical patients on discharge to avoid smoking, alcohol drinking, chewing cola nuts and strenuous exercise to promote healing and prevent complications. Patients were educated to keep their wound dry and clean. Patients were advised to eat nutritious food, vegetables and fruits and take their medications as prescribed. They were to report drug effects and come to the hospital for follow-up visits. Patients were urged to come for daily wound dressing at the outpatient department. On the contrary, some nurses did not educate patients on signs of wound healing or infection. Some nurses were rude to the patients during wound dressing. Nurses did not visit patients at home when they were discharged from the hospital.

Conclusions

The study showed that although nurses were able to educate discharged patients on how to manage their health at home, there is the need to improve communication and attitude to enhance care.