Harris John M, Fulginiti John V, Gordon Paul R, Elliott Thomas E, Davis Bennet E, Chabal Charles, Kutob Randa M
Medical Directions, Inc., Tucson, AZ 85712, USA.
Pain Med. 2008 Jul-Aug;9(5):542-54. doi: 10.1111/j.1526-4637.2007.00398.x. Epub 2008 Feb 5.
Despite a need for better physician pain management education, there are no widely accepted assessment or outcome measures to support this work.
Create a self-assessment tool to measure physician educational needs and the effectiveness of chronic pain educational programs.
We used expert consensus to draft a 142-item survey that covered essential areas of chronic pain management. We tested the survey in 106 physicians, including 22 pain management experts and used predefined psychometric criteria to eliminate 70 items. We then eliminated 22 remaining items that did not correlate with the management of a standardized chronic pain patient by 27 academic physicians. We evaluated internal consistency using Cronbach's alpha.
The final 50-item survey assessed physician knowledge, attitudes, and beliefs in: 1) initial pain assessment; 2) defining goals and expectations; 3) development of a treatment plan; 4) implementation of a treatment plan; 5) reassessment and management of longitudinal care; and 6) management of environmental issues. The survey demonstrated good internal consistency in all physician populations studied (alpha = 0.77-0.85). Average scores in 84 "pilot" physician users of a CME Website (135.8-138.5) were significantly lower (P < 0.01) than scores in 27 academic physicians (150.0), or 22 pain experts (177.5).
This survey, the KnowPain-50, has good psychometric properties, correlates with clinical behaviors, and appears to distinguish between physicians with different levels of pain management expertise. It may be a useful measure of the effectiveness of physician pain management education programs.
尽管需要对医生进行更好的疼痛管理教育,但目前尚无广泛接受的评估或结果指标来支持这项工作。
创建一种自我评估工具,以衡量医生的教育需求以及慢性疼痛教育项目的效果。
我们采用专家共识起草了一份包含142个条目的调查问卷,涵盖慢性疼痛管理的关键领域。我们在106名医生中对该问卷进行了测试,其中包括22名疼痛管理专家,并使用预先定义的心理测量标准剔除了70个条目。然后,我们又剔除了22个与27名学术医生对标准化慢性疼痛患者的管理无关的剩余条目。我们使用克朗巴哈系数评估内部一致性。
最终的50个条目调查问卷评估了医生在以下方面的知识、态度和信念:1)初始疼痛评估;2)确定目标和期望;3)制定治疗计划;4)实施治疗计划;5)重新评估和纵向护理管理;6)环境问题管理。该调查问卷在所有研究的医生群体中均显示出良好的内部一致性(系数=0.77 - 0.85)。继续医学教育网站的84名“试点”医生用户的平均得分(135.8 - 138.5)显著低于27名学术医生(150.0)或22名疼痛专家(177.5)(P < 0.01)。
这份名为KnowPain - 50的调查问卷具有良好的心理测量特性,与临床行为相关,并且似乎能够区分不同疼痛管理专业水平的医生。它可能是衡量医生疼痛管理教育项目效果的有用指标。