Department of Psychology, University of Regina, Regina, Saskatchewan.
Pain Res Manag. 2013 Jan-Feb;18(1):11-8. doi: 10.1155/2013/395481.
The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors.
To investigate the effectiveness of an expert-based continuing education program in pain assessment⁄management for LTC staff.
Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes⁄beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies.
Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants.
Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers.
长期护理(LTC)机构居民的疼痛评估和治疗不足已得到充分证实。研究人员已经确定,员工知识的差距和不准确的信念是导致这一问题的原因之一。
调查基于专家的继续教育计划在 LTC 员工疼痛评估/管理方面的效果。
参与者包括 131 名 LTC 工作人员,他们被随机分配到互动式疼痛教育(PE)计划或互动式对照组。PE 计划针对药物管理等知识差距,而对照组则提供一般的痴呆症教育,没有特定的临床重点。参与者参加了三次为时 3 小时的课程,并在计划开始前、结束后和两周后完成了与疼痛相关的知识和态度/信念的测量。研究人员对一部分参与者进行了焦点小组讨论,以评估他们对培训计划的看法以及实施疼痛相关策略的障碍。
使用方差分析的结果表明,与对照组相比,PE 组在疼痛知识和疼痛信念方面的得分有显著提高。实施疼痛相关策略的障碍确实存在。然而,定性分析表明,PE 组的参与者报告说,他们克服了许多这些障碍,并比对照组更频繁地使用疼痛管理策略,使用频率增加了四倍。
与之前的研究结果相反,本研究发现互动式 PE 计划在改变疼痛信念和提高知识方面是有效的。在 LTC 中持续开展 PE 具有解决一线 LTC 提供者知识差距的潜力。