Mayahara Masako, Wilbur JoEllen, O'Mahony Sean, Breitenstein Susan
1 College of Nursing, Rush University, Chicago, Illinois, USA.
2 Rush Medical College, Rush University, Chicago, Illinois, USA.
J Palliat Care. 2017 Apr;32(2):77-84. doi: 10.1177/0825859717722466. Epub 2017 Sep 4.
Informal hospice caregivers play a key role in managing patients' pain at home, but lack of adherence to doctor-prescribed analgesic regimens and medication errors are significant barriers to truly effective pain management. A digital pain diary may improve caregiver management of pain at home; however, most digital pain tools available today were developed without input from patients or caregivers. Accordingly, the purpose of this study was to develop a digital pain application (1) for hospice caregivers to record patient pain and analgesic use and (2) for nurses to monitor administration of analgesics by caregivers. Using advisory group methods, nurse case managers (n = 6), and informal caregivers (n = 3) helped us to convert a paper-based pain and analgesic diary into a digital format-the e-PAIN Reporter-and to refine the application. The e-PAIN Reporter provides information on patient pain assessment and pain management and reports to nurses in real time. Further testing is now needed to determine (1) the feasibility of using the e-PAIN Reporter and (2) its effectiveness in improving pain management for hospice patients.
非正式临终关怀护理人员在居家管理患者疼痛方面发挥着关键作用,但不遵守医生规定的镇痛方案以及用药错误是真正有效进行疼痛管理的重大障碍。数字疼痛日记可能会改善护理人员对居家疼痛的管理;然而,当今大多数可用的数字疼痛工具在开发时并未征求患者或护理人员的意见。因此,本研究的目的是开发一种数字疼痛应用程序:(1)供临终关怀护理人员记录患者疼痛和镇痛药使用情况;(2)供护士监测护理人员的镇痛药给药情况。通过咨询小组方法,护士个案管理员(n = 6)和非正式护理人员(n = 3)帮助我们将纸质疼痛和镇痛药日记转换为数字格式——电子疼痛报告器,并对该应用程序进行完善。电子疼痛报告器提供有关患者疼痛评估和疼痛管理的信息,并实时向护士报告。现在需要进一步测试以确定:(1)使用电子疼痛报告器的可行性;(2)其在改善临终关怀患者疼痛管理方面的有效性。