Cardarelli Roberto, Elder William, Weatherford Sarah, Roper Karen L, King Dana, Workman Charlotte, Stewart Kathryn, Kim Chong, Betz William
a Department of Family and Community Medicine , University of Kentucky College of Medicine , Lexington , KY , USA.
b Department of Family and Community Medicine , West Virginia University Health Science Center , Morgantown , WV , USA.
J Interprof Care. 2018 Sep;32(5):556-565. doi: 10.1080/13561820.2018.1452725. Epub 2018 Mar 30.
Chronic pain is increasingly recognized as a public health problem. We assessed the effectiveness of a multi-modal, interprofessional educational approach aimed at empowering healthcare professionals to make deliberative changes, especially in opiate prescribing practices. Education activities included enduring webcasts, regional interprofessional roundtable events, and state-level conference presentations within targeted Kentucky and West Virginia regions of the United States. Over 1,000 participants accessed the various activities. For the live events, the largest groups reached included nurses (38.1%), nurse practitioners (31.2%), and physicians (22.1%). In addition to our reach, higher levels of educational effectiveness were measured, specifically, learner's intentions to change practice patterns, confidence in meeting patient's needs, and knowledge of pain management guidelines. The majority of the conference (58%) and roundtable (69%) participants stated they intend to make a practice change in one or more areas of chronic pain patient management in post-event evaluation. Differences in pre- and post-activity responses on the measures of confidence and knowledge, with additional comparison to a control population who were not in attendance, were analyzed using non-parametric tests of significance. While neither activity produced significant changes in confidence from pre-activity, participants were more confident post-activity than their control group peers. There were significant changes in knowledge for both live event and webcast participants. Impactful chronic pain continuing the education that emphasizes collaborative care is greatly needed; these results show that the approaches taken here can impact learner's knowledge and confidence, and hold potential for creating change in how opioid prescribing is managed.
慢性疼痛日益被视为一个公共卫生问题。我们评估了一种多模式、跨专业教育方法的有效性，该方法旨在使医疗保健专业人员能够做出审慎的改变，尤其是在阿片类药物处方实践方面。教育活动包括持久的网络直播、地区性跨专业圆桌会议以及在美国肯塔基州和西弗吉尼亚州的目标地区举行的州级会议演讲。超过1000名参与者参加了各种活动。对于现场活动，参与人数最多的群体包括护士（38.1%）、执业护士（31.2%）和医生（22.1%）。除了我们的覆盖范围外，还测量了更高水平的教育效果，具体而言，学习者改变实践模式的意愿、满足患者需求的信心以及疼痛管理指南的知识。在会后评估中，大多数会议（58%）和圆桌会议（69%）参与者表示，他们打算在慢性疼痛患者管理的一个或多个领域做出实践改变。使用非参数显著性检验分析了活动前后在信心和知识测量方面的反应差异，并与未参加的对照组人群进行了额外比较。虽然两项活动在活动前到活动后的信心方面都没有产生显著变化，但参与者在活动后的信心比对照组同龄人更高。现场活动和网络直播参与者在知识方面都有显著变化。非常需要有影响力的慢性疼痛继续教育，强调协作护理；这些结果表明，这里采用的方法可以影响学习者的知识和信心，并有可能改变阿片类药物处方的管理方式。
