The purpose of this study was to determine if continued access to information following a baseline pain education program would increase knowledge and positive beliefs about cancer pain management, thus resulting in improved pain control during a 6-month follow-up period. Patients with cancer-related pain and their primary caregivers received a brief pain education program, and were then randomized into one of three information groups: a) usual care, b) pain hot line, and c) weekly provider-initiated follow-up calls for 1 month post-education. Sixty-four patients and their primary caregivers were recruited. Both patients and caregivers showed an improvement in knowledge and beliefs after the baseline pain education program. Continued access to pain information with either the pain hot line or provider-initiated weekly follow-up calls did not affect long-term outcomes of pain intensity, interference because of pain, adequacy of analgesics used, or pain relief. In addition, long-term outcomes did not differ between patients who had improvement and those who showed decline in knowledge and beliefs pre-post education. These findings suggest that a brief pain education program can improve knowledge and beliefs of both patient and primary caregiver. Continued access to pain related information using either a patient- or provider-initiated format did not affect long-term pain outcomes.
Despite progress in meeting Healthy People 2010 goals, African American (AA) men and women have higher mortality and morbidity rates as compared with Caucasian Americans. These may be attributed to lifestyle behaviors; however, this is a complex, multifactorial problem. The purpose of this study was to examine gender differences among AA lifestyle behaviors. A descriptive comparative design was used. The sample consisted of 223 AAs residing in southeastern United States. The health-promoting lifestyle profile (HPLP) was used to measure health-promoting behaviors. Independent t-test analysis revealed no statistically significant gender differences for total HPLP scores, t(220) = -1.49, p = 0.14. When controlling for income, education, and marital status, no significant interactions were seen with gender on HPLP. Independent t-test analyses revealed statistically significant differences for interpersonal relationship support, t(221) = -1.97, p = 0.05, health responsibility, t(214) = -2.46, p = 0.02, and nutrition t(219) = -3.27, p < 0.01, with women scoring higher than men. Although gender differences in AAs are evident for specific health-promoting lifestyle behaviors, these differences become less dominant when education and marital status were used as covariates.
Among the reasons that cancer pain is not controlled adequately are patient-related barriers. Patient beliefs that may contribute to poor outcome have been measured in previous research with the Barriers Questionnaire (BQ). The purpose of this study was to examine the internal consistency of a shortened version of the BQ. A sample of 217 outpatients with cancer completed a 17-item version of the scale. Factor analysis suggested two subscales, one reflecting beliefs about communication about pain and the other reflecting beliefs about the use of analgesics. Both subscales demonstrated adequate internal consistency. Beliefs did not differ between patients who had and those who had not experienced pain within the previous two weeks. Findings suggest the shortened BQ provides an internally consistent measure of two broad patient barriers to pain management.
Assessment of pain-related distress may be important in planning interventions. Common nursing interventions may be employed to reduce pain intensity and pain-related distress, which may result in enhanced physical and emotional well-being.
This quasiexperimental study investigated interdisciplinary collaboration over a 16-month period on units using different collaborative practice strategies. Measures of collaboration and perceived physician involvement in collaborative practice were completed by 335 licensed staff members working on seven general adult units in an acute care hospital located in an academic medical center. Data were collected at two time points: in 1993 and 1995. A small but statistically significant decline in collaboration was found (p = 0.01) over the 16-month period. Analysis of variance revealed a significant difference (p = 0.03) in collaboration related to the method used to develop collaborative paths. Post hoc Tukey's test indicated that the presence of a case manager without collaborative paths did show higher levels of collaboration (p = 0.05). Regardless of the strategy used, perceived high physician involvement was related to greater collaboration than perceived low involvement with differences increasing over time (p = 0.02). These findings suggest the importance of perceived physician involvement in collaborative practice to interdisciplinary collaboration.
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