A Systematic Review of the Effectiveness of Knowledge Translation Interventions for Chronic Noncancer Pain Management

Ospina, María; Taenzer, Paul; Rashiq, Saifee; MacDermid, Joy C.; Carr, Eloise; Chojecki, Dagmara; Harstall, Christa; Henry, James L.

doi:10.1155/2013/120784

Cited by 36 publications

(40 citation statements)

References 58 publications

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“…There is evidence that explanation to patients of their problems and possible treatments are a predominant reason for general practitioner and specialist consultation by patients with pain,14,29,30 and these improve patient satisfaction and adherence to treatment 31. However, trials of education alone are disappointing,32–35 and it remains unclear what content or process enables the chronic pain patient to change his or her understanding of pain and treatment options.…”

Section: Introductionmentioning

confidence: 99%

Are patients' and doctors' accounts of the first specialist consultation for chronic back pain in agreement?

White¹,

Lee²,

Williams³

2016

JPR

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IntroductionThe first consultation at a specialist pain clinic is potentially a pivotal event in a patient’s pain history, affecting treatment adherence and engagement with longer term self-management. What doctors communicate to patients about their chronic pain and how patients interpret doctors’ messages and explanations in pain consultations are under-investigated, particularly in specialist care. Yet, patients value personalized information about their pain problem.Patients and methodsSixteen patients in their first specialist pain clinic consultation and the doctors they consulted were interviewed shortly after the consultation. Framework analysis, using patient themes, was used to identify full match, partial match, or mismatch of patient–doctor dyads’ understandings of the consultation messages.ResultsPatients and doctors agreed, mainly implicitly, that medical treatment aiming at pain relief was primary and little time was devoted to discussion of self-management. Clinically relevant areas of mismatch included the explanation of pain, the likelihood of medical treatments providing relief, the long-term treatment plan, and the extent to which patients were expected to be active in achieving treatment goals.DiscussionOverall, there appears to be reasonable concordance between doctors and patients, and patients were generally satisfied with their first consultation with a specialist. Two topics showed substantial mismatch, the estimated likely outcome of the next planned intervention and, assuming (as doctors but not patients did) that this was unsuccessful, the long-term treatment plan. It appeared that more complex issues often generate divergence of understanding or agreement. Despite the widespread recommendations to medical practitioners to check patients’ understanding directly, it does not appear to be routine practice.ConclusionIt is hoped that this research encourages more detailed examination of shared and divergent experiences of pain consultations and also their influence on the subsequent course of intervention and adherence to treatment (not addressed here).

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Section: Introductionmentioning

confidence: 99%

Are patients' and doctors' accounts of the first specialist consultation for chronic back pain in agreement?

White¹,

Lee²,

Williams³

2016

JPR

View full text Add to dashboard Cite

show abstract

“…Ospina et al evaluated the effectiveness of knowledge translation (KT) interventions for pain management [21]. The researchers noted that interactive educational interventions, which were directed towards educating health providers, led to positive effects on patients' pain relief and improved patient's functional level.…”

Section: Strategies To Improve Pain Managementmentioning

confidence: 99%

“…The researchers noted that interactive educational interventions, which were directed towards educating health providers, led to positive effects on patients' pain relief and improved patient's functional level. However, the authors stated that many factors, which include lacking resources, as well as individual and organizational constraints, impede the incorporation of pain management/assessment practice changes [21]. Finally, Ospina et al noted that various knowledge translation interventions exist; however, there is a shortage of research available regarding theoretical and empirical frameworks for classifying pain management [21].…”

Section: Strategies To Improve Pain Managementmentioning

confidence: 99%

Improving Pain Management Knowledge Among Nurses

2018

Medical &Amp; Clinical Research

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Pain is the most commonly presented symptom among patients who are admitted to the emergency department. Unfortunately, many barriers to pain management exist thereby impacting emergency department patient care and outcomes, specifically regarding inadequate pain assessment, reassessment, and documentation. Thus, the quality improvement project aimed to increase emergency department nurses knowledge of pain management and utilization of pain assessment guidelines, resources, and policies. By nurses having sufficient education, they can provide timely and efficient care to support patient outcomes, improve patient comfort, and improve patient satisfaction. The Knowledge and Attitudes Survey Regarding Pain was utilized to conduct a pre and post-test assessment to measure emergency department nurses’ knowledge of pain management [1]. The results of the quality improvement project showed that nurses lacked adequate pain management knowledge, 45.45% of participants responded incorrectly to knowledge questions about pain before the intervention. However, after the project implementation, the results of the data analysis showed a statistically significant mean increase of 23.91% from pre-intervention (65.65%) to post-intervention (89.56%) after eight weeks of project implementation. This quality improvement project will provide a basis for future studies in improving nurses’ pain management knowledge.

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“…Meanwhile, there is an ever-growing body of research about the effectiveness of very specific pain assessment and treatment interventions on various dimensions of pain and associated phenomena for populations with and without CI. 9,11,[31][32][33][34] Only few studies have focused explicitly on effects of more general interventions in pain management strategies in NH, indicating that implementing changes in pain management practices is challenging regardless of the health-care setting. 35,36 Educational interventions which aim at improving nurses' knowledge and competencies in pain management are rather rare, yet some were found to have positive outcomes for individuals' pain situation.…”

Section: Introductionmentioning

confidence: 99%

<p>Nursing Education Intervention Effects on Pain Intensity of Nursing Home Residents with Different Levels of Cognitive Impairment: A Cluster-Randomized Controlled Trial</p>

Kutschar¹,

Berger²,

Brandauer³

et al. 2020

JPR

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Purpose: Pain management in nursing homes is challenging and pain prevalence remains high. The objective of this study was to improve the pain situation of nursing home residents following a nursing-related educational intervention within a cluster-randomized controlled trial (2016-2018). Participants: Clusters were nursing homes from one nursing home operator in Bavaria, Germany. Nursing home residents who were permanently registered in the facilities, at least 60 years of age, and who themselves or their legal guardians provided informed consent were included. Intervention: In addition to the implementation of pain nurses and pain care assistants, staff of the intervention group received an educational intervention in pain management, containing classroom (quality circles) and web-based training for nurses. Methods: Based on the Mini-Mental State Examination (MMSE), residents were either interviewed (MMSE 10-30) using self-report instruments or observed (MMSE 0-9) by proxy assessment. The primary outcome in residents able to self-report was maximum pain intensity according to Brief Pain Inventory (BPI); in those not able to self-report treatmentrelevant pain above cutoff (≥2) on the Pain Assessment in Advanced Dementia (PAINAD). Results: Out of 20 randomly selected clusters, 9 nursing homes from the control, and 6 nursing homes from the intervention group participated. Multilevel linear (n=347 residents, MMSE 10-30) and logistic regression (n=222 residents, MMSE 0-9) analyses were conducted. Maximum pain intensity was higher after intervention (B=1.32, p<0.01), decreased with a better quality of life (B=−0.07, p<0.001), and was lower when dementia diagnoses were present (B=−1.12, p<0.01). PAINAD scores before and after intervention did not differ significantly (OR=0.89, p=0.724), but chances to exhibit treatment-related pain were higher with decreasing MMSE (OR=0.94, p<0.05). Conclusion: While no significant positive intervention effect was measured, findings suggest nurses' raised awareness towards pain management. Overall results indicate that large-scale educational interventions seem to be less effective in complex nursing home settings without also including specific individual-based intervention measures.

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A Systematic Review of the Effectiveness of Knowledge Translation Interventions for Chronic Noncancer Pain Management

Cited by 36 publications

References 58 publications

Are patients' and doctors' accounts of the first specialist consultation for chronic back pain in agreement?

Are patients' and doctors' accounts of the first specialist consultation for chronic back pain in agreement?

Improving Pain Management Knowledge Among Nurses

<p>Nursing Education Intervention Effects on Pain Intensity of Nursing Home Residents with Different Levels of Cognitive Impairment: A Cluster-Randomized Controlled Trial</p>

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A Systematic Review of the Effectiveness of Knowledge Translation Interventions for Chronic Noncancer Pain Management

Cited by 36 publications

References 58 publications

Are patients&#39; and doctors&#39; accounts of the first specialist consultation for chronic back pain in agreement?

Are patients&#39; and doctors&#39; accounts of the first specialist consultation for chronic back pain in agreement?

Improving Pain Management Knowledge Among Nurses

<p>Nursing Education Intervention Effects on Pain Intensity of Nursing Home Residents with Different Levels of Cognitive Impairment: A Cluster-Randomized Controlled Trial</p>

Contact Info

Product

Resources

About

Are patients' and doctors' accounts of the first specialist consultation for chronic back pain in agreement?

Are patients' and doctors' accounts of the first specialist consultation for chronic back pain in agreement?