2.50
Hdl Handle:
http://hdl.handle.net/10755/150742
Type:
Presentation
Title:
Predictors of Clinical Outcomes of Pain Management
Abstract:
Predictors of Clinical Outcomes of Pain Management
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:McNeill, Jeanette, DPH/DrPH
P.I. Institution Name:University of Texas Health Science Center at Houston
Title:Associate Professor and Department Chair
Objective: The study examined pain management practices in two urban teaching hospitals in the Southwestern United States as part of institution-wide efforts to improve pain related outcomes. The study sought to answer questions about 1) patient outcomes (Pain Management Index scores, reported pain intensity, interference and patient satisfaction), and 2) education about pain management. Design: A survey design was used to gather data through both patient self-report and medical records. Patients answered 15 questions on the American Pain Society Outcomes Questionnaire (APS-POQ) which had been modified by adding a new item regarding satisfaction with pain management instruction. A computerized chart audit generated demographics and analgesic information to calculate the Pain Management Index (PMI). Sample: The sample was comprised of 552 English speaking, adult medical/surgical patients (314 males and 238 females) ranging in age from 20 - 92 in an urban teaching hospital. Mean age was 54 years. Setting: General medical/surgical units of two tertiary care, urban teaching hospitals were included; patients treated in emergency rooms, PACU, ICU, or labor and delivery units were excluded. Names of Variables or Concept: The dependent variables (reported pain intensity, interference, patient satisfaction and PMI scores) represented outcomes of pain management; independent variables were demographic factors, patient education and analgesic regimen. Measures/Instruments: Trained data collectors used three instruments: Demographic Data Sheet for age, gender, marital status, diagnosis, education, religion, analgesics administered, and other pertinent data, the American Pain Society Outcomes Questionnaire (APS-POQ) Modified, and the Pain Management Index. Findings: In descriptive and correlational analysis of the study variables, significant interrelationships between pain intensity, PMI scores and patient satisfaction were found, as well as less than adequate pain management for over 1/3 of the sample, and particularly for those over 65 years. Logistic regression was used to predict patient satisfaction and significant predictors included worst pain, patient satisfaction with nursing care and with instruction about pain management. Subscale reliabilities for the APS-POQ were >.8 for intensity, interference and satisfaction, and .9 for the new subscale regarding satisfaction with instruction. Conclusions: Consumers of health care are indicating higher expectations regarding pain management and are becoming more likely to report dissatisfaction when experiencing severe worst pain and less than adequate attention to their pain. The research findings indicate that education is a major factor in patient responses to pain management and in perceived satisfaction with management. Measuring satisfaction with instruction informs clinicians on how to improve clinical outcomes. The PMI is a useful tool to measure effectiveness of pain treatment and particularly assists clinicians in understanding the relationship of worst pain and appropriate analgesic administration. Implications: With regulatory and political mandates to improve pain management, initiatives to incorporate pain as the fifth vital sign are increasing. Recent requirements by JCAHO highlight the seriousness of the problem of ineffective pain management particularly for certain vulnerable groups, e.g., the elderly. The APS-POQ can form the basis of on-going quality monitoring. Questions added about patient satisfaction with pain management instruction provide data needed to support redesign of educational strategies, including the timing of instruction, specifics of pain management information and the instructional medium The PMI offers a useful outcome measure to determine adequacy of pain treatment, particularly, undertreatment of pain. Care providers in acute care facilities can be better equipped to intervene to achieve desired outcomes, thus leading the way for clinical improvements for patients in pain.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePredictors of Clinical Outcomes of Pain Managementen_GB
dc.identifier.urihttp://hdl.handle.net/10755/150742-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Predictors of Clinical Outcomes of Pain Management</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">McNeill, Jeanette, DPH/DrPH</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Texas Health Science Center at Houston</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor and Department Chair</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Jeanette.Adams-McNeill@uth.tmc</td></tr><tr><td colspan="2" class="item-abstract">Objective: The study examined pain management practices in two urban teaching hospitals in the Southwestern United States as part of institution-wide efforts to improve pain related outcomes. The study sought to answer questions about 1) patient outcomes (Pain Management Index scores, reported pain intensity, interference and patient satisfaction), and 2) education about pain management. Design: A survey design was used to gather data through both patient self-report and medical records. Patients answered 15 questions on the American Pain Society Outcomes Questionnaire (APS-POQ) which had been modified by adding a new item regarding satisfaction with pain management instruction. A computerized chart audit generated demographics and analgesic information to calculate the Pain Management Index (PMI). Sample: The sample was comprised of 552 English speaking, adult medical/surgical patients (314 males and 238 females) ranging in age from 20 - 92 in an urban teaching hospital. Mean age was 54 years. Setting: General medical/surgical units of two tertiary care, urban teaching hospitals were included; patients treated in emergency rooms, PACU, ICU, or labor and delivery units were excluded. Names of Variables or Concept: The dependent variables (reported pain intensity, interference, patient satisfaction and PMI scores) represented outcomes of pain management; independent variables were demographic factors, patient education and analgesic regimen. Measures/Instruments: Trained data collectors used three instruments: Demographic Data Sheet for age, gender, marital status, diagnosis, education, religion, analgesics administered, and other pertinent data, the American Pain Society Outcomes Questionnaire (APS-POQ) Modified, and the Pain Management Index. Findings: In descriptive and correlational analysis of the study variables, significant interrelationships between pain intensity, PMI scores and patient satisfaction were found, as well as less than adequate pain management for over 1/3 of the sample, and particularly for those over 65 years. Logistic regression was used to predict patient satisfaction and significant predictors included worst pain, patient satisfaction with nursing care and with instruction about pain management. Subscale reliabilities for the APS-POQ were &gt;.8 for intensity, interference and satisfaction, and .9 for the new subscale regarding satisfaction with instruction. Conclusions: Consumers of health care are indicating higher expectations regarding pain management and are becoming more likely to report dissatisfaction when experiencing severe worst pain and less than adequate attention to their pain. The research findings indicate that education is a major factor in patient responses to pain management and in perceived satisfaction with management. Measuring satisfaction with instruction informs clinicians on how to improve clinical outcomes. The PMI is a useful tool to measure effectiveness of pain treatment and particularly assists clinicians in understanding the relationship of worst pain and appropriate analgesic administration. Implications: With regulatory and political mandates to improve pain management, initiatives to incorporate pain as the fifth vital sign are increasing. Recent requirements by JCAHO highlight the seriousness of the problem of ineffective pain management particularly for certain vulnerable groups, e.g., the elderly. The APS-POQ can form the basis of on-going quality monitoring. Questions added about patient satisfaction with pain management instruction provide data needed to support redesign of educational strategies, including the timing of instruction, specifics of pain management information and the instructional medium The PMI offers a useful outcome measure to determine adequacy of pain treatment, particularly, undertreatment of pain. Care providers in acute care facilities can be better equipped to intervene to achieve desired outcomes, thus leading the way for clinical improvements for patients in pain.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T10:41:38Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T10:41:38Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.