A Spanish Instrument for Assessing Pain and Patient Satisfaction With Pain Management

2.50
Hdl Handle:
http://hdl.handle.net/10755/153894
Type:
Presentation
Title:
A Spanish Instrument for Assessing Pain and Patient Satisfaction With Pain Management
Abstract:
A Spanish Instrument for Assessing Pain and Patient Satisfaction With 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
Significance: Hispanics are at high risk for inadequate pain management. Patient factors, such as inadequate knowledge and health beliefs are confounded by failures of the health care system, most notably, lack of Spanish language tools and lack of cultural understanding among health care providers. The Bates Biocultural Model, describing the sociocultural influences on pain perception/response, provided a framework for a study to address a provider factor-lack of Spanish language instruments. Objective: The purpose of this study was to develop a Spanish language, culturally relevant instrument using the American Pain Society Patient Outcome Questionnaire (APS-POQ) as the basis for tool development. Design: The first phase of the two phase project began with qualitative interviews to gain a perspective on acute pain from the point of view of Hispanics/ Latinos recovering from a surgical experience, using the data to craft a new instrument. The second phase was quantitative, to test the psychometric properties of the new instrument. Population/Sample: The sample was comprised of 185 self-identified Hispanic/Latino participants, ranging in age from 18 to 77+ years, who had had a recent surgery. Thirty five participated in the qualitative interviews, while 150 participated in the psychometric testing of the new instrument. Approximately half had been born in Mexico and preferred to speak and think in Spanish. Methods: A combination of focus groups and individual interviews conducted in Spanish and English were used to develop the new Spanish instrument. Descriptive qualitative analysis identified patterns and themes describing the acute pain experience. Items were developed to form a new survey instrument assessing the pain experience from a Hispanic/Latino point of view. The survey instrument and a demographic tool, available in both Spanish and English, were tested using trained bilingual interviewers. Information was obtained from the medical record regarding the analgesic regimen ordered and administered within the last 24 hours. Pain Management Index (PMI) scores were computed from worst pain ratings and categories of analgesics administered. Findings. Descriptive qualitative analysis identified themes related to beliefs about pain, pain's interference with daily activities and relationships, management strategies, and opinions about health professionals' care and were used to construct the new instrument. The pain intensity, pain interference, satisfaction and beliefs subscales were modified with new wording reflecting specific cultural perspectives; a subscale about pain's interference with emotional well-being was added, as was an expectations subscale, including the pain relief goal. Patient satisfaction items were revised from items suggested in the interviews, e.g., being treated with respect, level of personal concern, family involvement, and instruction about pain management. The barriers/beliefs portion of the APS-POQ was revised to reflect culturally specific beliefs that pose barriers to pain management, e.g., pain's influence on feelings of control, use of non-drug methods for relief, and partnerships for pain management. Finally, a subscale regarding patient-initiated management strategies was compiled from reported strategies, e.g., prayer for self, tensing/relaxing, acceptance, drinking teas, and others which are rated as to use and effectiveness. Content validation using the method proposed by Lynn (1986), determined items' relevance and clarity and was conducted by the bicultural and interdisciplinary Advisory Board. The resulting questionnaire was validated by bilingual Hispanics with a recent surgical pain experience in order to establish equivalence of Spanish and English forms. Psychometric testing with 150 self-identified Hispanics is nearly complete (December, 2001). Data analysis will include factor analysis of the instrument to assess validity, and determination of internal consistency for the overall instrument and its subscales using Chronbach's Alpha. Descriptive statistics will be used to describe the sample, its pain intensity, interference, satisfaction, opinions about pain, approaches for managing pain and sources of information about pain. Additionally, regression analysis will determine the factors predicting the outcomes, pain intensity, patient satisfaction and PMI scores from the independent variables. Conclusions. The Hispanic's acute pain experience is influenced by physical, emotional and social factors. Satisfaction with management of pain is influenced by relationships with care providers, family support and the information Hispanic patients receive about their management. A culturally sensitive instrument, in the patient's preferred language can provide a means to obtain reliable and valid information about pain, interference related to pain and satisfaction with care and with patient education approaches to pain management. Implications. Research with Hispanics is faced with challenges in study design, data collection and interpretation. Each phase demands attention to cultural values and careful validation by representatives of the target population. Research-based practice change regarding pain management in Hispanics is urgently needed. The development of culturally appropriate, Spanish language instruments is an important first step.

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.titleA Spanish Instrument for Assessing Pain and Patient Satisfaction With Pain Managementen_GB
dc.identifier.urihttp://hdl.handle.net/10755/153894-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Spanish Instrument for Assessing Pain and Patient Satisfaction With 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">Significance: Hispanics are at high risk for inadequate pain management. Patient factors, such as inadequate knowledge and health beliefs are confounded by failures of the health care system, most notably, lack of Spanish language tools and lack of cultural understanding among health care providers. The Bates Biocultural Model, describing the sociocultural influences on pain perception/response, provided a framework for a study to address a provider factor-lack of Spanish language instruments. Objective: The purpose of this study was to develop a Spanish language, culturally relevant instrument using the American Pain Society Patient Outcome Questionnaire (APS-POQ) as the basis for tool development. Design: The first phase of the two phase project began with qualitative interviews to gain a perspective on acute pain from the point of view of Hispanics/ Latinos recovering from a surgical experience, using the data to craft a new instrument. The second phase was quantitative, to test the psychometric properties of the new instrument. Population/Sample: The sample was comprised of 185 self-identified Hispanic/Latino participants, ranging in age from 18 to 77+ years, who had had a recent surgery. Thirty five participated in the qualitative interviews, while 150 participated in the psychometric testing of the new instrument. Approximately half had been born in Mexico and preferred to speak and think in Spanish. Methods: A combination of focus groups and individual interviews conducted in Spanish and English were used to develop the new Spanish instrument. Descriptive qualitative analysis identified patterns and themes describing the acute pain experience. Items were developed to form a new survey instrument assessing the pain experience from a Hispanic/Latino point of view. The survey instrument and a demographic tool, available in both Spanish and English, were tested using trained bilingual interviewers. Information was obtained from the medical record regarding the analgesic regimen ordered and administered within the last 24 hours. Pain Management Index (PMI) scores were computed from worst pain ratings and categories of analgesics administered. Findings. Descriptive qualitative analysis identified themes related to beliefs about pain, pain's interference with daily activities and relationships, management strategies, and opinions about health professionals' care and were used to construct the new instrument. The pain intensity, pain interference, satisfaction and beliefs subscales were modified with new wording reflecting specific cultural perspectives; a subscale about pain's interference with emotional well-being was added, as was an expectations subscale, including the pain relief goal. Patient satisfaction items were revised from items suggested in the interviews, e.g., being treated with respect, level of personal concern, family involvement, and instruction about pain management. The barriers/beliefs portion of the APS-POQ was revised to reflect culturally specific beliefs that pose barriers to pain management, e.g., pain's influence on feelings of control, use of non-drug methods for relief, and partnerships for pain management. Finally, a subscale regarding patient-initiated management strategies was compiled from reported strategies, e.g., prayer for self, tensing/relaxing, acceptance, drinking teas, and others which are rated as to use and effectiveness. Content validation using the method proposed by Lynn (1986), determined items' relevance and clarity and was conducted by the bicultural and interdisciplinary Advisory Board. The resulting questionnaire was validated by bilingual Hispanics with a recent surgical pain experience in order to establish equivalence of Spanish and English forms. Psychometric testing with 150 self-identified Hispanics is nearly complete (December, 2001). Data analysis will include factor analysis of the instrument to assess validity, and determination of internal consistency for the overall instrument and its subscales using Chronbach's Alpha. Descriptive statistics will be used to describe the sample, its pain intensity, interference, satisfaction, opinions about pain, approaches for managing pain and sources of information about pain. Additionally, regression analysis will determine the factors predicting the outcomes, pain intensity, patient satisfaction and PMI scores from the independent variables. Conclusions. The Hispanic's acute pain experience is influenced by physical, emotional and social factors. Satisfaction with management of pain is influenced by relationships with care providers, family support and the information Hispanic patients receive about their management. A culturally sensitive instrument, in the patient's preferred language can provide a means to obtain reliable and valid information about pain, interference related to pain and satisfaction with care and with patient education approaches to pain management. Implications. Research with Hispanics is faced with challenges in study design, data collection and interpretation. Each phase demands attention to cultural values and careful validation by representatives of the target population. Research-based practice change regarding pain management in Hispanics is urgently needed. The development of culturally appropriate, Spanish language instruments is an important first step.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T12:35:36Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T12:35:36Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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