The effect of a translating research into practice (TRIP)--cancer intervention on cancer pain management in older adults in hospice.
The effect of a translating research into practice (TRIP)--cancer intervention on cancer pain management in older adults in hospice.
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将研究转化为实践（TRIP）的效果——癌症干预对临终关怀老年人癌症疼痛管理的影响。
DOI：
10.1111/j.1526-4637.2012.01405.x
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Forcucci,Chris
中科院分区：
文献类型：
--
作者：
Herr,Keela;Titler,Marita;Fine,PerryG;Sanders,Sara;Cavanaugh,JosephE;Swegle,John;Tang,Xiongwen;Forcucci,Chris
背景：疼痛是癌症患者的主要关注点，尤其是老年人，他们占癌症患者的最大部分，并且面临着一些最独特的疼痛挑战。临终关怀中心的首要任务之一是提供无痛死亡，虽然临终关怀中心的结局更好，但患者仍然因疼痛控制不佳而死亡。目的。本文报告了一项将研究转化为实践干预措施的结果，该干预措施旨在促进社区临终关怀中心对患有癌症的老年人采用基于证据的疼痛实践。这项机构人类受试者审查委员会批准的研究是在 16 个中西部地区实施的一项整群随机对照试验。 方法：利用新入院患者的回顾性病历来确定干预效果。此外，还对干预阶段完成时从临终关怀工作人员收集的调查和焦点小组数据进行了分析。结果。癌症疼痛实践指数（实验地点循证实践的总体综合结果衡量标准）的改善并不显着高于对照地点。实验组患者疼痛严重程度从基线到干预后的下降幅度更大；然而，结果并不具有统计显着性（P = 0.1032）。结论。研究结果表明，许多因素可能会影响多成分干预措施的实施，包括环境的独特特征和文化、参与变革过程的程度、竞争优先事项和混杂因素以及创新的复杂性（实践变革）。我们的结果表明，未来需要研究实施基于社区的临终关怀干预时要针对的具体因素，包括前瞻性地确定和衡量干预保真度。
Background.Pain is a major concern for individuals with cancer, particularly older adults who make up the largest segment of individuals with cancer and who have some of the most unique pain challenges. One of the priorities of hospice is to provide a pain-free death, and while outcomes are better in hospice, patients still die with poorly controlled pain.Objective.This article reports on the results of a Translating Research into Practice intervention designed to promote the adoption of evidence-based pain practices for older adults with cancer in community-based hospices.Setting.This Institutional Human Subjects Review Board-approved study was a cluster randomized controlled trial implemented in 16 Midwestern hospices.Methods.Retrospective medical records from newly admitted patients were used to determine the intervention effect. Additionally, survey and focus group data gathered from hospice staff at the completion of the intervention phase were analyzed.Results.Improvement on the Cancer Pain Practice Index, an overall composite outcome measure of evidence-based practices for the experimental sites, was not significantly greater than control sites. Decrease in patient pain severity from baseline to post-intervention in the experimental group was greater; however, the result was not statistically significant (P= 0.1032).Conclusions.Findings indicate a number of factors that may impact implementation of multicomponent interventions, including unique characteristics and culture of the setting, the level of involvement with the change processes, competing priorities and confounding factors, and complexity of the innovation (practice change). Our results suggest that future study is needed on specific factors to target when implementing a community-based hospice intervention, including determining and measuring intervention fidelity prospectively.