Achieving Excellence in Biopsychosocial Cancer Pain Management through a Comprehensive Quality Education Program

疼痛管理在整个癌症护理中至关重要，从诊断到治疗和生存，以及 晚期疾病和生命末期。改善癌症疼痛管理在未来十年至关重要， 鉴于(1)更多的癌症幸存者具有癌症及其治疗的长期后果，(2)更长 晚期癌症的存活率，有更多的时间和疼痛的复杂性，以及(3)越来越多的证据表明 慢性阿片类药物往往无效，并有许多不良影响和风险。癌症疼痛通常是 具有挑战性；它与许多问题相互作用，包括心理和社会关切以及其他症状， 尤其是疲劳和睡眠障碍。严重的癌症疼痛在美国仍然经常发生；质量 疼痛管理的效果往往不佳；关键有效的非药物策略，如康复，以及 心理社会方法，如患者教育和支持，未得到充分利用； 管理层坚持不懈。一个关键的解决方案，使用生物-心理-社会方法，不仅考虑到生物学方面， 但其他相关症状和与心理(例如，痛苦、情绪)和社会(例如，文化， 家庭、经济压力)因素。生物-心理-社会方法的有效性是公认的，但 提高癌症护理的使用需要跨学科的卫生专业教育和质量 改进方法。这一教育计划是基于广泛的健康专业教育 约翰霍普金斯大学彭博公共卫生医学院和支持肿瘤学项目 希望之城的教育项目。总体目标是提高美国治疗生物心理社会癌症的能力 疼痛管理。为了实现这一目标，我们将培训360名癌症护理专业人员(医生、护士、社会工作者 工人和其他人)对该奖项表示不满。在为期15周的计划中，参与者将参加8个在线研讨会 模拟计划，为期2天的技能强化讲习班，以及2个讲习班前准备和4个讲习班后 研讨会实施教师-参与者电话会议。目标是(1)实施一项课程 为医疗保健专业人员提供有关生物、心理和社会癌症疼痛管理原则的培训 质量改进，(2)维持和完善新获得的疼痛管理和质量改进 通过持续支持和建立网络社区获得技能，以及(3)评估有效性 计划结束后的教育和一年的可持续性。 一支由教师、顾问和 患者权益倡导者将计划、制作和评估该计划，包括专业和执行专家 教育、疼痛管理及相关问题和症状、以技能为基础的支持肿瘤学 教育和护理质量。首席调查员结合了数十年的教育经验 生物、心理、社会疼痛管理和项目开发方面的健康专业人员。我们得到了来自 地方和国家癌症网络和组织招募多样化、合格的参与者池和支持 落实到实践中，目标是改善患者护理和结果。

Pain management is critical throughout cancer care, from diagnosis through treatment and survivorship, and in advanced illness and at the end of life. Improving cancer pain management is critical over the next decade, given (1) more number of cancer survivors with long-term consequences of cancer and its treatment, (2) longer survival with advanced cancer, with more time with and complexity of pain, and (3) growing evidence that chronic opioids are often ineffective and have many adverse effects and risks. Cancer pain is often challenging; it interacts with many issues, including psychological and social concerns and other symptoms, especially fatigue and sleep disturbances. Severe cancer pain is still frequent in the United States; the quality of pain management is often suboptimal; key effective nonpharmacologic strategies, such as rehabilitation, and psychosocial approaches, such as patient education and support, are underused; and disparities in management persist. A key solution, using a biopsychosocial approach, considers not only biological aspects, but other related symptoms and interactions with psychological (e.g., distress, mood) and social (e.g., culture, family, financial stressors) factors. The effectiveness of biopsychosocial approaches is well-established, but improving use in cancer care requires both interdisciplinary health professional education and quality improvement approaches. This education program is based on the extensive health professional education programs at Johns Hopkins Bloomberg School of Public Health and Medicine and supportive oncology education programs of the City of Hope. The overall goal is to improve US capacity for biopsychosocial cancer pain management. To accomplish this, we will train 360 cancer care professionals (physicians, nurses, social workers and others) over the award. In a 15-week program, participants will participate in 8 webinars, an online simulation program, a 2-day intensive skills-based workshop, and 2 pre-workshop preparatory and 4 post- workshop implementation faculty-participant conference calls. The aims are to (1) implement a curriculum for training healthcare professionals in principles of biopsychosocial cancer pain management and quality improvement, (2) sustain and refine newly acquired pain management and quality improvement skills through ongoing support and building a networking community, and (3) assess the effectiveness of the education after the program and sustainability at one year. An expert team of faculty, advisors and patient advocates will plan, produce, and evaluate the program, including experts in professional and executive education, pain management and associated issues and symptoms, skills-based supportive oncology education and quality of care. The Principal Investigators have combined decades of experience in educating health professionals in biopsychosocial pain management and program development. We have support from local and national cancer networks and organizations to recruit a diverse, qualified participant pool and support implementation into practice, with the goal of improving patient care and outcomes.