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

疼痛管理在整个癌症护理过程中至关重要，从诊断到治疗和生存， 晚期疾病和生命的尽头。改善癌症疼痛管理在未来十年至关重要， 考虑到（1）更多的癌症幸存者具有癌症及其治疗的长期后果，（2）更长的 晚期癌症的生存率，更多的时间和复杂的疼痛，和（3）越来越多的证据表明， 慢性阿片类药物往往无效，并具有许多不良影响和风险。癌症疼痛通常 具有挑战性;它与许多问题相互作用，包括心理和社会问题以及其他症状， 尤其是疲劳和睡眠障碍。严重的癌症疼痛在美国仍然很常见;质量 疼痛管理往往是次优的;关键有效的非药物策略，如康复， 社会心理方法，如病人教育和支持，没有得到充分利用; 管理坚持。一个关键的解决方案，使用生物心理社会方法，不仅考虑生物方面， 但其他相关症状和与心理的相互作用（例如，苦恼、情绪）和社会（例如，文化， 家庭、财务压力因素。生物心理社会方法的有效性是公认的，但 改善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。该教育计划是基于广泛的卫生专业教育 约翰霍普金斯布隆伯格公共卫生与医学学院和支持性肿瘤学 希望之城的教育计划。总体目标是提高美国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）的奖励。在为期15周的计划中，参与者将参加8场网络研讨会、一场在线研讨会 模拟程序，为期2天的强化技能讲习班，2个讲习班前的准备和4个讲习班后， 研讨会实施教师参与者电话会议。其目的是（1）实施课程 用于培训医疗保健专业人员的生物心理社会癌症疼痛管理原则， 质量改进，（2）维持和完善新获得的疼痛管理和质量改进 通过持续的支持和建立网络社区来提高技能，以及（3）评估有效性 在一年的时间里， 一个由教师、顾问和 患者倡导者将计划，制作和评估该计划，包括专业和执行方面的专家 教育，疼痛管理和相关问题和症状，基于技能的支持性肿瘤学 教育和护理质量。主要研究人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的卫生专业人员。我们得到了来自 地方和国家癌症网络和组织招募一个多样化的合格参与者库，并支持 实施到实践中，以改善患者护理和结果为目标。

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.