DEVELOPMENT OF A CANCER PAIN INTERACTIVE VIDEODISC

目前提案的主要目标是发展一种癌症 疼痛互动视盘，一种创新的教学教育格式 医疗保健专业人员对评估的复杂性和 治疗癌症疼痛和障碍(例如，对药物的担忧 对癌症疼痛的有效管理。优势 互动视盘技术包括：1)最先进的 与有效疼痛控制程序相关的信息， 康复以及心理社会知识和技术的使用可以 简明扼要地介绍了符合癌症疼痛指南的 卫生保健机构正在建立的管理 政策和研究(AHCPR)；2)一旦开发，以互动视盘形式 是一种永久性的产品，完全可以用作教育工具 并将医学教育水平作为研究影响的研究工具 关于卫生保健专业人员的事实的结构化教育形式 关于癌症疼痛的知识、态度和表现 管理；3)由于光盘很容易传播，医生在 农村社区可以获得高质量的演示 癌症疼痛管理技术；4)因为这是一种基于计算机的 技术，交互式视盘可以很容易地修改以反映 该领域的新发展；以及5)互动媒体的使用 技术与国会一致通过的 高性能计算法案，确立了国家优先事项 建立连接个人计算机和中央计算机的信息基础设施 可用于研究和教育的计算节点。 随着癌症疼痛互动视盘的发展， 资助期的剩余时间将用于传播和 测试。癌症疼痛视频光盘将分发给医生 在达特茅斯-希区柯克医疗中心外展诊所医院 (新罕布夏州和佛蒙特州的小型社区医院)附属于 诺里斯·科顿癌症中心和其他由 新汉普郡和佛蒙特州癌症疼痛倡议和新 汉普郡美国癌症协会内科医生联络系统 一项随机研究的背景。医生将被随机分配到 接受以下两种教育形式之一：1)加强传播 干预，癌痛互动影碟加二 旨在加强光盘教育影响的干预措施(a 协助开发办公系统以帮助 癌痛评估和管理以及医生提醒系统) 或2)通常的传播干预，AHCPR的书面形式 癌症疼痛管理指南。在干预前后， 医生的知识和态度(问卷)和行为(图表 审查和患者退出问卷)将进行评估。我们预测 接触到交互式视盘和干预的医生 增强其教育影响将表现出更大的事前和事后 关于知识和态度测量的测试变化，并符合 AHCPR癌症疼痛管理指南，其中较大比例 病人。

The major goal of the current proposal is the development of a cancer pain interactive videodisc, an innovative educational format for teaching health care professionals about the complexities of the assessment and treatment of cancer pain and barriers (e.g., concerns about drug addiction) to the effective management of cancer pain. The advantages of the interactive videodisc technology include; 1) state-of-the-art information relevant to procedures for effective pain control, rehabilitation, and use of psychosocial knowledge and techniques can be succinctly presented that conform to the Guidelines for Cancer Pain Management which are being established by the Agency for Health Care Policy and Research (AHCPR); 2) once developed, in interactive videodisc is permanent product that can be utilized as an educational tool at all levels of medical education and as a research tool to study the impact of a structured educational format on health care professionals' factual knowledge, attitudes, and performance with regard to cancer pain management; 3) because the disc is easily disseminated, physicians in rural communities can have access to a high quality presentation of cancer pain management techniques; 4) because this is a computer-based technology, the interactive videodisc can easily be modified to reflect new development in the field; and 5) the use of interactive media technology is consistent with the unanimous passage by Congress of the High Performance Computing Act which establishes a national priority to build an information infrastructure linking personal computers to central computing nodes which can be used for research and education. Following the development of the cancer pain interactive videodisc, the remainder of the grant period will be devoted to dissemination and testing. The cancer pain videodisc will be disseminated to physicians at the Dartmouth-Hitchcock Medical Center, Outreach Clinic Hospitals (small community hospitals in New Hampshire and Vermont) affiliated with the Norris Cotton Cancer Center, and other physician group identified by the New Hampshire and Vermont Cancer Pain Initiatives and the New Hampshire American Cancer Society Physician Liaison System within the context of a randomized study. Physicians will be randomly assigned to be exposed to one of two educational formats: 1) Enhanced Dissemination Intervention, the cancer pain interactive videodisc plus two interventions designed to enhance the educational impact of the disc (a facilitator who assists in the development of office systems to aid in cancer pain assessment and management and a physician reminder system) or 2) Usual Dissemination Intervention, the written form of the AHCPR Guidelines for Cancer Pain Management. At pre- and post-intervention, physicians knowledge and attitudes (questionnaire) and behavior (chart review and patient exit questionnaire) will be assessed. We predict that physicians exposed to the interactive videodisc plus the interventions to enhance its educational impact will demonstrate greater pre- to post test change on measures of knowledge and attitudes and conform to the AHCPR Guidelines for Cancer Pain Management with a larger percentage of patients.