COMPUTERIZED PAIN REPORT & NURSING PAIN CONSULT PROTOCO

对于每年80多万美国人来说，未缓解的癌症疼痛是一种 主要健康问题部分归因于评估困难和 缺乏使用已知有效的镇痛剂的知识 对于85%到95%的癌症疼痛患者来说。作为一名 为了解决不必要的痛苦，我们提出了随机临床 比较威斯康星州癌症中心的常规护理和 计算机化疼痛评估和提供者决策支持协议 关于：a)患者结果(疼痛强度、质量、缓解；满意度 在176名与疼痛相关的患者的不同样本中 到骨转移；b)提供者的结果(疼痛记录； 处方止痛药的适当性；临床就诊时间)在 肿瘤学专家样本；以及c)患者-提供者伙伴关系 结果(录音临床期间以患者为中心的讨论内容 访问)。在前测和后测设计中，患者将完成 通常的疼痛评估，并使用新的计算机化疼痛评估工具 记录他们的痛苦。分配给新医院的患者的疼痛数据 协议将与他们的肿瘤学家和一台计算机共享 生成咨询，其中包括适当的止痛药列表 关于病人疼痛的特征。两国之间的相互作用 在常规诊所就诊期间，患者和提供者将被录音 并对访问期间的交流类型进行了分析。一周 稍后，患者将完成计算机化的疼痛评估工具以 记录下为他们的疼痛开出的任何疗法的效果。 此外，我们还将描述患者和提供者对 使用半结构化问题的计算机化疼痛工具及其应用 对数据进行内容分析。研究结果将被用来指导 对工具进行修订并计划组织层面的实施 这项新技术作为与电子医疗保健的接口 唱片。

For more than 800,000 Americans each year, unrelieved cancer pain is a major health problem attributed in part to assessment difficulties and to lack of knowledge about using the analgesics known to be effective for 85 percent to 95 percent of cancer patients with pain. As a solution to the unnecessary suffering, we propose a randomized clinical trial to compare effects of usual-care in the UW Cancer Center or a protocol of computerized pain assessment and provider decision support on: a) patient outcomes (pain intensity, quality, relief; satisfaction with pain level) in a diverse sample of 176 patients with pain related to bone metastasis; b) provider outcomes (pain documentation; appropriateness of prescribed analgesics; clinic visit length) in a sample of oncology specialists; and c) patient-provider partnership outcomes (patient-centered discussion content during audiotaped clinic visits). In a pre-test and post-test design, patients will complete usual pain assessments and use a new computerized pain assessment tool to document their pain. Pain data from patients assigned to the new protocol will be shared with their oncologists along with a computer generated consultation that includes a list of analgesics appropriate for the character of the patient's pain. The interaction between the patient and the provider during routine clinic visits will be audiotaped and analyzed for types of communication during the visit. One week later, patients will complete the computerized pain assessment tool to document the effect of any therapies prescribed for their pain. Additionally we will describe patient and provider receptivity to the computerized pain tool using semi-structured questions and applying content analysis to the data. Study findings will be used to guide revisions of the tool and to plan organizational level implementation of this new technology as an interface with the electronic health care record.