EDUCATING NURSES: MANAGING CANCER PAIN IN RURAL PATIENTS

拟议的教育计划的目的是：(1)增加护士的 了解癌痛评估、药理学和 非药物疗法，以及伦理和监管问题，以及(2) 教他们使用从纪念馆改编的协调护理计划 斯隆-凯特琳支持关怀计划，面向农村地区。该计划 将针对农村地区的护士，他们往往无法获得 关于癌症疼痛管理和机会的最新信息 接受癌症疼痛专家的持续咨询。 30名在农村工作的护士(3组，每组10人)将出差 到北卡罗来纳大学医院参加该计划(每周1天×6周 项目将进行3个为期6周的计划)。护士，医生， 药剂师、心理学家和委员会的纪律顾问 护理专业将构成该项目的师资队伍。该程序使用 男学的学习方法，在可教的环境中展示内容 时刻，提供重复，使用各种教学/学习方式 战略，并提供实践的机会。见习护士 将学习如何评估和评估患者的问题，了解 疼痛管理的临床药理学，为疼痛管理建立指南 非药物治疗，了解伦理和监管问题 影响到农村地区的患者和家庭，并将被教导使用 一个协调的支持性护理计划。在支持性护理部分 在这个项目中，见习护士将学习如何与 疼痛管理专家，协助制定指南 药物和非药物治疗，并教患者如何使用 认知行为疗法，如教育、放松、分散注意力 还有按摩。当护士学习使用支持性护理模式时 将在她的家里实施同样的模式。后续行动 电信会议将在1年后实施，以传达 癌症疼痛管理的最新进展。 该计划在提高知识、态度、 和护士的行为，并提高患者对疼痛的满意度 将使用自我控制来评估管理和生活质量 护士和病人共同参与的准实验滞后设计 自己的控制力。在教育开始前五周 计划，基线数据将从每一名进入 方案和由该护士护理的10名病人(30名护士×10名 每个病人)。同样的数据将从病人和护士那里收集 在护士进入教育计划的时候和在 该计划的完成。将收集更多的后续数据 从护士在完成后6个月和12个月 教育计划和患者在结束后5周和10周 这个项目。 如果项目成功地提高了护士的知识、态度、 和行为、病人满意度和生活质量，努力将 使未来的教育计划的传播得到支持 由AHEC提供，并每年提供后续电信会议 基础。

The aims of the proposed educational program are to (1) increase nurses' understanding of cancer pain assessment, pharmacologic and nonpharmacologic therapies, and ethical and regulatory issues, and (2) teach them to use a coordinated care program, adapted from the Memorial Sloan-Kettering Supportive Care program, for rural areas. The program will be targeted to nurses in rural areas, who often lack access to the most up-to-date information on cancer pain management and the opportunity to receive ongoing consultation from cancer pain experts. Thirty nurses who work in rural areas (3 cohorts of 10 each) will travel to UNC Hospitals 1 day/week x 6 weeks to participate in the program (the project will conduct 3 6-week programs). Nurses, physicians, pharmacists, a psychologist, and a discipline consultant for the Board of Nursing will constitute the faculty for the program. The program uses the androgogical approach to learning, presenting content at a teachable moment, providing repetition, using a variety of teaching/learning strategies, and providing opportunities for practice. Nurse trainees will learn how to assess and evaluate patient problems, understand the clinical pharmacology of pain management, establish guidelines for non-pharmacologic therapy, learn about ethical and regulatory issues affecting patients and families in rural areas, and will be taught to use a coordinated supportive-care program. In the supportive-care portion of the program, the nurse trainees will learn how to consult with a team of pain management experts, assist in establishing guidelines for pharmacologic and nonpharmacologic therapy, and teach patients how to use cognitive-behavioral therapies such as education, relaxation, distraction and massage. As the nurse learns to use the supportive care model she/he will implement the same model in her home setting. A follow-up telecommunication conference will be implemented 1 year later to convey the latest developments in cancer pain management. The effectiveness of the program in improving the knowledge, attitude, and behavior of nurses, and improving patient satisfaction with pain management and quality of life will be evaluated, using a self-control quasi-experimental lag design in which nurses and patients act as their own controls. Five weeks prior to the beginning of the educational program, baseline data will be collected from each nurse entering the program and from 10 patients cared for by that nurse (30 nurses x 10 patients each). The same data will be collected from patients and nurses at the time the nurse enters the educational program and at the completion of the program. Additional follow-up data will be collected from the nurses at 6 months and 12 months after completion of the educational program and from patients at 5 and 10 weeks after the end of the program. If the program is successful in improving nurses' knowledge, attitude, and behavior and patient satisfaction and quality of life, efforts will be made to have future dissemination of the educational program supported by AHEC and to offer follow-up telecommunication conferences on a yearly basis.