An Intervention for Improving Pain Assessment Skills

提高疼痛评估技能的干预措施

• 批准号: 6669395
• 负责人: LOUIS D BURGIO
• 金额: $ 7.05万
• 依托单位: UNIVERSITY OF ALABAMA IN TUSCALOOSA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-07-15 至 2005-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6669395
• 关键词: analgesia; behavior test; behavioral /social science research tag; caregivers; clinical research; cognition disorders; communication behavior; cues; data collection methodology /evaluation; depression; health surveys; human subject; mathematical model; mental disorder diagnosis; nursing care evaluation; nursing education; nursing homes; nursing intervention; nursing personnel; nursing skill /technique; pain; pain threshold; patient care management; quality of life; self examination; training

DESCRIPTION (provided by applicant): Assessing and managing pain among nursing home residents is often complicated by resident cognitive impairment and the lack of adequate skill training among direct-care staff. Although the gold standard for measuring pain in any population is widely recognized as self-report, most nursing home residents experience some degree of cognitive impairment such that applying this gold standard is problematic. Observational measures of pain are an important corollary to self-report among cognitively impaired nursing home residents and represent the primary means by which the pain of non-communicative residents can be assessed. The proposed feasibility study (R03) will address the lack of adequate skill training among direct care staff by providing a training and communication intervention to Certified Nursing Assistants (CNAs) and Licensed Practical Nurses (LPNs). The intervention will include didactic and hands-on training, as well as a staff motivational system to encourage direct-care staff in their efforts to implement the intervention in their day-to-day routine. Treatment implementation measures will also be used to assess the adequacy of training, the degree to which direct-care staff understood the training, and the consistency of intervention use in the everyday environment. The specific aims of this study are as follows: (1) to assess the feasibility and efficacy of a Pain Assessment and Communication Training (PACT) intervention for improving the detection of behavioral pain cues among nursing home residents with varying degrees of cognitive impairment; and (2) to assess the feasibility and efficacy of the PACT intervention for facilitating communication among CNAs and LPNs about resident pain. A secondary aim is to explore the impact of the PACT intervention on analgesic medication use, the most common pain management strategy used in nursing homes. This project attempts to extend Burgio and colleagues' staff training and motivational systems to a new area (pain assessment), using an interdisciplinary team (Drs. Ann Horgas and A. Lynn Snow) with expertise in pain assessment and nursing home research.

描述（由申请人提供）：评估和管理养老院居民的疼痛通常因居民认知障碍和直接护理人员缺乏足够的技能培训而变得复杂。尽管衡量任何人群疼痛的黄金标准被广泛认为是自我报告，但大多数养老院的居民都会经历某种程度的认知障碍，因此应用这一黄金标准是有问题的。疼痛的观察性测量是认知受损养老院居民自我报告的重要推论，也是评估非交流居民疼痛的主要手段。拟议的可行性研究（R03）将通过向注册护理助理（CNAs）和执业护士（lpn）提供培训和沟通干预，解决直接护理人员缺乏足够技能培训的问题。干预措施将包括教学和实践培训，以及员工激励系统，以鼓励直接护理人员努力在日常工作中实施干预措施。治疗实施措施还将用于评估培训的充分性、直接护理人员对培训的理解程度以及在日常环境中使用干预措施的一致性。本研究的具体目的如下：(1)评估疼痛评估与沟通训练（PACT）干预对不同程度认知障碍老人行为疼痛线索检测的可行性和有效性；(2)评估PACT干预的可行性和有效性，以促进CNAs和lpn之间关于住院疼痛的沟通。第二个目的是探讨PACT干预对镇痛药物使用的影响，这是疗养院中最常见的疼痛管理策略。这个项目试图将Burgio及其同事的员工培训和激励系统扩展到一个新的领域（疼痛评估），使用一个跨学科的团队(dr。安·霍格斯和a·林恩·斯诺)在疼痛评估和养老院研究方面的专业知识。