Cancer Pain Management-Decision Support Computer Program

描述（由申请人提供）：超过80%的癌症患者在疾病或治疗过程中都会经历疼痛。尽管癌症疼痛管理的标准指南被广泛传播和采用，但错误的评估以及随后对癌症疼痛的治疗不足和虐待仍然很常见，对妇女和少数民族的影响尤为严重。本研究的目的是开发一个具有自适应能力的标准化决策支持计算机程序（DSCP）（专家系统），以供护士基于癌症患者自身的观点和经验，有效地处理癌症疼痛体验的性别和种族差异，作为评估支持工具。具体目的是：a)收集美国四个种族（西班牙裔、非西班牙裔白人、非西班牙裔非裔美国人和非西班牙裔亚洲人）的癌症疼痛数据，确定癌症疼痛经历的性别和种族差异；b)根据这些收集到的数据和肿瘤护士的反馈制定DCSP。运用理论三角法、女性主义方法和模糊逻辑来指导研究过程。将采用创新的互联网数据收集方法，包括通过一般和特定种族的互联网癌症支持小组招募的400名癌症患者进行定量互联网调查，以及从互联网调查参与者中招募的四个不同种族的群体（每组30名成员）进行为期6个月的定性在线论坛。基于这些数据，将开发一个DSCP，包括知识库生成、决策和自适应模块。该专家系统的输出将根据性别和种族对患者的疼痛进行分类，并提出疼痛管理策略。来自30名肿瘤科护士的在线反馈将被纳入DSCP，以提高潜在用户的可接受性。长期目标是：a)扩展关于癌症疼痛经验的性别和种族差异的知识；B)有助于认识患者自身的癌症疼痛经历，以便能够从患者自己的观点和角度规划和提供医疗保健；C)建立护理专家系统，在临床环境中有效指导癌症疼痛的评估和管理；d)最终消除癌症疼痛评估和管理中的性别和种族偏见和不平等。

DESCRIPTION (provided by applicant): More than 80% of cancer patients experience pain during the course of their illness or treatment. Despite widespread dissemination and adoption of standard guidelines for cancer pain management, erroneous assessments and subsequent undertreatment and mistreatment of cancer pain are still common occurrences, disproportionately affecting women and ethnic minorities. The purpose of this study is to develop a standardized decision support computer program (DSCP) (an expert system) with self-adaptation capabilities that can be used by nurses as an assessment support tool for dealing effectively with gender and ethnic differences in cancer pain experiences based on cancer patients' own views and experiences. The specific aims are to: a) collect data on cancer pain among four ethnic groups (Hispanic, non-Hispanic Whites, non-Hispanic African-American, and non-Hispanic Asian) in the U.S. and determine gender and ethnic differences in cancer pain experiences; and b) develop a DCSP based on these collected data and feedback from oncology nurses. Using theoretical triangulation, a feminist approach and fuzzy logic will guide the research process. Innovative internet data collection methods will be used including a quantitative Internet survey among 400 cancer patients recruited through general and ethnic-specific Internet Cancer Support Groups, and qualitative online forums of 6-months duration among four ethnically different groups (30 members per group) recruited from among the Internet survey participants. Based on these data, a DSCP will be developed including Knowledge Base Generation, Decision-Making, and Self-Adaptation Modules. Output of this expert system will be classification of patients' pain according to gender and ethnicity with suggested pain management strategies. Online feedback from 30 oncology nurses will be incorporated into the DSCP to increase it acceptability among potential users. Long-term goals are to: a) extend knowledge about gender and ethnic differences in cancer pain experience; b) contribute to recognition of patients' own cancer pain experience so that health care can be planned and provided from patients' own views and perspectives; c) develop a nursing expert system that can effectively guide cancer pain assessment and management in clinical settings; and d) ultimately eliminate gender and ethnic biases and inequity in cancer pain assessment and management.