Testing a Complex Intervention for the Improvement of Cancer Pain Control in Hospital

Prandi, Cesarina and Costantini, Massimo and Ripamonti, Carla Ida and Visentin, Marco and Perfetti, Elisa and De Luca, Anna and Peruselli, Carlo (2012) Testing a Complex Intervention for the Improvement of Cancer Pain Control in Hospital. Palliative medicine, 26 (4).

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Abstract

Primary objective: To improve the cancer pain control in patients admitted to medical wards of the regions concerned, experiencing a complex intervention programme (information to patients, personnel training, organizational support) called PACIFICO. Model: Phase II pre-post quasi-experimental study - multicentric. Inclusion criteria: At ward level: Medicine, Oncology and Pneumology hospital departments of five Italian regions; at operators’ level: physicians and nurses working in the selected departments. Methodology: The training takes place at two levels: guides and teams. The guides, after being formed, will “contaminate” their colleagues. Their education aims at acquiring knowledge related to pain control, conducting peer training events, reproducing a specific educational content, discussing clinical cases and developing peer to peer counselling. It’s a package consisting of 14 lecture hours, followed by a 8 hours distance education and a final 6 hours module. An educational kit is provided. Inside their departments, the guides will then reproduce an educational event lasting 12 hs., discuss 3 clinical cases, have at least one peer to peer interview with each health operator and predispose the final audit (team level). Instruments: APS-POQ and PAK ScaleResults. 6 departments recruited, 12 guides completed their educational path and are now managing the field training. It’s now in progress the second phase of the trial, which includes the spread at team level. Conclusions: The study is in progress. The final results will be available in May 2012.The expected transformation can be traced back at patient: regular information about pain treatment to all inpatients; regular use of a NRS scale and subsequent correct therapeutic prescription and administration; pain relief in hospitalized patients.At operator level: improved knowledge and skills regarding pain management. Study financed by the Italian Health Ministry.

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