The effectiveness of a nursing staff development Intervention to improve pain management – A randomized controlled trial

2015 ◽  
Vol 8 (1) ◽  
pp. 54
Author(s):  
S. Zoëga ◽  
S.E. Ward ◽  
R.C. Serlin ◽  
H. Sveinsdottir ◽  
E.Th. Gretarsdottir ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Randomized Controlled Trial ◽  
Pain Management ◽  
Pain Assessment ◽  
Management Practices ◽  
Controlled Trial ◽  
University Hospital ◽  
Control Group ◽  
Randomized Controlled ◽  
Knowledge And Attitudes

AbstractAimsTo test the effectiveness of the Pain Resource Nurse (PRN) education program in a university hospital.MethodsThis was a randomized controlled trial. Two nurses from each of the 23 participating surgical and medical units were selected to participate in the PRN program. The program consisted of a three day course in pain management with a structured follow up. After a baseline measurement, the units were randomized to either receive the intervention or to serve as a wait-list control. The control group received the intervention following a second data collection 10 months from baseline. Data regarding knowledge and attitudes regarding pain were collected from nurses, but patient data were collected with the American Pain Society Patient Outcome Questionnaire and from medical records. Patients had to be ≥18 years, hospitalized for ≥24 h, alert and able to participate.ResultsParticipating patients were 308 at T1 (73% response rate (RR)) and 329 at T2 (79% RR). Participating nurses were 224 (48% RR) at T1 and 176 (38% RR) at T2. No difference was found between the intervention and control groups regarding knowledge and attitudes of nurses, or in any of the patient outcome variables. The only significant effect of the intervention was improvement in documented standardized pain assessment, which increased from 12% at T1 to 24% at T2 on the intervention units, compared to a decrease from 12% at T1 to 9% at T2 on the control units, p < 0.05.ConclusionsPatient outcomes remained unchanged after the intervention, as were nurses’ knowledge and attitudes. The intervention was, however, successful in changing pain assessment practices. Multifarious efforts to change nursing practice resulted in modest changes. Further studies are needed to advance pain management practices in clinical settings.

Effectiveness of spiritual care using spiritual pain assessment sheet for advanced cancer patients: A pilot non-randomized controlled trial

2019 ◽  
Vol 17 (1) ◽  
pp. 46-53
Author(s):  
Kaori Ichihara ◽  
Sayako Ouchi ◽  
Sachiko Okayama ◽  
Fukiko Kinoshita ◽  
Mitsunori Miyashita ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Controlled Trial ◽  
Usual Care ◽  
Pain Assessment ◽  
Spiritual Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Assessment Sheet

AbstractObjectiveTo obtain preliminary knowledge to design a randomized controlled trial to clarify the effects of spiritual care using the Spiritual Pain Assessment Sheet (SpiPas).MethodThe study was designed as a nonrandomized controlled trial. The study took place between January 2015 and July 2015 in a hematology and oncology ward and two palliative care units in Japan. Among 54 eligible patients with advanced cancer, 46 were recruited (24 in the control group vs. 22 in the intervention group). The intervention group received spiritual care using SpiPas and usual care; the control group received usual care. The primary outcome was the Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp). The secondary outcomes were the Hospital Anxiety and Depression Scale (HADS) and Comprehensive Quality of Life Outcome (CoQoLo).ResultA total of 33 (72%) and 23 (50%) patients completed 2- and 3-week follow-up evaluations, respectively. The differences in the changes during 2 weeks in total scores of FACIT-Sp and HADS were significant (95% confidence intervals, 3.65, 14.4, p < 0.01; –11.2 to –1.09, p = .02, respectively). No significant changes were observed in the total score of CoQoLo.Significance of resultsSpiritual care using the SpiPas might be useful for improving patient spiritual well-being. This controlled clinical trial could be performed and a future clinical trial is promising if outcomes are obtained within 2 weeks.

scholarly journals Effect of Physician-Pharmacist Participation in the Management of Ambulatory Cancer Pain Through a Digital Health Platform: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Lu Zhang ◽  
Howard L McLeod ◽  
Ke-Ke Liu ◽  
Wen-Hui Liu ◽  
Hang-Xing Huang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Medication Adherence ◽  
Pain Management ◽  
Cancer Pain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Randomized Controlled ◽  
Pain Scores

BACKGROUND Self-management of ambulatory cancer pain is full of challenges. Motivated by the need for better pain management, we developed a WeChat-supported platform, Medication Housekeeper (MediHK), to enhance communication, optimize outcomes, and promote self-management in the home setting. OBJECTIVE We conducted a randomized controlled trial to assess whether the joint physician-pharmacist team through MediHK would provide better self-management of ambulatory patients with cancer pain. METHODS Patients were randomly assigned to either an intervention group or control group. During the 4-week study period, the pharmacist would send 24-hour pain diaries daily, adverse drug reaction (ADR) forms every 3 days, and the Brief Pain Inventory form every 15 days to patients in the intervention group via MediHK. If a patient needed a change in drug/dosage or treatment of an ADR after the comprehensive review, the pharmacist would propose pharmacological interventions to the attending physician, who was then responsible for prescribing or adjusting pain medications. If no adjustments were needed, the pharmacist provided appropriate targeted education based on knowledge deficits. Patients in the control group received conventional care and did not receive reminders to fill out the forms. However, if the control group patients filled out a form via MediHK, the pain management team would review and respond in the same way as for the intervention group. The primary outcomes included pain intensity and pain interference in daily life. Secondary outcomes included patient-reported outcome measures, medication adherence, ADRs, and rehospitalization rates. RESULTS A total of 100 patients were included, with 51 (51%) in the intervention group and 49 (49%) in the control group. The worst pain scores, least pain scores, and average pain scores in the intervention group and the control group were statistically different, with median values of 4 (IQR 3-7) vs 7 (IQR 6-8; <i>P</i>=.001), 1 (IQR 0-2) vs 2 (IQR 1-3; <i>P</i>=.02), and 2 (IQR 2-4) vs 4 (IQR 3-5; <i>P</i>=.001), respectively, at the end of the study. The pain interference on patients' general activity, mood, relationships with others, and interests was reduced, but the difference was not statistically significant compared with the control group (<i>Ps</i>=.10-.76). The medication adherence rate increased from 43% to 63% in the intervention group, compared with an increase of 33% to 51% in the control group (<i>P</i>&lt;.001). The overall number of ADRs increased at 4 weeks, and more ADRs were monitored in the intervention group (<i>P</i>=.003). Rehospitalization rates were similar between the 2 groups. CONCLUSIONS The joint physician-pharmacist team operating through MediHK improved pain management. This study supports the feasibility of integrating the internet into the self-management of cancer pain. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1900023075; https://www.chictr.org.cn/showproj.aspx?proj=36901

scholarly journals Let’s Prefer the Pain Reducing Intervention, Buzzy or ShotBlocker: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Burcu Aykanat Girgin ◽  
Eda Aktaş ◽  
Derya Kılınç ◽  
Duygu Gözen
Keyword(s):  
Randomized Controlled Trial ◽  
Intramuscular Injection ◽  
Rating Scale ◽  
Controlled Trial ◽  
Pediatric Emergency ◽  
Parental Satisfaction ◽  
University Hospital ◽  
Control Group ◽  
Randomized Controlled ◽  
Lower Pain

INTRODUCTION: The aim of this study was to detect and compare the effects of ShotBlocker and Buzzy methods on pain, fear, and parental satisfaction during intramuscular injection. METHODS: This study was an experimental randomized controlled trial. The sample included 90 children at the ages of 6 and 12 to whom intramuscular injection was administered in the pediatric emergency department of a university hospital. The participants were randomly assigned to ShotBlocker (n=30), Buzzy (n=30), and control (n=30) groups. Child Information Form, Wong-Baker FACES Pain Rating Scale, Children’s Fear Scale, and Parental Satisfaction Questionnaire were used to collect the data. RESULTS: ShotBlocker and Buzzy groups had significantly lower pain and fear scores and higher parental satisfaction than control group after the procedure (p=0.0001). The lowest pain and fear score and the highest parental satisfaction score were observed in Buzzy group (p=0.0001). DISCUSSION AND CONCLUSION: Both ShotBlocker and Buzzy methods reduce pain and fear of children during intramuscular injection and increasing satisfaction of their parents. However, when compared to ShotBlocker, Buzzy method is more effective in reducing intramuscular injection-related pain and fear and should be preferred primarily.

scholarly journals Effect of Physician-Pharmacist Participation in the Management of Ambulatory Cancer Pain Through a Digital Health Platform: Randomized Controlled Trial

10.2196/24555 ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. e24555
Author(s):  
Lu Zhang ◽  
Howard L McLeod ◽  
Ke-Ke Liu ◽  
Wen-Hui Liu ◽  
Hang-Xing Huang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Medication Adherence ◽  
Pain Management ◽  
Cancer Pain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Randomized Controlled ◽  
Pain Scores

Background Self-management of ambulatory cancer pain is full of challenges. Motivated by the need for better pain management, we developed a WeChat-supported platform, Medication Housekeeper (MediHK), to enhance communication, optimize outcomes, and promote self-management in the home setting. Objective We conducted a randomized controlled trial to assess whether the joint physician-pharmacist team through MediHK would provide better self-management of ambulatory patients with cancer pain. Methods Patients were randomly assigned to either an intervention group or control group. During the 4-week study period, the pharmacist would send 24-hour pain diaries daily, adverse drug reaction (ADR) forms every 3 days, and the Brief Pain Inventory form every 15 days to patients in the intervention group via MediHK. If a patient needed a change in drug/dosage or treatment of an ADR after the comprehensive review, the pharmacist would propose pharmacological interventions to the attending physician, who was then responsible for prescribing or adjusting pain medications. If no adjustments were needed, the pharmacist provided appropriate targeted education based on knowledge deficits. Patients in the control group received conventional care and did not receive reminders to fill out the forms. However, if the control group patients filled out a form via MediHK, the pain management team would review and respond in the same way as for the intervention group. The primary outcomes included pain intensity and pain interference in daily life. Secondary outcomes included patient-reported outcome measures, medication adherence, ADRs, and rehospitalization rates. Results A total of 100 patients were included, with 51 (51%) in the intervention group and 49 (49%) in the control group. The worst pain scores, least pain scores, and average pain scores in the intervention group and the control group were statistically different, with median values of 4 (IQR 3-7) vs 7 (IQR 6-8; P=.001), 1 (IQR 0-2) vs 2 (IQR 1-3; P=.02), and 2 (IQR 2-4) vs 4 (IQR 3-5; P=.001), respectively, at the end of the study. The pain interference on patients' general activity, mood, relationships with others, and interests was reduced, but the difference was not statistically significant compared with the control group (Ps=.10-.76). The medication adherence rate increased from 43% to 63% in the intervention group, compared with an increase of 33% to 51% in the control group (P<.001). The overall number of ADRs increased at 4 weeks, and more ADRs were monitored in the intervention group (P=.003). Rehospitalization rates were similar between the 2 groups. Conclusions The joint physician-pharmacist team operating through MediHK improved pain management. This study supports the feasibility of integrating the internet into the self-management of cancer pain. Trial Registration Chinese Clinical Trial Registry ChiCTR1900023075; https://www.chictr.org.cn/showproj.aspx?proj=36901

scholarly journals Role of Esomeprazole in Early Preeclampsia: A Randomized Controlled Trial

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Atwa KA ◽  
◽  
Ibrahim ZM ◽  
Elshaer M ◽  
Taha OT ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Gestational Age ◽  
Controlled Trial ◽  
Intervention Group ◽  
University Hospital ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Expectant Treatment ◽  
Randomized Controlled ◽  
Significant Prolongation

Objective: To investigate the efficacy of esomeprazole in managing early preeclampsia. Methods: This randomized controlled trial was conducted at the Obstetric/Gynecology department of Suez Canal University Hospital. We included 160 women between 26-31 years of age, with a singleton pregnancy. Eighty women received esomeprazole along with expectant treatment, whereas 80 women received expectant treatment alone. They were followed up from the date of diagnosis up to four weeks after delivery. The gestational age at termination as well as any complications during the follow-up period were documented and compared between both groups. Results: The mean age of the participants was 30.64 ± 1.62. The gestation of women in the intervention group was longer than those within the control group, with a gestational age at termination of 34.53 ± 1.21 versus 32.78 ± 1.60, respectively (P<0.001). Moreover, women in the intervention group had significantly lower incidences of fits (P= 0.005), antepartum hemorrhage (P=0.005), DIC (P=0.032), and IUFD (P<0.001). Conclusions: Esomeprazole is associated with a significant prolongation of gestation in women with early preeclampsia.

scholarly journals Hospice Family Caregiver Involvement in Care Plan Meetings: A Mixed-Methods Randomized Controlled Trial

2016 ◽  
Vol 34 (9) ◽  
pp. 849-859 ◽  
Author(s):  
Debra Parker Oliver ◽  
George Demiris ◽  
Karla Washington ◽  
Robin L. Kruse ◽  
Greg Petroski
Keyword(s):  
Randomized Controlled Trial ◽  
Mixed Methods ◽  
Pain Management ◽  
Rural Areas ◽  
Controlled Trial ◽  
Care Plan ◽  
Control Group ◽  
Patients With Cancer ◽  
Randomized Controlled ◽  
Caregiver Involvement

Background and Objective: Untrained family caregivers struggle with complicated medical management regimens for hospice patients. An intervention was tested to improve caregiver’s perception of pain management and patient’s pain. Design, Setting, and Participants: The intervention was tested with a 2-group (usual care vs intervention) randomized controlled trial using parallel mixed-methods analysis of 446 caregivers in 3 Midwestern hospice programs representing rural and urban settings. Intervention: Web conferencing or telephones were used to connect caregivers with the hospice care team during care plan meetings. Measurements: Caregiver’s perceptions of pain management were the primary outcome. Secondary outcomes included caregiver quality of life, patient’s pain, and anxiety. Video recordings, field notes, and caregiver and staff interviews provided qualitative data. Results: The overall perception of pain management was not changed by the participation in hospice team meetings. Perceptions of fatalism improved for intervention participants, and the intervention participants perceived their patients’ pain was better controlled than those in the control group. The intervention was found to be feasible to deliver in rural areas. Caregiver’s anxiety and patient’s pain were correlated ( r = .18; P = .003), and subanalysis indicated that caregivers of patients with cancer may benefit more from the intervention than other hospice caregivers. Qualitative analyses provided understanding of caregiver’s perceptions of pain, cost, and facilitators and barriers to routine involvement of family in care plan meetings. Limitations and Conclusion: The hospice philosophy is supportive of caregiver involvement in care planning, and technology makes this feasible; the intervention needs modification to become translational as well as additional measurement to assess effectiveness. Caregiver education and emotional support should occur outside the meeting, and a strong leader should facilitate the meeting to control efficiency. Finally, the intervention may benefit caregivers of patients with cancer more than others.

Recovery After Adenotonsillectomy—Do Steroids Help? Outcomes From a Randomized Controlled Trial

2020 ◽  
pp. 019459982097325
Author(s):  
Ariana G. Greenwell ◽  
Amal Isaiah ◽  
Kevin D. Pereira
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Control ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Primary Objective ◽  
University Hospital ◽  
Control Group ◽  
Randomized Controlled ◽  
Phone Calls ◽  
Ed Visits

Objectives The primary objective was to compare pain control following adenotonsillectomy (AT) in children with and without a single postoperative dose of oral dexamethasone in addition to standard analgesic medication. The secondary objective was to compare changes in caregiver-reported snoring, return to normal diet and baseline function, and the number of phone calls and emergency department (ED) visits. Study Design Prospective randomized controlled trial. Setting Tertiary care university hospital. Methods Children aged 3 to 10 years with sleep-disordered breathing who were scheduled to undergo AT were randomized to receive standard analgesia with or without dexamethasone (0.6 mg/kg) administered on the third postoperative day. Standard analgesia was defined as alternating weight-based doses of ibuprofen and acetaminophen. A nurse practitioner blinded to the study condition performed telephone surveys postoperatively, and the electronic medical record was reviewed. Results Enrollment comprised 149 children, of whom 119 were included. When compared with the control group (n = 61, 51%), children who received dexamethasone (n = 58, 49%) had a greater decrease in reported pain score on day 4 (mean ± SD, 2.5 ± 3.1 vs 1.1 ± 3.5, P < .001). Additionally, steroid use was associated with fewer caregiver phone calls (18 [29.5%] vs 6 [10%]) and ED visits (6 [10%] vs 1 [2%]). Conclusion A single dose of dexamethasone administered on day 3 after adenotonsillectomy significantly improved pain control. There were fewer phone calls and ED visits in the steroid arm. These results support the use of oral steroids as an adjunct for postoperative pain control in children undergoing AT.

scholarly journals Yoga and Aerobic Dance for Pain Management in Juvenile Idiopathic Arthritis: Protocol for a Pilot Randomized Controlled Trial

10.2196/12823 ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. e12823 ◽  
Author(s):  
Karine Toupin April ◽  
Jennifer Stinson ◽  
Sabrina Cavallo ◽  
Laurie Proulx ◽  
George A Wells ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Management ◽  
Training Program ◽  
Controlled Trial ◽  
Female Adolescents ◽  
Control Group ◽  
Aerobic Dance ◽  
Randomized Controlled ◽  
Dance Training ◽  
Pilot Randomized Controlled Trial

Background Juvenile idiopathic arthritis (JIA) is one of the most common types of arthritis among children. According to JIA guidelines for physical activity (PA), structured PA interventions led to improved health outcomes. However, many PA programs, such as yoga and aerobic dance, have not been studied in this population despite being popular among youth. Web-based PA programs could provide patients with accessible and affordable interventions. Objective The primary aims of the proposed pilot randomized controlled trial (RCT) are to examine (1) the feasibility of conducting a full-scale RCT to evaluate the effectiveness of two popular types of PA: a yoga training program and an aerobic dance training program, in female adolescents (aged 13-18 years) with JIA compared with an electronic pamphlet control group; and (2) the acceptability of these interventions. Methods A three-arm prospective randomized open-label study with a parallel group design will be used. A total of 25 female adolescents with JIA who have pain will be randomized in a ratio of 2:2:1 to one of the 3 groups: (1) online yoga training program (group A: n=10); (2) online aerobic dance training program (group B: n=10); and (3) electronic pamphlet control group (group C: n=5). Participants in groups A and B will complete 3 individual 1-hour sessions per week using online exercise videos, as well as a 1-hour virtual group session per week using a videoconferencing platform for 12 weeks. Participants from all groups will have access to an electronic educational pamphlet on PA for arthritis developed by the Arthritis Society. All participants will also take part in weekly online consultations with a research coordinator and discussions on Facebook with participants from their own group. Feasibility (ie, recruitment rate, self-reported adherence to the interventions, dropout rates, and percentage of missing data), acceptability, and usability of Facebook and the videoconferencing platform will be assessed at the end of the program. Pain intensity, participation in general PA, morning stiffness, functional status, fatigue, self-efficacy, patient global assessment, disease activity, and adverse events will be assessed using self-administered electronic surveys at baseline and then weekly until the end of the 12-week program. Results This pilot RCT has been funded by the Arthritis Health Professions Association. This protocol was approved by the Children’s Hospital of Eastern Ontario Research Ethics Board (#17/08X). As of May 11, 2020, recruitment and data collection have not started. Conclusions To our knowledge, this is the first study to evaluate the effectiveness of yoga and aerobic dance as pain management interventions for female adolescents with JIA. The use of online programs to disseminate these 2 PA interventions may facilitate access to alternative methods of pain management. This study can lead to a full-scale RCT. International Registered Report Identifier (IRRID) PRR1-10.2196/12823

scholarly journals A Randomized Controlled Trial Evaluating a Pain Assessment and Management Program for Respite Workers Supporting Children With Disabilities Part One: Pain-Related Knowledge and Perceptions

2021 ◽  
Vol 126 (4) ◽  
pp. 271-288 ◽  
Author(s):  
Lara M. Genik ◽  
Elisabeth L. Aerts ◽  
Paula C. Barata ◽  
Chantel C. Barney ◽  
Stephen P. Lewis ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Assessment ◽  
Controlled Trial ◽  
Management Program ◽  
Control Group ◽  
Intention To Treat ◽  
Randomized Controlled ◽  
Parallel Group ◽  
Pain Knowledge

Abstract This parallel group randomized controlled trial tested effectiveness of the Let's Talk About Pain training on respite workers' (RW) pain-related knowledge and feasibility-confidence-skill ratings using between-group and within-group analyses. Fourteen children's respite organizations were randomized to pain or control training. Participants (nintervention = 66; ncontrol = 92) underwent a 3–3.5 hour training and completed measures at pre-, post-, and 4–6 week follow-up. Intention-to-treat (nintervention = 65; ncontrol = 92) and per-protocol (nintervention = 26–38; ncontrol = 40–57) analyses were conducted. Pain training participants demonstrated significantly higher pain knowledge and feasibility-confidence-skill ratings post-follow-up versus control group and significant increases in knowledge from pre-post. Significant gains were maintained from post-follow-up. Results represent a promising step towards enhancing pain-related care for children with IDD.

Reducing Pain after Second Trimester Genetic Amniocentesis by Postprocedural Cryotherapy: A Randomized Controlled Trial

2021 ◽  
Vol 104 (8) ◽  
pp. 1235-1240
Keyword(s):  
Randomized Controlled Trial ◽  
Pregnant Women ◽  
Pain Perception ◽  
Controlled Trial ◽  
University Hospital ◽  
Control Group ◽  
Second Trimester ◽  
Randomized Controlled ◽  
Genetic Amniocentesis ◽  
And Control

Objective: To evaluate the effectiveness of cryotherapy on pain reducing after the second trimester genetic amniocentesis. Materials and Methods: A prospective randomized controlled trial was performed at Maternal-Fetal-Medicine (MFM) Unit at Thammasat University Hospital, Thailand between December 2019 and March 2020. The participants were pregnant women who underwent amniocentesis for genetic evaluation during the study period were divided into two groups, study and control. After finishing amniocentesis, study and control groups received jelly pack at temperature 4-degree Celsius and room temperature, respectively. The pain measurement was 10-cm visual analog scale (VAS) before, during, and 15 and 30 minutes after amniocentesis. Demographic characters and VAS score were recorded and evaluated. Results: Two hundred forty pregnant women between 15 and 22 weeks of gestation were recruited and equally allocated into two groups. There were no differences between the two group in demographic data, indication, anticipated, and actual pain scores (p=0.327 and 0.401, respectively). Median pain score at 15 and 30 minutes after the procedure in the study group were 1 and 0 (p=0.202) while in the control group it was 2 and 1 (0.039). Patients’ satisfaction after finishing the procedure was not significantly different. Conclusion: Cryotherapy was effective in decreasing maternal pain perception after amniocentesis. Keywords: Pregnancy; Amniocentesis; Cold pack; Cryotherapy; Pain

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