Deborah B. McGuire

Knowledge and Beliefs Regarding Pain in a Sample of Nursing Faculty.

Pain is a significant problem impacting between 50 per cent and 80 per cent of cancer patients and affecting overall quality of life. Studies have documented that nurses and other health care professionals are inadequately prepared to care for patients in pain. Several reasons have been identified including inadequacies in nursing and medical education, absence of curriculum content related to pain management, and faculty attitudes and beliefs related to pain. This article presents data from a cross-sectional mall survey that consisted of a self-administered knowledge and beliefs questionnaire and a self-reported pain curriculum questionnaire. Faculty from 14 baccalaureate nursing schools in the United States participated in the study. The study suggests that in baccalaureate schools of nursing, faculty knowledge and beliefs about pain and the curriculum content related to pain may be less than optimal.

A comparison of the Hopkins Pain Rating Instrument with standard visual analogue and verbal descriptor scales in patients with cancer pain

A self-contained, portable, pain rating instrument that provides an immediate result for documentation purposes was developed to improve pain assessment in cancer patients. The Hopkins Pain Rating Instrument (HPRI) is a 5 x 20 cm plastic visual analogue scale (VAS) with a sliding marker that moves within a groove that measures 10 cm. The side facing the patient resembles a traditional VAS while the opposite side is marked in cm to quantify pain intensity. This psychometric study, which employed a descriptive correlational design, evaluated the reliability and validity of the HPRI by comparing it with a traditional VAS and verbal descriptor scale (VDS). Outpatients with and without pain and inpatients with pain rated their major pain site with the three instruments, which were presented in random order. This was followed by a mental status exam and re-rating of pain with the same instruments to assess test--retest reliability. Completing the study were 71 patients with a variety of cancers and a mean age of 52.8 years. Of these patients, 68% had pain and 54% were receiving opioid analgesics. The most common pain sites were the back, leg, and epigastric areas. On initial and repeat testing, there were high correlations between the HPRI and the VAS (r = 0.99, P less than 0.0001) and the VDS (r = 0.85, P less than 0.0001). The correlation coefficients for test--retest reliability for the HPRI, VAS, and VDS were 0.97, 0.97, and 0.94 (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Fixed-interval v as-needed analgesics in cancer outpatients

Abstract Many health professionals advocate medicating cancer patients in pain with fixed-interval analgesic schedules, but there is little research to support this approach. A pilot study in cancer outpatients was conducted to test the hypothesis that patients randomized to fixed-interval schedules of oral narcotic analgesics would report lower pain intensity than patients randomized to as-needed schedules. Twelve patients were randomized to fixed-interval and eight to as-needed schedules. They were followed for five consecutive days, recording amount and time they took analgesics, and rating pain intensity three times daily on a 10 cm visual analogue scale. A one-way repeated measures analysis of variance revealed no differences between the two groups of patients. Possible explanations for the findings include small sample size, unreliable measures of pain intensity, inadequate analgesic doses or intervals, or individual characteristics of the pain experience. Further research must address methodologic and measurement problems involved in the study of pain and its management to clarify the issue of analgesic scheduling in cancer outpatients.

The nursing research review process in a clinical setting

In their efforts to meet research requirements, graduate students and faculty members sometimes find it necessary to gain access to a clinical setting. The authors address the review process researchers must undergo to obtain such access by investigating the experience of the Nursing Service Research Committee (NSRC) of the University of Illinois Hospital and Clinics. They present for the period extending from July 1, 1980, to June 30, 1984, (1) the number of applications reviewed and the outcomes of the reviews, (2) a description of the types of approvals, classified according to types of principal investigators, and (3) the specific types of recommendations made in the approval process and their relationship to changes made in the application process. The improvements attributable to the NSRC are discussed along with remaining problems, for which the authors suggest possible solutions.