The Use of a Digital Application for Reporting Pain and Pain Management in Home Hospice
概览
- 阶段
- 不适用
- 干预措施
- e-PainSupport
- 疾病 / 适应症
- Pain
- 发起方
- Rush University Medical Center
- 入组人数
- 88
- 试验地点
- 1
- 主要终点
- Minimally Important Clinical Change in Worst Pain Intensity
- 状态
- 已完成
- 最后更新
- 上个月
概览
简要总结
Poor adherence to pain management and high pain intensity associated with serious, advanced illness is a major public health concern. This randomized clinical trial will test the efficacy of a newly enhanced digital pain and pain management application (e-PainSupport) for use in a home hospice setting. The e-PainSupport application delivers an education module about pain management to patients and caregivers, expedites pain reporting to nurses, and facilitates adherence to pain management. The overall goal of the e-PainSupport application is to improve pain management and reduce patient pain intensity in the home hospice setting.
详细描述
High pain intensity is a common symptom experienced by patients with serious advanced illness. However, pain management for patients in home hospice is less than optimal. Impediments to improving pain intensity are poor adherence to pain management regimen due in part to caregiver lack of knowledge (a barrier to reporting pain and using analgesics) and lack of self-efficacy (confidence) in administering analgesics. Digital applications may facilitate pain management by: (1) delivering education to increase knowledge and self-efficacy, (2) expediting pain reporting to nurses, and (3) improving adherence to pain management. e-PainSupport is a self-administered, digital pain management application developed in collaboration with hospice nurses and caregivers. It is directly linked to a patient's medical record and enhanced by an evidence-based educational module. It has three elements: (a) Educational Module, (b) Patient Pain Record, and (c) Pain Summary for Nurses. The purpose of this study is to test the effects of e-PainSupport on home hospice patient pain intensity when used by patients, caregivers and nurses. Participants (132 triads of patient, caregiver, and the hospice nurse assigned to the patient will be recruited from one large Midwest hospice agency. Patient and caregiver outcomes will be assessed at baseline and 2 weeks post baseline. Data will be analyzed with multi-level modeling. Post-intervention semi-structured interviews will be conducted with nurses who provided care to patients in the e-PainSupport condition. Qualitative content analysis will be used to identify themes related to perceived practice changes after using e-PainSupport. e-PainSupport has potential as a useful tool to advance home hospice care by enhancing the quality of caregiver pain management, facilitating nurse-patient communication, and improving management of patient pain intensity.
研究者
Masako Mayahara
Associate Professor and Associate Chairperson
Rush University Medical Center
入排标准
入选标准
- •prior enrollment of their hospice nurse
- •receives analgesics for pain
- •speaks and reads English
- •age 18 or older
- •has a primary informal caregiver who is available for the 2 weeks of the study
- •expected survival of at least 2 weeks
- •can verbalize pain.
- •Inclusion criteria (caregiver)
- •speaks and reads English
- •age 18 or older
排除标准
- 未提供
研究组 & 干预措施
e-PainSupport Condition
e-PainSupport is a self-administered, digital pain application. Over the course of the two weeks, caregivers and patients will record the severity of patient's pain and how much pain medicine they use to control patient's pain in the e-PainSupport application.
干预措施: e-PainSupport
Standard Care Condition
Patients and caregivers will be given a paper copy of the same list of resources for pain management included in the Education Module of the e-PainSupport condition at baseline.
结局指标
主要结局
Minimally Important Clinical Change in Worst Pain Intensity
时间窗: Baseline to 2-weeks post baseline
At least 20 percent change on the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity-Short Form 3a v1.0: 3 items: Worst pain and average pain in past 7 days scored from 1 = no pain, 2= mild, 3 = moderate, 4= severe, 5 = very severe pain. Higher scores indicates higher pain intensity.
Minimally Important Clinical Change in Average Pain Intensity
时间窗: Baseline to 2-weeks post baseline
At Least 20 Percent Change on the PROMIS Average Pain Scale. Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity-Short Form 3a v1.0: Average pain in past 7 days, and current pain, scored from 1 = no pain, 2= mild, 3 = moderate, 4= severe, 5 = very severe pain, summed for a range of 3 to 15. Higher scores indicates higher pain intensity.
Minimally Important Clinical Change in Current Pain Intensity
时间窗: Baseline to 2-weeks post baseline
At least 20 percent change on the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity-Short Form 3a v1.0: 3 items: current pain, scored from 1 = no pain, 2= mild, 3 = moderate, 4= severe, 5 = very severe pain. Higher scores indicates higher pain intensity.
次要结局
- Change in the Continuous Score of the Pain Intensity Scale(Baseline to 2-weeks post baseline)