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A theory-based educational intervention targeting nurses' attitudes and knowledge concerning cancer-related pain management: a study protocol of a quasi-experimental design.

ABSTRACT: Pain is one of the most frequent problems among patients diagnosed with cancer. Despite the availability of effective pharmacological treatments, this group of patients often receives less than optimal treatment. Research into nurses' pain management highlights certain factors, such as lack of knowledge and attitudes and inadequate procedures for systematic pain assessment, as common barriers to effective pain management. However, educational interventions targeting nurses' pain management have shown promise. As cancer-related pain is also known to have a negative effect on vital aspects of the patient's life, as well as being commonly associated with problems such as sleep, fatigue, depression and anxiety, further development of knowledge within this area is warranted.A quasi-experimental study design will be used to investigate whether the implementation of guidelines for systematic daily pain assessments following a theory-based educational intervention will result in an improvement in knowledge and attitude among nurses. A further aim is to investigate whether the intervention that targets nurses' behaviour will improve hospital patients' perception of pain. Data regarding nurses' knowledge and attitudes to pain (primary outcome), patient perception regarding pain (secondary outcome), together with socio-demographic variables, will be collected at baseline and at four weeks and 12 weeks following the intervention.Nursing care is nowadays acknowledged as an increasingly complicated activity and "nursing complexity is such that it can be seen as the quintessential complex intervention." To be able to change and improve clinical practice thus requires multiple points of attack appropriate to meet complex challenges. Consequently, we expect the theory-based intervention used in our quasi-experimental study to improve care as well as quality of life for this group of patients and we also envisage that evidence-based guidelines targeting this patient group's pain will be implemented more widely.ClinicalTrials.gov NCT01313234.

SUBMITTER: Borglin G

PROVIDER: S-EPMC3189876 | biostudies-literature | 2011 Sep

REPOSITORIES: biostudies-literature

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A theory-based educational intervention targeting nurses' attitudes and knowledge concerning cancer-related pain management: a study protocol of a quasi-experimental design.

Borglin Gunilla G Gustafsson Markus M Krona Hans H

BMC health services research 20110923

<h4>Background</h4>Pain is one of the most frequent problems among patients diagnosed with cancer. Despite the availability of effective pharmacological treatments, this group of patients often receives less than optimal treatment. Research into nurses' pain management highlights certain factors, such as lack of knowledge and attitudes and inadequate procedures for systematic pain assessment, as common barriers to effective pain management. However, educational interventions targeting nurses' pa ...[more]

PMID: 21942991

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Project description:Registered Nurses (RNs) play an important role in caring for patients suffering from cancer pain. A lack of knowledge regarding pain management and the RNs' own perception of cancer pain could act as barriers to effective pain management. Educational interventions that target RNs' knowledge and attitudes have proved promising. However, an intervention consisting of evidence-based practice is a multifaceted process and demands behavioural and cognitive changes to sustain the effects of the intervention. Therefore, our study aimed to investigate if a theory-based educational intervention could change RNs' knowledge and attitudes to cancer pain and pain management, both four and 12 weeks after the start of the intervention.A quasi-experimental design with non-equivalent control groups was used. The primary outcome was measured using a modified version of the instrument Nurses' Knowledge and Attitudes Survey Regarding Pain (NKAS) at baseline, four weeks and 12 weeks after the start of the intervention to evaluate its persistence. The intervention's educational curriculum was based on the principles of Ajzen's Theory of Planned Behaviour and consisted of interactive learning activities conducted in workshops founded on evidence-based knowledge. The RN's own experiences from cancer pain management were used in the learning process.The theory-based educational intervention aimed at changing RNs knowledge and attitudes regarding cancer pain management measured by primary outcome NKAS resulted in a statistical significant (p<0.05) improvement of total mean score from baseline to four weeks at the intervention ward.The findings of this study, suggest that a theory-based educational intervention focused at RNs can be effective in changing RN's knowledge and attitudes regarding cancer pain management. However, the high number of dropouts between baseline and four weeks needs to be taken into account when evaluating our findings. Finally, this kind of theory-based educational intervention with interactive learning activities has been sparsely researched and needs to be evaluated further in larger projects.Clinical Trials. Gov: NCT01313234.

Project description:OBJECTIVES Driven by innovations in healthcare, observation medicine (OM) is expanding as a medical specialty. Despite exponential growth, education on OM remains underemphasized in the internal medicine (IM) residency programs. We assessed the impact of an educational intervention pairing didactic and experiential learning with an interdepartmental approach on IM residents’ confidence, knowledge, and attitudes when providing observation care to patients with neuro-cardiovascular diseases in the hospital setting. METHODS Our multifaceted intervention incorporated OM’s principles and practice in a flipped classroom with the team-, case-, lecture- and evidence-based learning model. Kirkpatrick’s evaluation model was used to assess the educational intervention’s effectiveness according to the first three levels, ie, reaction, learning, and behavior, using quantitative surveys. The surveys were completed pre-intervention, and immediately upon completion of the educational intervention. RESULTS Of 55 eligible residents, 55 (100%) participated in this intervention. Fifty (90%) completed the pre-intervention survey, and 21 (38%) completed the immediate post-intervention survey. Kirkpatrick’s evaluation framework showed that the intervention had a positive impact on residents’ motivational reaction (attention, relevance, confidence, and satisfaction [ARCS], M = 3.8, SD = 0.87), their knowledge of common observation diagnoses (pre = 49%, post = 63%), particularly on cardiac diagnostic workup and approach to patients with transient neurological symptoms (P < .05), and their behavior and self-assessment of core competency domains (pre-mean = 2.69, post-mean = 3.18, P < .001). CONCLUSIONS Our multimodal intervention provides a framework for a structured OM educational experience that can be incorporated into residency training, even without a formal observation unit rotation. The analysis also offers literary data on the current state of OM education in an IM residency program and supports the need to expand OM's educational resources to counteract the growth in hospital observation services. Future research should include an analysis of residents’ knowledge and skills from a longitudinal OM experience and advancing the results to residency programs where observation care is as applicable as ours.

Project description:Background and aimsSubstance use among adolescents especially smoking, is becoming a public health problem in the Kurdistan region of Iraq. School-based health education is an appropriate approach for improving students' knowledge regarding substance use in an attempt to prevent or reduce such problem The purpose of the study was to examine the effect of an educational intervention for high school students to improve their knowledge for substance use and its negative consequences, which will, in turn, motivate students to take protective measures against substance use.MethodsThis quasi-experimental (one group; pre, and post-test) design was carried out in Erbil city from January 2017 to June 2017. A random sampling technique was employed to collect a sample of 280 students amongst four high schools in Erbil city which is the capital of Kurdistan Region-Iraq. A self- administered questionnaire on knowledge assessment regarding substance use was developed and validated by the experts regarding the relevance of the items. A structured teaching program for imparting knowledge on various aspects of substance use was developed based on extensive review of literature and experts' opinion. The intervention program consisted of a series of 4 education modules. These modules were mainly taught by "Rabers" over a period of four weeks (one session per week). SPSS version 21 was used for data entry and analysis. Data was analyzed through descriptive and inferential statistics (McNemar tests, paired t-test, and Chi-square test).ResultsOut of 280 students, a total of 270 students completed a pre and post-intervention survey. Of the 270 students, 124 (45.9%) were males and 146 (54.1%) were females. The mean age ± SD of the participants was 16.59 ± 0.784 years, ranging from 15-18 years. The study reveals a statistically significant improvement in the mean score of knowledge of students following the implementation of a health education program from 15.959 ± 3.25 to 20.633 ± 3.26 (p < 0.001). Moreover, no one of the students remained with poor knowledge, and relatively more than half (50.2%) of the students have upgraded to good knowledge level.ConclusionImplementing a health education program about substance use on high school students in Erbil city had improved the knowledge of students about this topic.

Project description:BackgroundNurses are particularly vulnerable to acquiring tuberculosis (TB) because they are in the frontline of patient care. There is inadequate implementation of cost-effective TB infection control (TBIC) measures in most health facilities. Training has been shown to be effective in improving the knowledge and work practices of nurses. This study sought to utilize a multi-method educational intervention to improve the TBIC-related knowledge and practices of nurses in two secondary health facilities in Ibadan, South-West Nigeria.MethodsThis quasi-experimental study involved 200 nurses (100 each in the intervention and comparison groups). Baseline data were collected in May 2014. This was followed by training of the nurses in the intervention group. After 6 months, the second wave of data was collected and the nurses in the comparison group also received the training thereafter. The final wave of data collection took place 12 months after the commencement of the study. The mean scores of the nurses were determined and comparison was made between both groups at different time points using independent t-test.ResultsThe nurses in both groups were statistically comparable in their socio-demographic characteristics, and baseline mean knowledge (68.6 and 67.7%) and practice scores (79.1 and 80.6%) respectively. After the intervention group received the intervention, there were appreciable improvements in the scores at 6 months (knowledge - 85.9%, practice - 98.5%), which were significantly different from those of the comparison group (knowledge - 69.5%, practice - 78.8%). A large effect size was demonstrated in the improvement in knowledge score in the intervention group at 6 months compared with the other group (Cohen's d = 1.7). Similarly, there were improvements in the scores of the nurses in the comparison group at 12 months after the group had also received the intervention (knowledge - 88.2%, practice - 93.5%). At this point, the mean scores between both groups were no longer significantly different.ConclusionsThe improvement in post-intervention scores implies that the educational intervention adopted for this study was effective in improving TBIC among the nurses. It also underscores the importance of continuous training/retraining of nurses and other healthcare workers in improving and sustaining TBIC at health facilities.

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A theory-based educational intervention targeting nurses' attitudes and knowledge concerning cancer-related pain management: a study protocol of a quasi-experimental design.

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A theory-based educational intervention targeting nurses' attitudes and knowledge concerning cancer-related pain management: a study protocol of a quasi-experimental design.

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