The effects of a pain management training program on nurse pain assessment accuracy and patient satisfaction
Woodward, George David
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The effects of a brief training program for nurses consisting of information relevant to the assessment and management of patient pain were examined. The accuracy of nurse assessments of patient pain and patient ratings of satisfaction with the pain management care received from their nurses were of particular interest. Additionally, the study investigated differences between cancer and orthopedic pain. Participants in the study included 30 nurses employed on the oncology and orthopedic units of a private general hospital and 129 patients attended by the participating nurses. Fourteen nurses, 7 from each of the hospital units, received a brief training program consisting of information relevant to pain assessment and management skills. The remainder of the nurses, 8 from each unit, comprised a control group and did not receive the training. Patients completed a questionnaire consisting of (a) Short-Form McGill Pain Questionnaire (SF-MPQ), (b) two visual-analog pain intensity scales, and (c) two visual-analog satisfaction scales. The nurse questionnaire consisted of (a) two visualanalog pain intensity scales and (b) a verbal pain rating scale. A hierarchical research design was employed to investigate four research questions. The data were analyzed using analysis of variance and correlational techniques. Results showed that trained nurses were able to predict the pain ratings of their patients significantly more accurately than untrained nurses (p < .01). No significant differences were found in nurse ratings of "actual" patient pain, however, with the ratings of both trained and untrained nurses being equally lower than patient ratings of pain. Additionally, no significant differences were found in satisfaction ratings given by the patients of trained and untrained nurses. Differences in patient reports of pain were found using the 15 descriptor adjectives of the SF-MPQ, with the patients of the trained nurses endorsing the sensory adjectives at a significantly higher rate. These findings are seen as suggestive that, while the training program provided some of the knowledge and skills necessary to make more accurate pain assessments, it was not as effective in changing some of the false beliefs and preconceived notions about pain held by the nurses. Implications for practice and further research are discussed.