From hospital to home care: a randomized controlled trial of a Pain Education Programme for cancer patients with chronic pain.
OBJECTIVE
To investigate the role of district nurses in the care of cancer patients with chronic pain at home, as well as the effects of a Pain Education Programme for patients and their district nurses. The Pain Education Programme consisted of a tailored multi-method approach in which they were educated about pain, instructed how to report pain, and how to contact health care providers.


BACKGROUND
No educational programs for patients in pain have been studied in outpatients nor integrated with the home care provided.


METHODS
One hundred and four patients and their 115 district nurses were enrolled in a prospective, longitudinal, randomized controlled study. The primary outcome of interest was type of care provided by district nurses, satisfaction with the pain treatment, and agreement in estimating patients' pain intensity.


RESULTS
Results showed that continuity of care was poor as only 36% of the district nurses were informed about patients' pain by hospital nurses. Pain was rarely the reason for referring the patient to district nursing after discharge. Although pain control was not a main reason for district nurses to visit a patient, pain was a subject for discussion in 76% of visits. Besides discussing the pain problem with patients, district nurses provided only a few pain-relieving interventions. District nurses randomized to the intervention group significantly better estimated patients' pain intensity, and were more satisfied about patients' pain treatment, but no differences were found in their assessment of patients' pain relief.


CONCLUSIONS
These findings suggest a significant but moderate effect of the Pain Education Programme, with district nurses only playing a minor role in the treatment of cancer pain.
de Wit
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R
Health Scientist, and Head Pain Expertise Center, Pain Expertise Center, University Hospital Rotterdam, The Netherlands. dewit@pijn.azr.nl
van Dam
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F
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D024802:Nurse's Role; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000209:etiology / Q000451:nursing*; D059408:Pain Management; D010147:Pain Measurement; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires