title: The effect of a translating research into practice (TRIP)--cancer intervention on cancer pain management in older adults in hospice.
abstract: BACKGROUND
  Pain is a major concern for individuals with cancer, particularly older adults who make up the largest segment of individuals with cancer and who have some of the most unique pain challenges. One of the priorities of hospice is to provide a pain-free death, and while outcomes are better in hospice, patients still die with poorly controlled pain.
  
  
  OBJECTIVE
  This article reports on the results of a Translating Research into Practice intervention designed to promote the adoption of evidence-based pain practices for older adults with cancer in community-based hospices.
  
  
  METHODS
  This Institutional Human Subjects Review Board-approved study was a cluster randomized controlled trial implemented in 16 Midwestern hospices.
  
  
  METHODS
  Retrospective medical records from newly admitted patients were used to determine the intervention effect. Additionally, survey and focus group data gathered from hospice staff at the completion of the intervention phase were analyzed.
  
  
  RESULTS
  Improvement on the Cancer Pain Practice Index, an overall composite outcome measure of evidence-based practices for the experimental sites, was not significantly greater than control sites. Decrease in patient pain severity from baseline to post-intervention in the experimental group was greater; however, the result was not statistically significant (P = 0.1032).
  
  
  CONCLUSIONS
  Findings indicate a number of factors that may impact implementation of multicomponent interventions, including unique characteristics and culture of the setting, the level of involvement with the change processes, competing priorities and confounding factors, and complexity of the innovation (practice change). Our results suggest that future study is needed on specific factors to target when implementing a community-based hospice intervention, including determining and measuring intervention fidelity prospectively.
authors: University of Iowa, College of Nursing, Iowa City, IA 52242, USA. keela-herr@uiowa.edu
authors: Keela
authors: K
authors: Herr
authors: Marita
authors: M
authors: Titler
authors: Perry G
authors: PG
authors: Fine
authors: Sara
authors: S
authors: Sanders
authors: Joseph E
authors: JE
authors: Cavanaugh
authors: John
authors: J
authors: Swegle
authors: Xiongwen
authors: X
authors: Tang
authors: Chris
authors: C
authors: Forcucci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000209:etiology / Q000451:nursing* / Q000628:therapy*; D019317:Evidence-Based Medicine / Q000379:methods; D005260:Female; D006738:Hospices / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000451:nursing*; D009859:Oncology Nursing / Q000379:methods / Q000458:organization & administration; D059408:Pain Management / Q000379:methods*; D057170:Translational Research, Biomedical / Q000379:methods