title: Development and mixed-methods evaluation of a pain assessment video training program for long-term care staff.
abstract: BACKGROUND
  Inadequacies in pain assessment and management in long-term care have been well documented. Insufficient pain education and inaccurate beliefs about the nature of pain and aging have been identified as possible contributors. The present study addresses the need for improved, efficient and feasible continuing pain education through the use of an assessment training video.
  
  
  METHODS
  A total of 148 long-term care staff viewed and evaluated the training video. Knowledge changes and pain beliefs were assessed postvideo and at a four-week follow-up. Beliefs about pain, as well as pain and aging, were also examined using multivariate procedures to determine whether these variables influenced participants' evaluation of the video. Focus groups were also conducted, and transcripts were analyzed using thematic content analysis.
  
  
  RESULTS
  Pain assessment knowledge improved postvideo and at the four-week follow-up. Participants positively evaluated the content and quality of the video. Individuals who held stronger beliefs (at baseline) about the organic nature of pain provided more positive evaluations. Barriers to implementation of practices in the video identified by the focus groups (and qualitative analysis) included time, workload and resistance to change. Facilitators to implementation included continued management support and observing the benefits to implementation.
  
  
  CONCLUSIONS
  The present study provides support for the use of video training. However, based on the focus group results, top-down implementation approaches with ongoing management involvement throughout the implementation process may be needed to achieve sustained changes in pain assessment practices. A model useful for sustained implementation was proposed and discussed, and is hoped to facilitate future research.
authors: Michelle M
authors: MM
authors: Gagnon
authors: Thomas
authors: T
authors: Hadjistavropoulos
authors: Jaime
authors: J
authors: Williams
mesh_terms: D001291:Attitude of Health Personnel; D004509:Education, Nursing, Continuing / Q000379:methods*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009726:Nurses; D009728:Nursing Assistants / Q000193:education*; D010147:Pain Measurement / Q000379:methods*; D014741:Video Recording
references: Can J Occup Ther. 1999 Dec;66(5):221-8
references: 10641374
references: J Pain Symptom Manage. 2000 Dec;20(6):424-39
references: 11131261
references: J Am Geriatr Soc. 2005 Oct;53(10):1798-805
references: 16181182
references: Pain Res Manag. 2013 Jan-Feb;18(1):25-32
references: 23457683
references: J Contin Educ Nurs. 2007 Mar-Apr;38(2):58-66; quiz 67-8, 93
references: 17402377
references: J Am Geriatr Soc. 2004 Jun;52(6):867-74
references: 15161448
references: J Adv Nurs. 2003 Jan;41(1):99-108
references: 12519293
references: West J Nurs Res. 2007 Aug;29(5):561-80; discussion 581-8
references: 17548894
references: Nurs Philos. 2004 Jul;5(2):147-59
references: 15189555
references: Pain Res Manag. 2007 Autumn;12(3):195-203
references: 17717611
references: Pain. 2005 Jun;115(3):234-237
references: 15876496
references: Br J Nurs. 2002 Jul  11-24;11(13):902-3, 906-12
references: 12131844
references: Pain Med. 2009 Apr;10(3):506-20
references: 19254336
references: JAMA. 2001 Apr 25;285(16):2081
references: 11311096
references: Pain Manag Nurs. 2013 Dec;14(4):220-227
references: 24315245
references: Nurs Res. 1998 Jul-Aug;47(4):235-42
references: 9683119
references: Gerontologist. 2004 Aug;44(4):469-78
references: 15331804
references: Physiother Can. 2010 Spring;62(2):104-13
references: 21359040
references: Pain Manag Nurs. 2004 Mar;5(1):37-49
references: 14999652
references: J Am Geriatr Soc. 2002 Jun;50(6 Suppl):S205-24
references: 12067390
references: J Nurs Care Qual. 2004 Oct-Dec;19(4):322-7
references: 15535537
references: Pain Manag Nurs. 2006 Jun;7(2):44-52
references: 16730317
references: J Pain. 2001 Jun;2(3):171-80
references: 14622827
references: J Pain Symptom Manage. 1997 Sep;14(3):175-88
references: 9291704
references: Int J Geriatr Psychiatry. 2005 Aug;20(8):730-7
references: 16035124
references: Clin J Pain. 2008 Oct;24(8):697-707
references: 18806535
references: Gerontol Geriatr Educ. 2009;30(1):1-20
references: 19214843
references: Clin J Pain. 2007 Jan;23(1 Suppl):S1-43
references: 17179836
references: Pain. 1992 Dec;51(3):267-272
references: 1491853
references: Pain Res Manag. 2009 Nov-Dec;14(6):439-44
references: 20011714
references: Pain Res Manag. 2007 Autumn;12(3):177-84
references: 17717609
references: Pain Res Manag. 2013 Jan-Feb;18(1):11-8
references: 23457681
references: Pain Med. 2007 Nov-Dec;8(8):678-89
references: 18028046
references: J Pain Symptom Manage. 2000 Apr;19(4):240-8
references: 10799790
references: J Am Med Dir Assoc. 2005 May-Jun;6(3 Suppl):S13-9
references: 15890286
references: Pain. 2004 Jul;110(1-2):140-8
references: 15275761
references: J Adv Nurs. 2003 Mar;41(6):575-84
references: 12622866