title: An Educational Intervention to Reduce Pain and Improve Pain Management for Malawian People Living With HIV/AIDS and Their Family Carers: A Randomized Controlled Trial.
abstract: BACKGROUND
  Advances being made in improving access to HIV drugs in resource-poor countries mean HIV patients are living longer, and, therefore, experiencing pain over a longer period of time. There is a need to provide effective interventions for alleviating and managing pain.
  
  
  OBJECTIVE
  To assess whether a pain educational intervention compared with usual care reduces pain severity and improves pain management in patients with HIV/AIDS and their family carers.
  
  
  METHODS
  This was a randomized, parallel group, superiority trial conducted at HIV and palliative care clinics of two public hospitals in Malawi. A total of 182 adults with HIV/AIDS (Stage III or IV) and their family carers participated; carer participants were those individuals most involved in the patient's unpaid care. The educational intervention comprised a 30 minute face-to-face meeting, a leaflet, and a follow-up telephone call at two weeks. The content of the educational intervention covered definition, causes, and characteristics of pain in HIV/AIDS; beliefs and myths about pain and pain medication; assessment of pain; and pharmacological and nonpharmacological management. The primary outcome was average pain severity measured by the Brief Pain Inventory-Pain Severity subscale. Assessments were recorded at baseline before randomization and at eight weeks after randomization.
  
  
  RESULTS
  Of the 182 patient/carer dyads randomly allocated, 157 patient/carer dyads completed the trial. Patients in the intervention group experienced a greater decrease in pain severity (mean difference = 21.09 points, 95% confidence interval = 16.56-25.63; P < 0.001).
  
  
  CONCLUSIONS
  A short pain education intervention is effective in reducing pain and improving pain management for Malawian people living with HIV/AIDS and their family carers.
authors: Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, Division of Nursing, Queen's Medical Centre, Nottingham, United Kingdom.
authors: Kennedy
authors: K
authors: Nkhoma
authors: Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, Division of Nursing, Queen's Medical Centre, Nottingham, United Kingdom. Electronic address: jane.seymour@nottingham.ac.uk.
authors: Jane
authors: J
authors: Seymour
authors: School of Health Sciences, University of East Anglia, Norwich, United Kingdom.
authors: Antony
authors: A
authors: Arthur
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008295:Malawi; D008297:Male; D010146:Pain / Q000503:physiopathology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics
keywords: HIV/AIDS; carers; educational intervention; pain; palliative care; trial