Nurses reported improvements in their knowledge, confidence, and skills related to the management of complex cancer pain following participation in an online educational program called Advanced Pain Assessment and Management (APAM). This study was published in the American Journal of Hospice and Palliative Care.
Although pain is a commonly reported symptom in patients with cancer, studies have shown that achieving effective pain control in this population has been challenging. Hence, there is a critical need for educational programs focusing on both biological and technical, as well as psychosocial and cognitive, aspects of pain management in cancer care.
The report described the online, 7-module, nurse-facilitated, educational APAM intervention for oncology nurses developed by an advanced practice nurse at the de Souza Institute, part of the University Health Network in Toronto, Canada, and based on the pain management guidelines from Cancer Care Ontario and the National Comprehensive Cancer Network. In addition, the report presented outcomes for, and feedback from, nurse participants of this program.
The APAM program modules covered topics such as pathophysiology of pain, pain assessment, identifying different types of pain syndromes, approaches to pharmacological management of pain, opioid dosing and assessment of opioid-associated risks, managing intractable pain, and nonpharmacologic approaches to pain management.
Program participants completed a survey on their knowledge/attitude/confidence before and after participating in APAM. Following each program module, participants were required to answer questions related to their clinical practices, and post comments, in the context of a collaboration forum that was overseen by a nurse program facilitator. Learning was assessed through questions on module content and assigned readings, as well as completion of an opioid calculation/conversion assignment, and development of a final case study within an assigned group of 3 to 5 program participants.
Of the 306 nurse participants enrolled in the APAM program between January 2012 and September 2017, overall confidence in knowledge and skills at baseline was only 57.5%, with the lowest levels of confidence associated with management of intractable pain (42.1%). Program participants spent an average of 1 hour and 4 minutes on each module; 71.9% of participants passed the course, 14.3% failed, and 13.8% did not complete it. At postprogram assessment, the level of course satisfaction was high, and overall confidence in knowledge and skills was 75.7%. Mixed-model results showed postprogram improvements in confidence were independent of sociodemographic background, clinical role, and professional educational level.
Leung YW, Wong J, Kiteley C, Ellis J, Esplen MJ. Addressing educational needs in managing complex pain in cancer populations: Evaluation of APAM: An online educational intervention for nurses [published online February 27, 2019]. Am J Hosp Palliat Care. doi: 10.1177/1049909119832819