Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Chang CM (1), Cheng KY (1), Ng KY (1)
Affiliation :
Pain Management Unit, Department of Anaesthesia and Operating Theatre Services, New Territories West Cluster
Introduction :
Patients with chronic pain (CP) often experience reduced activity, negative thoughts, and a loss of independence, which can lead to physical deterioration, negative emotions, social tension, unhelpful beliefs, and behaviors, making it harder to cope with pain. Therefore, a biopsychosocial approach is necessary for managing CP. Unfortunately, most chronic pain patients (CPP) lack awareness of the interactions between biopsychosocial factors and pain. They tend to rely on pharmacological treatments without knowledge of holistic pain management, which is the most effective approach.
In April 2023, the NTWC pain nurse team developed a pilot pain management program called "LWwCP" to address this issue.
Objectives :
The program aims to improve CPP's understanding of the relationship between pain, contributing factors, and consequences. It covers various pain management modalities, including pharmacological and non-pharmacological approaches, and teaches coping skills. Active engagement, experiential learning, and peer support are encouraged through discussions, sharing sessions, and interactive activities.
Methodology :
The pilot program consisted of four monthly morning sessions held over four consecutive months, accommodating 6-8 patients with chronic pain who expressed interest. The program included icebreaker games, exercises, pharmacological and non-pharmacological pain management, coping skills, and Nagomi Art.
To measure the program's effects, participants completed questionnaires before the first session and after the last session. These questionnaires included the Brief Pain Inventory (BPI), Pain Self-Efficacy Questionnaire (PSEQ), Depression Anxiety Stress Scale (DASS-21), and Pain Catastrophizing Scale (PCS). Additionally, a tailored questionnaire assessed participants' feedback and satisfaction. Participants rated the program on a scale of 0 to 10 for pain knowledge gained, utilization of coping skills, and overall satisfaction.
Result & Outcome :
Seven patients (1 male, 6 females) with chronic pain, aged 52 to 70, were recruited. Five female patients completed the program, while two withdrew.
After the program, participants showed significant improvements in self-confidence and sense of control over pain, with an average PSEQ score increase from 31.2 to 37.6 out of 60, representing an 11% increase.
There was a slight reduction in average pain severity from 6.02 to 5.78 out of 10, and average interference in daily life decreased from 5.9 to 5.18 out of 10. However, two participants experienced severe pain due to wrist sprains and pain flare-ups during the last session, which may have influenced these results.
Psychological improvements were less pronounced, with only two participants showing improvements in PCS and DASS scores. One participant had a significant reduction in depression score from 24 to 12, anxiety score decreased from 20 to 16, and stress score decreased from 32 to 20.
All participants reported an 8/10 increase in pain-related knowledge and utilization of coping skills taught in the program.
Overall, participants expressed satisfaction with the program, enjoying the content, activities, and peer interaction. They also highlighted the positive influence of peer support and expressed willingness to recommend the program.
In conclusion, the nurse-led LWwCP program shows potential as an adjunctive measure for CPP to enhance pain-related knowledge and coping efficacy. However, due to the small sample size, definitive benefits or negative effects cannot be determined. Further studies with larger sample sizes are recommended to evaluate the effects of the nurse-led PMP in the future.
