Chronis disease management - Research Paper Example

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Chronic disease management is one of the most difficult aspects of health care delivery.It includes various procedures and processes of treatment which help prevent the exacerbation of symptoms and ensure the availability of comfort measures for the chronically ill patients. …
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Download file to see previous pages In the paper by Miaskowski, et.al. (2004), the authors sought to test the effectiveness of the PRO-SELF Pain Control Program when compared with standard care in reducing pain intensity scores, increasing appropriate analgesic prescriptions, and increasing analgesic intake in cancer outpatients with pain from bone metastasis. This study covered seven outpatient settings in Northern California, including a university-based cancer center, two community-based oncology practices, one health maintenance organization, one outpatient radiation therapy center, one veteran’s affairs facility, and one military hospital. In this study, the patients were assigned randomly in either the PRO-SELF intervention or standard care intervention. Those under standard care were visited by a research nurse three times, and then called three times by phone between home visits. Those under the PRO-SELF setting patients were visited by specially trained intervention nurses and then received a psychoeducational intervention. They were instructed on how to use a pillbox, and were given instructions on how to communicate with their doctor about pain symptoms and changes needed in analgesic prescriptions. Patients were also instructed during follow-up home visits and three phone calls on how to improve cancer pain management. To ensure the ethical treatment of this study, the authors gained the respondent’s written consent, after explaining to them the purpose of the research and the fact that their identity would remain confidential throughout the research. The ethical committee was consulted first and their review and consent secured before the rest of the research process was carried out. A sample of atleast 150 patients was needed in order to complete this study. Descriptive statistics and frequency distributions were established for the patients’ demographic and disease-related qualities. Independent student’s t-tests and x2 analysis were carried out to determine differences in demographics, disease, and pain qualities between patients in the two treatment groups. Analyses of variance were carried out to establish if there were changes in pain intensity scores over time. The McNemar test was then used to establish differences over time based on kinds of analgesic prescriptions. The P-value of less than .05 was considered statistically significant. This study revealed that pain intensity scores were reduced significantly from baseline figures in the PRO-SELF group, as compared to the standard treatment group. The percentage of patients in the PRO-SELF group with the most appropriate kind of analgesia increased significantly from 28.3% to 37.0% as compared to the standard group which changed from 29.6% to 32.5%. The study therefore established that using a psychoeducational intervention, which includes nurse coaching within the standard of self-care, can improve pain management for cancer patients. Critical Analysis The authors are credible authors for this research. They possess the ...Download file to see next pagesRead More
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