在儿科肿瘤学实践中实施数字疼痛评估工具的促进因素和障碍:质量改进项目的定性评估。

IF 1 4区 医学 Q3 NURSING
Rachel Hamilton, Cynthia Nguyen, Denise Mills, Jennifer N Stinson, Lindsey A Jibb
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引用次数: 0

摘要

背景:大多数癌症儿童和青少年都经历过急性疼痛,许多人还经历过持续时间较长的慢性疼痛,这对健康相关的生活质量造成了负面影响,并导致长期发病。数字应用程序可以帮助加强疼痛评估和管理,为患癌儿童和青少年提供一种易于使用的工具,将疼痛描述为一种多方面的生物-心理-社会结构。Pain Squad 是一款适用于儿童和青少年癌症患者的多维癌症疼痛评估应用程序,具有易用性、可接受性和心理计量学合理性。本项目旨在评估将 Pain Squad 应用于儿科肿瘤常规治疗的能力。方法:要求护士长在 6 个月的实施期内为患者开具 "疼痛小分队 "应用处方。实施期结束后,我们对护士支持者进行了半结构式录音访谈,以调查护士在实施 Pain Squad 过程中遇到的促进因素和障碍。结果实施 "疼痛小分队 "的促进因素和障碍被归纳为四个与实施研究综合框架 (CFIR) 相关的总体主题:(a) "疼痛小分队 "应用程序的特点;(b) 诊所环境及其背景;(c) 护士实施冠军;(d) 在临床实践中实施 "疼痛小分队 "的过程。结论:接受访谈的护士认为,Pain Squad 有潜力改善儿童癌痛护理,但日常使用的障碍也很明显,这与内部环境有关,尤其是应用程序处方与当前护士工作流程之间缺乏兼容性。使用 "CFIR "来绘制已确定的实施促进因素和障碍,可以正式支持对可能提高成功使用机会的因素的认识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Facilitators and Barriers to the Implementation of a Digital Pain Assessment Tool in Pediatric Oncology Practice: A Qualitative Evaluation of a Quality Improvement Project.

Background: Most children and adolescents with cancer experience acute pain, and many experience longer-lasting chronic pain, negatively impacting health-related quality of life and resulting in long-term morbidity. Digital apps can aid in enhancing pain assessment and management by offering children and adolescents with cancer an accessible tool to describe their pain as a multifaceted biopsychosocial construct. Pain Squad is a useable, acceptable, and psychometrically sound multidimensional cancer pain assessment app for children and adolescents with cancer. This project aimed to evaluate the capacity to implement Pain Squad into routine pediatric oncology practice. Method: Nurse champions were asked to prescribe the Pain Squad app to patients over a 6-month implementation period. After the implementation period, we conducted audiorecorded, semistructured interviews with nurse champions to investigate the facilitators and barriers related to nurses' experiences with implementing Pain Squad. Results: The facilitators and barriers to Pain Squad implementation were organized into four overarching Consolidated Framework for Implementation Research (CFIR)-related themes: (a) characteristics of the Pain Squad app; (b) clinic setting and its context; (c) nurse implementation champions; and (d) the process of implementing Pain Squad into clinical practice. Conclusions: Interviewed nurses believed Pain Squad had the potential to improve child cancer pain care, but barriers to everyday use were evident, described in relation to the internal setting, especially the lack of compatibility between app prescription and current nurse workflows. The use of CFIR to map identified implementation facilitators and barriers can formally support the recognition of factors that may boost the chances of successful uptake.

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CiteScore
3.30
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