Measuring the Quality of Care Related to Pain Management

A Multiple-Method Approach to Instrument Development

A new approach to measuring pain management enhances methods for examining the effects of nursing on patient outcomes and can improve understanding of how nurses make a difference in the lives of individuals with pain.

Multiple studies reveal that pain is managed inadequately in hospitalized patients. Research to document the effects of nursing on pain has been limited by the inability to measure the quality of care effectively. This study aims to develop a short, reliable and valid measure of nursing care quality related to pain management to be administered to inpatients at the end of each shift. The authors used a three-phase process to establish content validity and evaluate patient understanding of survey items for their Pain Care Quality (PainCQ) instrument.

Key Findings:

  • Phase I: 101 items representing four constructs were generated from the transcriptions of 33 qualitative interviews conducted with cancer patients in pain.
  • Phase II: Two panels of pain experts reviewed items. Validity was established if 8 of 9 experts agreed the item was relevant.
  • Phase III: Cognitive interviews were conducted with 39 hospitalized cancer patients reporting pain to evaluate response processes.

Forty-four items were retained in the PainCQ that were understood and judged easily by hospitalized patients with pain. The result is an instrument that can be used for both clinical and research purposes. Further research on how various constructs measured by the PainCQ affect pain outcomes is recommended.

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