DEVELOPMENT &TESTING OF AN INSTRUMENT TO ASSESS PAIN

University Of Miami Coral Gables, Coral Gables FL

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Abstract

The long-term objective of this study is to improve nurses' pain assessment practices in adults from diverse cultural and socioeconomic backgrounds who are experiencing all types of pain. In order to achieve this broad objective, the primary aim of this study is to further develop an empirically-derived pain assessment instrument that is psychometrically sound and sensitive to needs and preferences of this vulnerable population. Previous research suggests that, although pain is a health problem in its own right, it is also the most poorly managed. This may be partially attributable to the absence of a standardized approach to pain assessment which, in turn, may be the result of a lack of appropriate tools for multidimensional pain assessment. In a Clinical context, an assessment tool that is comprehensive, yet short and simple, is essential for the acquisition of data to direct pain relief interventions. Typically, the numbers of instruments that have been developed as part of pain research are unidimensional, and actually measure, rather than assess, pain. Moreover the few multidimensional pain assessment instruments that are routinely used in pain research have either been developed on or used with homogeneous populations, lack psychometric evidence of validity and reliability in heterogeneous pain populations, or lack clinical utility due to length and1or complexity. Additionally, these instruments have been developed utilizing a deductive approach that, while an accepted method of item generation, may not capture the subjective nature of the phenomenon of pain. The pain assessment instrument refined and tested in this study was initially developed utilizing an inductive approach of grounded theory technique. The present study will employ focus group methodology for refinement of instrument items in order to establish content validity. The focus groups will represent a cross-section of a total of 30 Black, White and Hispanic adult males and females who are currently experiencing pain problems representative of acute, chronic and cancer pain in 4 South Florida hospitals. The refined pain assessment instrument will then be administered to a heterogeneous random pain sample of 200 Black, White and Hispanic adult males and females in the same 4 South Florida hospital settings. Data collected will include the following domains of information in addition to pain assessment: 1) social-psychological factors including anxiety (Spielberger's State Anxiety Scale) and depression (Beck Depression Inventory 11), and 2) broad socioeconomic and demographic factors. All instruments will be self-administered following verbal instructions from the P.I. The scope of the data collection instruments will provide a unique opportunity to assess the concurrent validity of the new pain assessment instrument. An exploratory factor analysis will be conducted to assess the instrument's construct validity.