Improving cancer pain management by homecare nurses.

PURPOSE/OBJECTIVES: To demonstrate the effects of a program, directed at homecare nurses, of structured educational interventions on the management of pain and opioid-related side effects in homecare patients with cancer.

DESIGN: A longitudinal multilevel, randomized, controlled clinical trial.

SETTING: Midwestern region in the United States.

SAMPLE: 202 nurses caring for patients with cancer recruited from homecare agencies.

METHODS: The two-tiered educational program focused on basic and advanced pain management strategies, particularly in the area of pharmacologic options and assertive communication skills. Instruments used were the Nurses' Knowledge and Attitudes Survey Regarding Pain, the barriers questionnaire, perception of control over pain, and a demographic questionnaire.

MAIN RESEARCH VARIABLES: Knowledge and attitudes about pain management, barriers to pain management, and perception of control over pain.

FINDINGS: Nurses in the intervention group had a significant increase in their knowledge, a more positive attitude about pain management, fewer perceived barriers to pain management, and an increase in perceived control over pain compared to the nurses who did not receive the intervention.

CONCLUSIONS: The educational program Power Over Pain has beneficial effects for homecare nurses caring for patients with cancer pain.

IMPLICATIONS FOR NURSING: A need exists for homecare nurses to gain more insight into pain management strategies and enhance their advocacy skills to improve pain management for patients with cancer treated in the home.