THE RELATIONSHIP OF STAFF EMPATHY, PERSONAL PAIN HISTORY, BURNOUT AND PATIENT SATISFACTION WITH CARE TO HEALTH CARE PROFESSIONAL'S PERCEPTION OF CANCER PATIENT'S PAIN INTENSITY.
Contributors: New York University.
Published: 1995
Subjects: Psychology, Industrial.; Health Sciences, Nursing.
Description: Prior research has identified the multifactorial barriers to adequate pain management including inaccurate assessment of cancer patient pain. To better understand the variables affecting the Physician's and Nurse's estimation of cancer patient's pain intensity this study sought to determine the contribution of knowledge of effective cancer pain management, personal pain history, empathy and burnout levels, number of years experience in treating cancer patients and patient satisfaction with care to concordance between Health Care Professionals (HCP) rating of patient pain intensity and oncology patients independent rating of pain intensity. On the day of a clinic or hospital room visit HCPs (N = 61) rated the pain of three patients under their care who they knew from a prior visit were experiencing pain. A total of one hundred and eighty three (N = 183) inpatients and outpatients, the majority of whom had metastatic disease, were assessed with the following measures the (1) Brief Pain Inventory, the (2) Medical Interview Satisfaction Scale and the (3) Sociodemographic Questionnaire. Within the month of rating three patients' pain HCPs were assessed with the following: (1) Human Services Survey, (2) Interpersonal Reactivity Index and (3) Cancer Pain Management Survey.

The study results demonstrate that HCP's at Memorial Sloan-Kettering Cancer Center (MSKCC) who volunteered to participate in this study were highly knowledgeable in effective cancer pain management, highly concordant in assessment of cancer patient's pain and were highly empathic and had low levels of burnout. This study did not obtain support for its hypotheses in the form of significant associations between concordance and the above named variables. Unexpectedly the present study found a high rate of concordance in HCPs' estimation of patients' pain intensity: 90% of HCPs' pain scores were within two points of the respective patients score. The Pain Management Index indicated that the percentage of patients with adequate analgesia was 76.9% and those with inadequate analgesia was 25.9%.

The study results, to some extent, reflect the institutional priority that has been given to addressing cancer patient's pain. The present study found a high overall correlation between patient and HCP ratings of patients pain intensity. (r =.50, p =.0001) and a statistically significant correlation between HCPs' rating of patients pain and patients (n = 118) with moderate to severe pain ($\ge$4), r =.19, p =.05. Moreover, the present study found that HCPs significantly overestimated (49.5%) patient pain intensity, a finding that has never before been reported.

The unexpectedly high rate of concordance of HCP ratings of patients' pain intensity, HCPs' overestimation of patient pain at MSKCC and adequacy of pain management reflected by the PMI (77% adequate analgesia) might be due to the impact of institution wide pain management interventions with staff that were completed while the study was carried out. The findings suggest that systematic pain management interventions with staff may significantly improve assessment of cancer patients' pain intensity and its treatment.
Notes: Source: Dissertation Abstracts International, Volume: 56-11, Section: B, page: 6435.

Thesis (PH.D.)--NEW YORK UNIVERSITY, 1995.

School code: 0146.