摘要：

<td colspan="2" class="item-title">Eliciting Patient Related Barriers to Pain Management by Questionnaire Versus Interview <tr class="item-sponsor"><td class="label">Conference Sponsor:<td class="value">Midwest Nursing Research Society<tr class="item-year"><td class="label">Conference Year:<td class="value">2004<tr class="item-author"><td class="label">Author:<td class="value">Ezenwa, Miriam, BSN, RN<tr class="item-address"><td class="label">Contact Address:<td class="value">SON, 600 Highland Ave, K6/393 CSC, Madison, WI, 53792, USA<tr class="item-co-authors"><td class="label">Co-Authors:<td class="value">Suzanne Ameringer, MSN, RN, Doctoral Student; KoKung Kevin Wang, MS; Susan Hughes, MSN, RN, Research Coordinator; Ron Serlin, PhD, Professor; Sandra E. Ward, PhD, RN, FAAN, Professor<td colspan="2" class="item-">Eight attitudinal barriers (concerns about addiction, fatalism, tolerance, monitoring, complaining, distracting, immune function and side effects) to cancer pain management have been identified and shown to have a negative impact on analgesic use, pain severity, and quality of life. Traditionally these barriers have been elicited by patients' self-report on a questionnaire (the Barriers Questionnaire-II) (BQ-II), but we have wondered if they could as readily be elicited by open-ended interview. Framework. The parent study providing the data was guided by a theory of patient education called The Representational Approach to Patient Education (REP), in which open-ended interviews are used to ascertain subjects' cognitive representations of health problems in order to subsequently provide educational information that is individualized to their situations. Subjects. 52 adults with cancer, mean (SD) age 57.63 (12.71), who were subjects in the intervention arm of a randomized trial of REP. Method. At baseline subjects completed the BQ-II, a measure of 8 barriers to pain management. For this analysis, responses were dichotomized (present/absent) for each barrier. During the open-ended interview nurses noted whether the interview elicited spontaneous mention of each barrier. Results. The McNemar test compared the proportion of subjects from whom each barrier was elicited by BQ-II versus interview. In all barriers except tolerance, the methods differed significantly. For side effects the interview was better, whereas for the remaining barriers the BQ-II was more effective. Percent agreement ranged from 20% to 69%. Implications. High agreement between the methods had been expected, but instead the BQ-II uncovered more barriers than the interview with poor to moderate agreement between the methods. The BQ-II may elicit general beliefs about pain management, while the interview draws out barriers that are specific to an individual's experience. Further study is needed to explain this difference and to determine its significance for the REP.

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