Background Standardized pain-intensity measurement across different tools would enable practitioners to have confidence in clinical decision-making for pain management. Objectives The purpose was to examine the degree of agreement among unidimensional pain scales, and to determine the accuracy of the multidimensional pain scales in the diagnosis of severe pain. Methods A secondary analysis was performed. The sample included a convenience sample of 480 cancer patients recruited from both the internet and community settings. Cancer pain was measured using the Verbal Descriptor Scale (VDS), the Visual Analog Scale (VAS), the Faces Pain Scale (FPS), the McGill Pain Questionnaire-Short Form (MPQ-SF) and the Brief Pain Inventory-Short Form (BPI-SF). Data were analyzed using a multivariate analysis of variance (MANOVA) and a receiver operating characteristics (ROC) curve. Results The agreement between the VDS and VAS was 77.25%, while the agreement was 71.88% and 71.60% between the VDS and FPS, and VAS and FPS, respectively. The MPQ-SF and BPI-SF yielded high accuracy in the diagnosis of severe pain. Cutoff points for severe pain were > 8 for the MPQ-SF and > 14 for the BPI-SF, which exhibited high sensitivity and relatively low specificity. Conclusion The study found substantial agreement between the unidimensional pain scales, and high accuracy of the MPQ-SF and the BPI-SF in the diagnosis of severe pain. Implications for Practice Use of one or more pain screening tools that have been validated diagnostic accuracy and consistency will help classify pain effectively and subsequently promote optimal pain control in multi-ethnic groups of cancer patients.
The purpose of this study was to determine racial/ethnic differences in midlife women's sleep-related symptoms, relationships between their physical activity and sleep-related symptoms, and specific factors associated with their sleep-related symptoms in each racial/ethnic group. This was a secondary analysis of the data from 542 midlife women in the United States. The data were analyzed using descriptive statistics, χ tests, analysis of variance, hierarchical multiple linear regression analyses, and logistic regression analyses. The findings indicated that physical activities could improve midlife women's sleep-related symptoms, but the types of physical activities and racially/ethnically different factors associated with sleep-related symptoms need to be considered.
Simulation is commonly used in nursing education to teach clinical skills. Here, we describe the development processes, implementation, and evaluation of an epidemiology simulation used in a community and public health nursing undergraduate clinical course at the University of Pennsylvania. The simulation was designed to teach students the principles and concepts of outbreak investigation and was based on the 2003 Severe Acute Respiratory Syndrome outbreak in Toronto, Canada. The simulation places students in the role of a public health nurse in the outbreak investigation team, working in groups of five to seven students to complete analyses and make recommendations under time and information constraints. Since piloting in spring 2014, we have run the simulation three times (summer and fall 2014 and summer 2015). Student evaluations show high levels of engagement and interest and substantial increase in the skills and expertise required in an outbreak investigation. We share key lessons learned, including resources required for simulation development and delivery, revisions to the simulation format and content in response to student feedback, and transferability and sustainability of the simulation. Overall, simulation was a feasible and effective modality to teach epidemiology and should be considered in community and public health nursing courses.
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