Date of Completion

4-19-2018

Embargo Period

4-18-2018

Keywords

pain management, life history calendar, pain communication

Major Advisor

Dr. Deborah D. McDonald

Associate Advisor

Dr. E. Carol Polifroni

Associate Advisor

Dr. Juliette M. Shellman

Field of Study

Nursing

Degree

Doctor of Philosophy

Open Access

Open Access

Abstract

The purpose of this study was to develop and test a computerized pain management life history calendar (PMLHC) for use with older adults with osteoarthritis. A two-phase, descriptive research design was used to test the instrument for clinical and research applications. In Phase 1 focus groups, providers (N = 10) shared their thoughts of a mockup PMLHC output. During Phase 2, community dwelling older adults (N = 24) self-administered a PMLHC and were interviewed. An iterative process was used to refine the instrument using feedback from participants and researcher observations.

Content analysis on transcripts of audio-recordings from focus group discussions and individual interviews used a priori coding categories of positive, negative, supportive and non-supportive comments of feasibility and acceptability, and ideas for improvement. A descriptive examination was completed of older adults’ PMLHCs (e.g. when treatments began, duration of treatments, and timing of changes including outcomes for treatments). Content accuracy was examined for the final version with a subset of 12 older adults.

Providers supported a future version integrated with electronic health records, although results indicated the current version was unacceptable. Due to error rates, the self-administered PMLHC was deemed not yet feasible. Additionally, older adults reported that filling out the PMLHC was a self-reflective activity that helped them think about their pain self-management. Future work should explore the self-reflection potential of the PMLHC. With further development, the PMLHC has the potential to enhance communication about past pain management strategies and assist to identify tailored pain treatment regimens.

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