Kennedy Nkhoma1, Jane Seymour2, Antony Arthur3. 1. Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, Division of Nursing, Queen's Medical Centre, Nottingham, United Kingdom. 2. Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, Division of Nursing, Queen's Medical Centre, Nottingham, United Kingdom. Electronic address: jane.seymour@nottingham.ac.uk. 3. School of Health Sciences, University of East Anglia, Norwich, United Kingdom.
Abstract
CONTEXT: Advances being made in improving access to HIV drugs in resource-poor countries mean HIV patients are living longer, and, therefore, experiencing pain over a longer period of time. There is a need to provide effective interventions for alleviating and managing pain. OBJECTIVES: To assess whether a pain educational intervention compared with usual care reduces pain severity and improves pain management in patients with HIV/AIDS and their family carers. METHODS: This was a randomized, parallel group, superiority trial conducted at HIV and palliative care clinics of two public hospitals in Malawi. A total of 182 adults with HIV/AIDS (Stage III or IV) and their family carers participated; carer participants were those individuals most involved in the patient's unpaid care. The educational intervention comprised a 30 minute face-to-face meeting, a leaflet, and a follow-up telephone call at two weeks. The content of the educational intervention covered definition, causes, and characteristics of pain in HIV/AIDS; beliefs and myths about pain and pain medication; assessment of pain; and pharmacological and nonpharmacological management. The primary outcome was average pain severity measured by the Brief Pain Inventory-Pain Severity subscale. Assessments were recorded at baseline before randomization and at eight weeks after randomization. RESULTS: Of the 182 patient/carer dyads randomly allocated, 157 patient/carer dyads completed the trial. Patients in the intervention group experienced a greater decrease in pain severity (mean difference = 21.09 points, 95% confidence interval = 16.56-25.63; P < 0.001). CONCLUSION: A short pain education intervention is effective in reducing pain and improving pain management for Malawian people living with HIV/AIDS and their family carers.
RCT Entities:
CONTEXT: Advances being made in improving access to HIV drugs in resource-poor countries mean HIVpatients are living longer, and, therefore, experiencing pain over a longer period of time. There is a need to provide effective interventions for alleviating and managing pain. OBJECTIVES: To assess whether a pain educational intervention compared with usual care reduces pain severity and improves pain management in patients with HIV/AIDS and their family carers. METHODS: This was a randomized, parallel group, superiority trial conducted at HIV and palliative care clinics of two public hospitals in Malawi. A total of 182 adults with HIV/AIDS (Stage III or IV) and their family carers participated; carer participants were those individuals most involved in the patient's unpaid care. The educational intervention comprised a 30 minute face-to-face meeting, a leaflet, and a follow-up telephone call at two weeks. The content of the educational intervention covered definition, causes, and characteristics of pain in HIV/AIDS; beliefs and myths about pain and pain medication; assessment of pain; and pharmacological and nonpharmacological management. The primary outcome was average pain severity measured by the Brief Pain Inventory-Pain Severity subscale. Assessments were recorded at baseline before randomization and at eight weeks after randomization. RESULTS: Of the 182 patient/carer dyads randomly allocated, 157 patient/carer dyads completed the trial. Patients in the intervention group experienced a greater decrease in pain severity (mean difference = 21.09 points, 95% confidence interval = 16.56-25.63; P < 0.001). CONCLUSION: A short pain education intervention is effective in reducing pain and improving pain management for Malawian people living with HIV/AIDS and their family carers.
Authors: Samuel Ojima Adejoh; Florien Boele; David Akeju; Adlight Dandadzi; Elizabeth Nabirye; Eve Namisango; Elizabeth Namukwaya; Bassey Ebenso; Kennedy Nkhoma; Matthew J Allsop Journal: Palliat Med Date: 2020-12-23 Impact factor: 4.762