| Summary: | 碩士 === 國立中山大學 === 醫務管理研究所 === 95 === Pain is experienced in 30-50% of cancer patients during active antineoplastic
therapy and in 60-90% of patients with advanced cancer. One of the root causes for inadequate medication is inadequate pain assessment. Therefore, a hospital-based quasi-experimental study was implemented to evaluate the effect of a continuing education and institutionalization program（CEI）on nurses’ cancer pain assessment. There were 57 frequency-matched patient-nurse dyads were interviewed by the structured questionnaire at three different stages (pre-test, post-continuing education and post- institutionalization ). After these 171 patients were discharged, their charts were reviewed and abstracted. Chi-square test and ANOVA were used in the statistical analysis. The results showed that CE only made statistically significant improvement on patients’ pain impact of relationship, pain impact of sleep, satisfaction, and hesitancy to report pain. Additionally, institutionalization made significant improvement on patient’s now pain and average pain severity, nurses’ accurate assessment of patient’s pain ratings of mild pain and expected pain, and documentation of pain assessment. In conclusion, CE and institutionalization of cancer pain assessment were effective in cancer pain management in two different fields, one was the improvement of patient’ pain severity and satisfaction and the other was the improvement of nurse’s practices of cancer pain assessment. Quality comes from improving the process , not evaluating the output after fact. The suggestion was that the head nurse of the ward audited actively on unit and rewards for chart documentation. The management of good quality required the good administrator. To whom persisted endless of quality improvement , they can study the further analysis and comparison within five years after institutionalization.
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