Our long-term goal is to first assess and ultimately manage pain after lung cancer surgery using computer technologies to minimize pain assessment barriers and thereby support clinical pain management processes. The first step in assuring high quality pain management is appropriate pain assessment. However, the barriers to pain assessment are among the causes for unrelieved pain. The lack of time-efficient comprehensive pain assessment tools and patients' difficulties in completing the tools are among the most known barriers to assessing pain in Turkey. Recent studies show that Americans are able to use computers to report their pain. A computerized format for pain assessment called PAINReportIt, published in 2003, is the first interactive software extension of the 1970 McGill Pain Questionnaire. This innovative method can provide pain measurement items to responders in serial display screens accompanied by pop-up screens. It has been tested in English-, Spanish-, and Mandarin Chinese-speaking adults, but it has not been tested among Turkish- speaking adults. Furthermore, there are not any tablet-based pain assessment tools being used in hospitals or clinics in Turkey. Therefore, to establish our potential for collaboration, we used a committee approach with 3 bilingual translators to independently translate PAINReportIt from English to Turkish, reconcile differences, and agree on an integrated version. We now propose a three-component study to validate and facilitate implementation of the Turkish- PAINReportIt in Turkey: (1) a qualitative study to assess patients' interpretation of the Turkish-PAINReportIt items and instructions among 20 Turkish lung cancer outpatients who will participate in cognitive (think-aloud) interviews to validate the Turkish-PAINReportIt, (2) an 8-member focus group with lung cancer surgeons and surgical nurses to discuss the issues and benefits they would anticipate if the Turkish-PAINReportIt were implemented in research studies and cancer care, and (3) a longitudinal study to profile post-thoracotomy pain recovery among 80 Turkish lung cancer patients who will be asked to complete the tool on an Internet-enabled tablet daily on postoperative days 1 to 4 and at their 2-week postoperative follow-up visit. Patients will complete a usability and acceptability questionnaire to share their opinions about using Turkish-PAINReportIt to report their pain.
The specific aims are to (1) describe the meanings attributed to the Turkish-PAINReportIt items and instructions by Turkish patients who are post- thoracotomy for lung cancer treatment, (2) identify the technical and human (patient, nurse, and physician) factors that could be barriers or facilitators to use the Turkish-PAINReportIt, (3) characterize the pain (location, intensity, quality, pattern) they experience longitudinally after surgery when pain is expected to decrease as their recovery progresses. We expect to discover barriers that can be addressed and facilitators for successful adoption in cancer research and practice in Turkey. Successful use of the tablet-based pain tool could lead to improved pain control for the Turkish people diagnosed annually with lung and other cancers.
An innovative tablet-based pain assessment program has been tested in English-, Spanish-, and Mandarin Chinese-speaking adults, but it has not been tested among Turkish-speaking adults, who have no current access to any tablet-based pain assessment tools in hospitals or clinics in Turkey despite plans for wireless access there in the near future. We propose to help transfer such technology by validating the Turkish- PAINReportIt in a study of patients with lung cancer pain from their lung surgery. We expect to discover some barriers that can be addressed and facilitators for successful implementation of this technology in cancer research and practice in Turkey. Successful use of the tablet-based pain assessment tool could lead to improved pain control for the 100,000 Turkish people diagnosed annually with cancer, especially the 30,000 diagnosed with lung cancer.
