Pain is a frequently reported symptom among persons with HIV/AIDS. Despite this many such patients receive insufficient pain relief. Poor pain management is a complex problem involving interactions among three parties: the health care system, the health care provider and the patient. The proposed intervention is designed to address one important set of barriers: patients' lack of and/or misinformation about pain and its treatment, and inadequate pain communication skills. The research will test the impact of a patient """"""""activation"""""""" intervention that seeks to increase patient involvement in their care by improving their knowledge of and communication skills about pain and its treatment. The study will feature a stratified, randomized experimental design in which 320 HIV/AIDS patients who have been experiencing pain over the prior two weeks will be assigned to one of 4 different treatment arms: 1) standard care; 2) attention placebo; 3) a one time exposure to the experimental intervention; and 4) a two-time exposure to the experimental intervention. Participants will be assessed at the clinic visit just prior to seeing their primary care provider (""""""""baseline""""""""), then randomized into one of the study arms. They will be assessed again immediately after their provider encounter and at one month and 6 months post-baseline to determine the long-term effects. The impact of the intervention will be examined in 3 different types of health providers -- nurse practitioners, physician's assistants, and primary care physicians at 2 different ambulatory health care settings. Outcomes to be assessed include patient-reported satisfaction with care, involvement in medical decision making, level of provider-patient communication, health-related quality of life, distress, perceived self-efficacy, and adequacy of pain management.
| Newshan, Gayle; Bennett, JoAnne; Holman, Susan (2002) Pain and other symptoms in ambulatory HIV patients in the age of highly active antiretroviral therapy. J Assoc Nurses AIDS Care 13:78-83 |
