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Feasibility of e-Pain Reporter

A Digital Pain Management Tool for Informal Caregivers in Home Hospice

Mayahara, Masako, PhD, RN, CHPN, FPCN; Wilbur, Joellen, PhD, RN, FAAN; Fogg, Louis, PhD; Breitenstein, Susan M., PhD, RN, FAAN; Miller, Arlene Michaels, PhD, RN, FAAN

Journal of Hospice & Palliative Nursing: June 2019 - Volume 21 - Issue 3 - p 193–199
doi: 10.1097/NJH.0000000000000548
Symptom Management Series
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Informal hospice caregivers often have difficulty managing patient pain at home. We developed a digital application, e-Pain Reporter, for informal caregivers to record and providers to monitor patient pain and pain management. The purpose of this study was (1) to assess the feasibility of informal caregivers using the e-Pain Reporter for 9 days in home hospice by investigating recruitment and retention and caregiver satisfaction with and frequency of use of the e-Pain Reporter and (2) describe patient pain characteristics and caregiver’s barriers to pain management and self-efficacy in providing patient care in the home. One-group pre-post design was used. Patient-caregiver dyads were recruited from 1 hospice agency. Caregivers were asked to report all patient pain and pain management using the e-Pain Reporter. Feasibility of the e-Pain Reporter was assessed by the average number of times caregivers recorded breakthrough and daily pain and caregiver satisfaction with the app. The 27-item Barriers Questionnaire II and 21-item Caregiver Self-efficacy Scale were administered at baseline. Fourteen dyads enrolled, 2 patients died, and 12 dyads completed the study. Mean number of pain reports over 9 days was 10.5. Caregivers reported high overall satisfaction with the e-Pain Reporter. Barriers scores were moderately high, suggesting erroneous beliefs and misconceptions about pain reporting and use of analgesics, but self-efficacy in managing pain was also high (93% confidence). Findings suggest that the e-Pain Reporter is a feasible method to report and monitor caregiver management of pain at home. Caregiver high barriers and high overconfidence suggest the need for an educational component to the e-Pain Reporter to address misconceptions about pain and pain management.

Masako Mayahara, PhD, RN, CHPN, FPCN, is assistant professor, Department of Community, Systems and Mental Health, Rush University College of Nursing, Chicago, Illinois.

Joellen Wilbur PhD, RN, FAAN, is professor and independence foundation chair in nursing associate dean for research, Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, Illinois.

Louis Fogg, PhD, is associate professor, Department of Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois.

Susan M. Breitenstein, PhD, RN, FAAN, is associate professor, director, Community Outreach and Engagement, Ohio State University College of Nursing, Columbus.

Arlene Michaels Miller, PhD, RN, FAAN, is professor, Department of Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois.

The authors have no conflicts of interest to disclose.

Address correspondence to Masako Mayahara, PhD, RN, CHPN, Department of Community Systems and Mental Health Nursing, Rush University College of Nursing, 600 S. Paulina, Suite 1063, Chicago, IL 60612 (masako_mayahara@rush.edu).

© 2019 by The Hospice and Palliative Nurses Association.