Research tools:
KSA questionnaires: (Appendices A +B) The purpose was to examine the effectiveness of the educational intervention among the physicians participating in the study. The Likert-type scale9 was used to assess physician reflection on the process. Satisfaction Scale ranged from: 1 = strongly Disagree, 2 = Disagree, 3 = Disagree to a certain extent, 4 = Agree to a certain extent, 5 = Agree, 6 = strongly agree.
The physicians were asked to indicate the extent of their agreement with the range of statements regarding their satisfaction with the department’s conduct and their personal conduct in dealing with a painful patient.
Part B was a Likert-type modified ”KnowPain50” [KP50] questionnaire10. The KP50 helps to assess the level of knowledge and approach of physicians to pain management. By using this tool, it became possible to assess the gaps in the level of professional knowledge, the general approach to pain and how it should be treated.
KP50 modified knowledge questionnaire, included 15 selected questions that were found to be most relevant to internal medicine physician, from the original KP50 questionnaire.
Intervention tools :
The intervention tool was the educational intervention that included the following:
1. Pain Relief Protocol (Appendix C) –This Protocol was a pocket pamphlet distributed to all physicians in the department. It was based on the drug availability from the hospital’s pharmacy. In the protocol, treatment was divided according to three levels of pain: mild, moderate and severe, each of which were categorized into acute and chronic treatment (”Chronic” referred to pain relief treatment administrated around the clock during the patient’s stay in the department). In addition, the protocol included a section regarding neuropathic pain, an opiate conversion table and their possible side effects.
2. Weekly training sessions (Appendix D) - 10 sessions of 90 minutes each. These ssions included a general approach to the painful patient, familiarity with the common types of pain encountered by physicians within the internal department and the pharmacology of pain medications. Emphasis was placed on drug therapy in the internal medicine department for common conditions such as oncological, musculoskeletal, visceral pain etc.