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.