The Program for the Study of Health Care Relationships funded 11 researchers in CT to study various aspects of health care relationships and adherence. The individuals listed below each received grants for one year (2001-02). They were awarded funds on the basis of a competitive review process and the scientific merit of their proposals. The wide range of disciplines they represent and their research interests demonstrated the diversity and complexity inherent in studying health care relationships.

• Development of an Instrument to Measure Patients' Trust of Health Care Providers
• Exploration of the Effect of Nausea, Self-Efficacy, and Health Care Relationships on Medication Adherence in HIV/AIDS Patients
• Advance Care Planning: A Team Approach
• Assisting Older Adults To Communicate Their Pain After Surgery
• The Effect of a Specialized RN Intervention Designed to Maximize Patient-Provider Relationships on Adherence to Anti-Depressant Medication
• Pilot Study of Rapid Electronic Adherence Reporting with Provider Feedback on Adherence to Antiretroviral Therapy (HCR 01-12)
• Development of a Measure of Family Management of Childhood Chronic Illness
• The Contribution of Health Care Professionals to Parent and Child Self-Management of Type 1 Diabetes
• Enhancing Treatment Access and Adherence among Women of Hispanic Origin: The Roles of Relationships and Cultural Responsiveness in Behavioral Health Care
• Elicitation of Patient with Adaptive Conjoint Analysis

Assisting Older Adults To Communicate Their Pain After Surgery

Deborah Dillon McDonald, Glenda Thomas, Karen Livingston, & Judith Severson

Problem
To assess the pain relief effect of an intervention assisting elders' to communicate their pain.

Design
A posttest-only two-group experiment was used.

Sample
Forty preoperative single total knee arthroplasty elders were randomly assigned to either a control group where elders watched a 10-minute videotape on managing postoperative pain or a treatment group where elders watched a 15-minute videotape on managing postoperative pain and communicating pain management needs.

Methods
A research assistant measured the elders' postoperative pain on postoperative day one and two, and one and seven days after hospital discharge using the Brief Pain Inventory. Measures included pain intensity; pain interference with walking, mood, and sleep; and pain relief. The most recently administered analgesics expected to have a therapeutic effect were converted to an equianalgesic morphine dose.

Findings
Both groups reported moderate pain intensity during postoperative day one and two. Treatment group elders reported less pain interference with sleep postoperative day one, M = 3.6 (SD = 2.64) compared to control group elders M = 6.4 (SD = 3.46), F(1,38) = 8.39, p < .006, Eta2 = .18.

Conclusion
The pain communication intervention had modest, but significant effects on reducing pain interference with sleep during the early postoperative period. Implications: Greater pain relief might be achieved when both older adults and their healthcare providers are more knowledgeable about pain management and pain communication.

Copyright 2003Yale University School of Nursing, Yale University, New Haven, CT 06536All Rights Reserved