ID

41446

Description

Ferrell, B. R., Eberts, M. T., McCaffery, M., Grant, M.. (2012) . The Clinical Decision Making Survey (CDMS) . Measurement Instrument Database for the Social Science. Retrieved 10.10.2020, from www.midss.ie Key references: Ferrell, B. R., Eberts, M. T., McCaffery, M., Grant, M. (1991). Clinical decision making and pain. Cancer Nurs. 1991 Dec;14(6):289-97. Primary use / Purpose: The Clinical Decision Making Survey (CDMS) is a 14-item survey. Its purpose is to obtain information from nurses relating to their decision making processes when they are dealing with patients who are experiencing pain. Background: Nurses are forced to make difficult decisions when presented with patients who are experiencing pain. Ethical dilemmas can also arise around issues such over-medication, under-medication, and opioid side effects to name a few. It is important to gain an understanding of how nurses make these decisions so that more insight can be gained into the factors influencing those decision making processes. Digital Object Identifier (DOI): http://dx.doi.org/10.13072/midss.329

Link

www.midss.ie

Keywords

Versions (1)
  1. 10/11/20 10/11/20 -
Copyright Holder

Ferrell, B. R., Eberts, M. T., McCaffery, M., Grant, M.

Uploaded on

October 11, 2020

DOI

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License

Creative Commons BY 4.0
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Measurement Instrument Database for the Social Science (MIDSS)

English

The Clinical Decision Making Survey (CDMS)

1 forms  
Dear Colleague: Thank you for agreeing to participate in our study of Clinical Decision Making Regarding Pain Management. This is a new area of investigation and we appreciate your efforts in adding to this important area of nursing. We are asking you to do two things: 1. Identify a patient that you are caring for who has a problem of pain. This should be a patient for whom you are providing direct nursing care, for example as primary nurse for a shift or for a home visit. Care for the patient as you normally would but try to remember your interventions related to the patient’s pain. 2. Within 24 hours of your caring for this patient, please complete the questionnaire in the enclosed envelope. Some of these questions may not apply to your patient interaction but please answer as best you can. The survey is anonymous and we ask that you do not identify yourself or the patient by name. We anticipate that it will require approximately 15-20 minutes of your time. Thank you in advance for your assistance and your thoughtful responses. Think about your interaction with this patient in pain:
Description

Dear Colleague: Thank you for agreeing to participate in our study of Clinical Decision Making Regarding Pain Management. This is a new area of investigation and we appreciate your efforts in adding to this important area of nursing. We are asking you to do two things: 1. Identify a patient that you are caring for who has a problem of pain. This should be a patient for whom you are providing direct nursing care, for example as primary nurse for a shift or for a home visit. Care for the patient as you normally would but try to remember your interventions related to the patient’s pain. 2. Within 24 hours of your caring for this patient, please complete the questionnaire in the enclosed envelope. Some of these questions may not apply to your patient interaction but please answer as best you can. The survey is anonymous and we ask that you do not identify yourself or the patient by name. We anticipate that it will require approximately 15-20 minutes of your time. Thank you in advance for your assistance and your thoughtful responses. Think about your interaction with this patient in pain:

1. How did you assess/determine the patient’s intensity of pain (how much pain he/she had)? Check all that apply
Description

1. How did you assess/determine the patient’s intensity of pain (how much pain he/she had)? Check all that apply

Alias
UMLS CUI-1
C1320357
UMLS CUI-2
C2911685
1.1.1 Observing the patient's activity/mobility.
Description

Pain intensity (observable entity), Evaluation Method, Activity or Mobility

Data type

boolean

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C0547136
1.1.2 What did you observe?
Description

Pain intensity (observable entity), Evaluation Method, Activity or Mobility

Data type

text

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C0547136
1.2.1 Observing the patient’s behaviors.
Description

Pain intensity (observable entity), Evaluation Method, Behavior

Data type

boolean

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C0004927
1.2.2 What did you observe?
Description

Pain intensity (observable entity), Evaluation Method, Behavior

Data type

text

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C0004927
1.3 Asking the patient how much pain he/she had.
Description

Pain intensity (observable entity), Evaluation Method, patient interview

Data type

boolean

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C0683518
1.4 Relied on information from the physicians notes of medical records.
Description

Pain intensity (observable entity), Evaluation Method, Medical Records

Data type

boolean

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C0025102
1.5 Relied on verbal information from other nurses.
Description

Pain intensity (observable entity), Evaluation Method, Verbal information

Data type

boolean

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C1549471
1.6 Relied on written information from the nursing documentation.
Description

Pain intensity (observable entity), Evaluation Method, Written Documentation

Data type

boolean

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C3272241
1.7.1 Other
Description

Pain intensity (observable entity), Evaluation Method, Other

Data type

boolean

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C0205394
1.7.2 Describe
Description

Pain intensity (observable entity), Evaluation Method, Other

Data type

text

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C0205394
1.8 Please look over each of your answers to Question 1. Please star* the one answer that you believe most influenced your assessment of the patient’s pain.
Description

Pain intensity (observable entity), Evaluation Method

Data type

text

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C2911685
2. Did you ask the patient questions about his/her pain?
Description

2. Did you ask the patient questions about his/her pain?

Alias
UMLS CUI-1
C0030193
UMLS CUI-2
C1522634
2.1 Did you ask the patient questions about his/her pain?
Description

Pain, Question (Inquiry)

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C1522634
2.2 If yes, please list the questions you asked and the patient’s responses.
Description

Pain, Question (Inquiry), Answer, Response (communication)

Data type

text

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C1522634
UMLS CUI [1,3]
C2911692
3. Did you use any type of pain intensity/pain relief measure such as a pain rating scale to measure the patient’s pain?
Description

3. Did you use any type of pain intensity/pain relief measure such as a pain rating scale to measure the patient’s pain?

Alias
UMLS CUI-1
C1320357
UMLS CUI-2
C0681889
UMLS CUI-3
C0451615
UMLS CUI-4
C0681889
3.1 Did you use any type of pain intensity/pain relief measure such as a pain rating scale to measure the patient’s pain? If yes, please describe the measure and the patient’s score or rating on that measure
Description

Pain intensity (observable entity), rating scale; Pain relief, rating scale

Data type

boolean

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C0681889
UMLS CUI [2,1]
C0451615
UMLS CUI [2,2]
C0681889
3.2 Measure
Description

Pain intensity (observable entity), rating scale; Pain relief, rating scale

Data type

text

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C0681889
UMLS CUI [2,1]
C0451615
UMLS CUI [2,2]
C0681889
3.3 Number scale/from to (fill in numbers). Other scale/please describe:
Description

Pain intensity (observable entity), rating scale; Pain relief, rating scale

Data type

text

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C0681889
UMLS CUI [2,1]
C0451615
UMLS CUI [2,2]
C0681889
3.4 The patient’s score on the scale
Description

Pain intensity (observable entity), rating scale, Score; Pain relief, rating scale, Score

Data type

text

Alias
UMLS CUI [1,1]
C1320357
UMLS CUI [1,2]
C0681889
UMLS CUI [1,3]
C0449820
UMLS CUI [2,1]
C0451615
UMLS CUI [2,2]
C0681889
UMLS CUI [2,3]
C0449820
4. What pain medications were ordered for the patient? (drug, dose, route, frequency)
Description

4. What pain medications were ordered for the patient? (drug, dose, route, frequency)

Alias
UMLS CUI-1
C0002771
4.1 DRUG
Description

Analgesics

Data type

text

Alias
UMLS CUI [1]
C0002771
4.2 DOSE
Description

Analgesics, Dosage

Data type

text

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C0178602
4.3 ROUTE
Description

Analgesics, Drug Administration Routes

Data type

text

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C0013153
4.4 FREQ
Description

Analgesics, Frequencies (time pattern)

Data type

text

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C0439603
5. What pain medication did you give the patient today?
Description

5. What pain medication did you give the patient today?

Alias
UMLS CUI-1
C0002771
UMLS CUI-2
C0310367
5.1 DRUG
Description

Analgesics, Today

Data type

text

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C0310367
5.2 DOSE
Description

Analgesics, Today, Dosage

Data type

text

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C0310367
UMLS CUI [1,3]
C0178602
5.3 ROUTE
Description

Analgesics, Today, Drug Adminstration Routes

Data type

text

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C0310367
UMLS CUI [1,3]
C0013153
5.4 FREQ
Description

Analgesics, Today, Frequencies (time pattern)

Data type

text

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C0310367
UMLS CUI [1,3]
C0013153
6. If you gave medication, or encouraged the patient to take medication, other than exactly as ordered, please explain
Description

6. If you gave medication, or encouraged the patient to take medication, other than exactly as ordered, please explain

Alias
UMLS CUI-1
C0580105
6.1 Gave the med less frequently than ordered e.g. gave it on a prn basis rather than every 4 hours as ordered.
Description

Change of medication, Less often

Data type

boolean

Alias
UMLS CUI [1,1]
C0580105
UMLS CUI [1,2]
C3843156
6.2 Gave the med more frequently than ordered e.g. gave it q 3 hours instead of waiting q 4 hrs.
Description

Change of medication, Frequencies (time pattern), increase

Data type

boolean

Alias
UMLS CUI [1,1]
C0580105
UMLS CUI [1,2]
C0439603
UMLS CUI [1,3]
C0442805
6.3 Gave a medicine for the pain other than the pain medicine i.e. an antiemetic, sedative, sleeping pill, etc., ordered for another reason.
Description

Change of medication, Uses non-analgesic relief measures

Data type

boolean

Alias
UMLS CUI [1,1]
C0580105
UMLS CUI [1,2]
C0518065
7. Did you document your assessments, evaluations of the patient’s pain?
Description

7. Did you document your assessments, evaluations of the patient’s pain?

Alias
UMLS CUI-1
C0030193
UMLS CUI-2
C0220825
UMLS CUI-3
C0920316
7.1 Did you document your assessments, evaluations of the patient’s pain?
Description

Pain, Evaluation, Documentation

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0220825
UMLS CUI [1,3]
C0920316
7.2 If yes, where?
Description

Pain, Evaluation, Documentation, Place

Data type

text

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0220825
UMLS CUI [1,3]
C0920316
UMLS CUI [1,4]
C0442504
7.3 Other: explain
Description

Pain, Evaluation, Documentation, Place

Data type

text

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0220825
UMLS CUI [1,3]
C0920316
UMLS CUI [1,4]
C0442504
8. Did this patient have any written orders for non-drug interventions for pain? Check all that apply:
Description

8. Did this patient have any written orders for non-drug interventions for pain? Check all that apply:

Alias
UMLS CUI-1
C0030193
UMLS CUI-2
C0033082
UMLS CUI-3
C1705178
8.1 Medical Order
Description

Pain, Prescriptions, Non-drug, Order (action), Medical

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0033082
UMLS CUI [1,3]
C1705178
UMLS CUI [1,4]
C0205476
8.2 Nursing Order
Description

Pain, Prescriptions, Non-drug, Order (action), Nurses

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0033082
UMLS CUI [1,3]
C1705178
UMLS CUI [1,4]
C0028661
8.3 Actually Used
Description

Pain, Prescriptions, Non-drug, Usage

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0033082
UMLS CUI [1,3]
C0457083
8.4 Heating Pad
Description

Pain, Prescriptions, Non-drug, Heating Pads

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0033082
UMLS CUI [1,3]
C0181154
8.5 K pad
Description

Pain, Prescriptions, Non-drug, Heating/Cooling Pads, Circulating-Liquid

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0033082
UMLS CUI [1,3]
C0181440
8.6 Ice pack
Description

Pain, Prescriptions, Non-drug, Ice Bags

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0033082
UMLS CUI [1,3]
C0181264
8.7 TENS
Description

Pain, Prescriptions, Non-drug, Transcutaneous Electric Nerve Stimulation

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0033082
UMLS CUI [1,3]
C0040654
8.8 Physical Therapy
Description

Pain, Prescriptions, Non-drug, Physical therapy

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0033082
UMLS CUI [1,3]
C0949766
8.9.1 Other
Description

Pain, Prescriptions, Non-drug, Other

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0033082
UMLS CUI [1,3]
C0205394
8.9.2 Other: describe:
Description

Pain, Prescriptions, Non-drug, Other

Data type

text

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0033082
UMLS CUI [1,3]
C0205394
9. Did you contact the patient’s doctor today regarding the pain?
Description

9. Did you contact the patient’s doctor today regarding the pain?

Alias
UMLS CUI-1
C0030193
UMLS CUI-2
C0332158
UMLS CUI-3
C0031831
9.1 Did you contact the patient’s doctor today regarding the pain? If yes, check all that apply
Description

Pain, Contact with, Physicians

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0332158
UMLS CUI [1,3]
C0031831
9.2 To report a change in the pain.
Description

Pain, Changing

Data type

boolean

Alias
UMLS CUI [1,1]
C0030193
UMLS CUI [1,2]
C0392747
9.3 To discuss the need for an increased amount of medication.
Description

Adjust medications or medication dose, as appropriate

Data type

boolean

Alias
UMLS CUI [1]
C1735490
9.4 To discuss the need for a change in drug or route of administration.
Description

Change of medication, Patient need for (contextual qualifier); Change - procedure, Drug Administration Routes, Patient need for (contextual qualifier)

Data type

boolean

Alias
UMLS CUI [1,1]
C0580105
UMLS CUI [1,2]
C0686904
UMLS CUI [2,1]
C4319952
UMLS CUI [2,2]
C0013153
UMLS CUI [2,3]
C0686904
To discuss a side effect of the medication, e.g. nausea.
Description

Adverse effects, Discussion (communication)

Data type

boolean

Alias
UMLS CUI [1,1]
C0879626
UMLS CUI [1,2]
C2584313
10. Please identify any barriers/problems to providing this patient with optimum pain relief. (Check all that apply.)
Description

10. Please identify any barriers/problems to providing this patient with optimum pain relief. (Check all that apply.)

Alias
UMLS CUI-1
C0451615
UMLS CUI-2
C2698651
UMLS CUI-3
C0033213
10.1 Nursing staff time.
Description

Pain relief, Problem, Nursing staff, Time

Data type

boolean

Alias
UMLS CUI [1,1]
C0451615
UMLS CUI [1,2]
C0033213
UMLS CUI [1,3]
C0028698
UMLS CUI [1,4]
C0040223
10.2 Knowledge of nurses.
Description

Pain relief, Problem, Nurses, expertise

Data type

boolean

Alias
UMLS CUI [1,1]
C0451615
UMLS CUI [1,2]
C0033213
UMLS CUI [1,3]
C0028661
UMLS CUI [1,4]
C0870520
10.3 Knowledge of physicians.
Description

Pain relief, Problem, Physicians, expertise

Data type

boolean

Alias
UMLS CUI [1,1]
C0451615
UMLS CUI [1,2]
C0033213
UMLS CUI [1,3]
C0031831
UMLS CUI [1,4]
C0870520
10.4 Knowledge of patient or family.
Description

Pain relief, Problem, Knowledge, Patients; Pain relief, Problem, Knowledge, Family

Data type

boolean

Alias
UMLS CUI [1,1]
C0451615
UMLS CUI [1,2]
C0033213
UMLS CUI [1,3]
C0376554
UMLS CUI [1,4]
C0030705
UMLS CUI [2,1]
C0451615
UMLS CUI [2,2]
C0033213
UMLS CUI [2,3]
C0376554
UMLS CUI [2,4]
C0015576
10.5 Inadequate medications ordered.
Description

Pain relief, Problem, Prescribes medications, Inadequate (qualifier)

Data type

boolean

Alias
UMLS CUI [1,1]
C0451615
UMLS CUI [1,2]
C0033213
UMLS CUI [1,3]
C3166216
UMLS CUI [1,4]
C0205412
10.6 Physician cooperation.
Description

Pain relief, Problem, cooperation, Physicians

Data type

boolean

Alias
UMLS CUI [1,1]
C0451615
UMLS CUI [1,2]
C0033213
UMLS CUI [1,3]
C0392337
UMLS CUI [1,4]
C0031831
10.7 Patient cooperation in taking medications.
Description

Pain relief, Problem, Patient Non-Compliance

Data type

boolean

Alias
UMLS CUI [1,1]
C0451615
UMLS CUI [1,2]
C0033213
UMLS CUI [1,3]
C1321605
UMLS CUI [1,4]
C0376405
11. Nurses frequently are required to make decisions about the patient’s pain. Please indicate any decisions you made regarding the patient’s pain?
Description

11. Nurses frequently are required to make decisions about the patient’s pain. Please indicate any decisions you made regarding the patient’s pain?

Alias
UMLS CUI-1
C0030193
UMLS CUI-2
C0679006
11.1 If the patient had pain.
Description

Decision, Pain

Data type

boolean

Alias
UMLS CUI [1,1]
C0679006
UMLS CUI [1,2]
C0030193
11.2 How much pain the patient had.
Description

Decision, How Much Pain Felt

Data type

boolean

Alias
UMLS CUI [1,1]
C0679006
UMLS CUI [1,2]
C4526619
11.3 What meds to give.
Description

Decision, Pain, Pharmaceutical Preparations

Data type

boolean

Alias
UMLS CUI [1,1]
C0679006
UMLS CUI [1,2]
C0030193
UMLS CUI [1,3]
C0013227
11.4 When to give the medications.
Description

Decision, Pain, Pharmaceutical Preparations, When (temporal qualifier)

Data type

boolean

Alias
UMLS CUI [1,1]
C0679006
UMLS CUI [1,2]
C0030193
UMLS CUI [1,3]
C0013227
UMLS CUI [1,4]
C1948054
12. Nurses sometimes experience conflicts in managing the patient’s pain. Indicate any of the ethical/professional conflicts.
Description

12. Nurses sometimes experience conflicts in managing the patient’s pain. Indicate any of the ethical/professional conflicts.

Alias
UMLS CUI-1
C0002766
UMLS CUI-2
C0009671
12.1 You sometimes experience
Description

Pain management, Conflict (Psychology), Sometimes

Data type

text

Alias
UMLS CUI [1,1]
C0002766
UMLS CUI [1,2]
C0009671
UMLS CUI [1,3]
C1998882
12.2 You experienced with this patient
Description

Pain management, Conflict (Psychology), Patients

Data type

text

Alias
UMLS CUI [1,1]
C0002766
UMLS CUI [1,2]
C0009671
UMLS CUI [1,3]
C0030705
13. Please provide the following demographic data
Description

13. Please provide the following demographic data

Alias
UMLS CUI-1
C0011298
UMLS CUI-2
C0028661
13.1 your age
Description

Nurses, Age

Data type

integer

Measurement units
  • years
Alias
UMLS CUI [1,1]
C0028661
UMLS CUI [1,2]
C0001779
years
13.2 Gender
Description

Nurses, Gender

Data type

text

Alias
UMLS CUI [1,1]
C0028661
UMLS CUI [1,2]
C0079399
13.3 Number of years in nursing
Description

Nurses, Count of entities, Employment, year

Data type

integer

Alias
UMLS CUI [1,1]
C0028661
UMLS CUI [1,2]
C0449788
UMLS CUI [1,3]
C0014003
UMLS CUI [1,4]
C0439234
13.4 Areas of practice
Description

Nurses, Field, Occupations

Data type

text

Alias
UMLS CUI [1,1]
C0028661
UMLS CUI [1,2]
C1521738
UMLS CUI [1,3]
C0028811
13.5 Your work setting
Description

Nurses, Workplace

Data type

text

Alias
UMLS CUI [1,1]
C0028661
UMLS CUI [1,2]
C0162579
14. Description of the patient you identified to answer the above questions:
Description

14. Description of the patient you identified to answer the above questions:

Alias
UMLS CUI-1
C0030705
14.1 age
Description

Patient, Age

Data type

integer

Measurement units
  • years
Alias
UMLS CUI [1,1]
C0030705
UMLS CUI [1,2]
C0001779
years
14.2 Gender
Description

Patient, Gender

Data type

text

Alias
UMLS CUI [1,1]
C0030705
UMLS CUI [1,2]
C0079399
14.3 Medical diagnosis
Description

Patient, Diagnosis

Data type

text

Alias
UMLS CUI [1,1]
C0030705
UMLS CUI [1,2]
C0011900
14.4 Pain type
Description

Patient, Pain, Type - attribute

Data type

text

Alias
UMLS CUI [1,1]
C0030705
UMLS CUI [1,2]
C0030193
UMLS CUI [1,3]
C0332307
14.5 Location of the patient
Description

Patient, Location

Data type

text

Alias
UMLS CUI [1,1]
C0030705
UMLS CUI [1,2]
C0450429
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Similar models

The Clinical Decision Making Survey (CDMS)

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Dear Colleague: Thank you for agreeing to participate in our study of Clinical Decision Making Regarding Pain Management. This is a new area of investigation and we appreciate your efforts in adding to this important area of nursing. We are asking you to do two things: 1. Identify a patient that you are caring for who has a problem of pain. This should be a patient for whom you are providing direct nursing care, for example as primary nurse for a shift or for a home visit. Care for the patient as you normally would but try to remember your interventions related to the patient’s pain. 2. Within 24 hours of your caring for this patient, please complete the questionnaire in the enclosed envelope. Some of these questions may not apply to your patient interaction but please answer as best you can. The survey is anonymous and we ask that you do not identify yourself or the patient by name. We anticipate that it will require approximately 15-20 minutes of your time. Thank you in advance for your assistance and your thoughtful responses. Think about your interaction with this patient in pain:
Item Group
1. How did you assess/determine the patient’s intensity of pain (how much pain he/she had)? Check all that apply
C1320357 (UMLS CUI-1)
C2911685 (UMLS CUI-2)
Pain intensity (observable entity), Evaluation Method, Activity or Mobility
Item
1.1.1 Observing the patient's activity/mobility.
boolean
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C0547136 (UMLS CUI [1,3])
Pain intensity (observable entity), Evaluation Method, Activity or Mobility
Item
1.1.2 What did you observe?
text
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C0547136 (UMLS CUI [1,3])
Pain intensity (observable entity), Evaluation Method, Behavior
Item
1.2.1 Observing the patient’s behaviors.
boolean
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C0004927 (UMLS CUI [1,3])
Pain intensity (observable entity), Evaluation Method, Behavior
Item
1.2.2 What did you observe?
text
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C0004927 (UMLS CUI [1,3])
Pain intensity (observable entity), Evaluation Method, patient interview
Item
1.3 Asking the patient how much pain he/she had.
boolean
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C0683518 (UMLS CUI [1,3])
Pain intensity (observable entity), Evaluation Method, Medical Records
Item
1.4 Relied on information from the physicians notes of medical records.
boolean
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C0025102 (UMLS CUI [1,3])
Pain intensity (observable entity), Evaluation Method, Verbal information
Item
1.5 Relied on verbal information from other nurses.
boolean
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C1549471 (UMLS CUI [1,3])
Pain intensity (observable entity), Evaluation Method, Written Documentation
Item
1.6 Relied on written information from the nursing documentation.
boolean
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C3272241 (UMLS CUI [1,3])
Pain intensity (observable entity), Evaluation Method, Other
Item
1.7.1 Other
boolean
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Pain intensity (observable entity), Evaluation Method, Other
Item
1.7.2 Describe
text
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Item
1.8 Please look over each of your answers to Question 1. Please star* the one answer that you believe most influenced your assessment of the patient’s pain.
text
C1320357 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
undefined item
Code List
1.8 Please look over each of your answers to Question 1. Please star* the one answer that you believe most influenced your assessment of the patient’s pain.
CL Item
1.1 (1)
CL Item
1.2 (2)
CL Item
1.3 (3)
CL Item
1.4 (4)
CL Item
1.5 (5)
CL Item
1.6 (6)
CL Item
1.7.1 (7)
Item Group
2. Did you ask the patient questions about his/her pain?
C0030193 (UMLS CUI-1)
C1522634 (UMLS CUI-2)
Pain, Question (Inquiry)
Item
2.1 Did you ask the patient questions about his/her pain?
boolean
C0030193 (UMLS CUI [1,1])
C1522634 (UMLS CUI [1,2])
Pain, Question (Inquiry), Answer, Response (communication)
Item
2.2 If yes, please list the questions you asked and the patient’s responses.
text
C0030193 (UMLS CUI [1,1])
C1522634 (UMLS CUI [1,2])
C2911692 (UMLS CUI [1,3])
Item Group
3. Did you use any type of pain intensity/pain relief measure such as a pain rating scale to measure the patient’s pain?
C1320357 (UMLS CUI-1)
C0681889 (UMLS CUI-2)
C0451615 (UMLS CUI-3)
C0681889 (UMLS CUI-4)
Pain intensity (observable entity), rating scale; Pain relief, rating scale
Item
3.1 Did you use any type of pain intensity/pain relief measure such as a pain rating scale to measure the patient’s pain? If yes, please describe the measure and the patient’s score or rating on that measure
boolean
C1320357 (UMLS CUI [1,1])
C0681889 (UMLS CUI [1,2])
C0451615 (UMLS CUI [2,1])
C0681889 (UMLS CUI [2,2])
Pain intensity (observable entity), rating scale; Pain relief, rating scale
Item
3.2 Measure
text
C1320357 (UMLS CUI [1,1])
C0681889 (UMLS CUI [1,2])
C0451615 (UMLS CUI [2,1])
C0681889 (UMLS CUI [2,2])
Pain intensity (observable entity), rating scale; Pain relief, rating scale
Item
3.3 Number scale/from to (fill in numbers). Other scale/please describe:
text
C1320357 (UMLS CUI [1,1])
C0681889 (UMLS CUI [1,2])
C0451615 (UMLS CUI [2,1])
C0681889 (UMLS CUI [2,2])
Pain intensity (observable entity), rating scale, Score; Pain relief, rating scale, Score
Item
3.4 The patient’s score on the scale
text
C1320357 (UMLS CUI [1,1])
C0681889 (UMLS CUI [1,2])
C0449820 (UMLS CUI [1,3])
C0451615 (UMLS CUI [2,1])
C0681889 (UMLS CUI [2,2])
C0449820 (UMLS CUI [2,3])
Item Group
4. What pain medications were ordered for the patient? (drug, dose, route, frequency)
C0002771 (UMLS CUI-1)
Analgesics
Item
4.1 DRUG
text
C0002771 (UMLS CUI [1])
Analgesics, Dosage
Item
4.2 DOSE
text
C0002771 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
Analgesics, Drug Administration Routes
Item
4.3 ROUTE
text
C0002771 (UMLS CUI [1,1])
C0013153 (UMLS CUI [1,2])
Analgesics, Frequencies (time pattern)
Item
4.4 FREQ
text
C0002771 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Item Group
5. What pain medication did you give the patient today?
C0002771 (UMLS CUI-1)
C0310367 (UMLS CUI-2)
Analgesics, Today
Item
5.1 DRUG
text
C0002771 (UMLS CUI [1,1])
C0310367 (UMLS CUI [1,2])
Analgesics, Today, Dosage
Item
5.2 DOSE
text
C0002771 (UMLS CUI [1,1])
C0310367 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,3])
Analgesics, Today, Drug Adminstration Routes
Item
5.3 ROUTE
text
C0002771 (UMLS CUI [1,1])
C0310367 (UMLS CUI [1,2])
C0013153 (UMLS CUI [1,3])
Analgesics, Today, Frequencies (time pattern)
Item
5.4 FREQ
text
C0002771 (UMLS CUI [1,1])
C0310367 (UMLS CUI [1,2])
C0013153 (UMLS CUI [1,3])
Item Group
6. If you gave medication, or encouraged the patient to take medication, other than exactly as ordered, please explain
C0580105 (UMLS CUI-1)
Change of medication, Less often
Item
6.1 Gave the med less frequently than ordered e.g. gave it on a prn basis rather than every 4 hours as ordered.
boolean
C0580105 (UMLS CUI [1,1])
C3843156 (UMLS CUI [1,2])
Change of medication, Frequencies (time pattern), increase
Item
6.2 Gave the med more frequently than ordered e.g. gave it q 3 hours instead of waiting q 4 hrs.
boolean
C0580105 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
C0442805 (UMLS CUI [1,3])
Change of medication, Uses non-analgesic relief measures
Item
6.3 Gave a medicine for the pain other than the pain medicine i.e. an antiemetic, sedative, sleeping pill, etc., ordered for another reason.
boolean
C0580105 (UMLS CUI [1,1])
C0518065 (UMLS CUI [1,2])
Item Group
7. Did you document your assessments, evaluations of the patient’s pain?
C0030193 (UMLS CUI-1)
C0220825 (UMLS CUI-2)
C0920316 (UMLS CUI-3)
Pain, Evaluation, Documentation
Item
7.1 Did you document your assessments, evaluations of the patient’s pain?
boolean
C0030193 (UMLS CUI [1,1])
C0220825 (UMLS CUI [1,2])
C0920316 (UMLS CUI [1,3])
Item
7.2 If yes, where?
text
C0030193 (UMLS CUI [1,1])
C0220825 (UMLS CUI [1,2])
C0920316 (UMLS CUI [1,3])
C0442504 (UMLS CUI [1,4])
Pain, Evaluation, Documentation, Place
Code List
7.2 If yes, where?
CL Item
Nurses' notes (1)
CL Item
Progress notes (2)
CL Item
Other: explain (3)
Pain, Evaluation, Documentation, Place
Item
7.3 Other: explain
text
C0030193 (UMLS CUI [1,1])
C0220825 (UMLS CUI [1,2])
C0920316 (UMLS CUI [1,3])
C0442504 (UMLS CUI [1,4])
Item Group
8. Did this patient have any written orders for non-drug interventions for pain? Check all that apply:
C0030193 (UMLS CUI-1)
C0033082 (UMLS CUI-2)
C1705178 (UMLS CUI-3)
Pain, Prescriptions, Non-drug, Order (action), Medical
Item
8.1 Medical Order
boolean
C0030193 (UMLS CUI [1,1])
C0033082 (UMLS CUI [1,2])
C1705178 (UMLS CUI [1,3])
C0205476 (UMLS CUI [1,4])
Pain, Prescriptions, Non-drug, Order (action), Nurses
Item
8.2 Nursing Order
boolean
C0030193 (UMLS CUI [1,1])
C0033082 (UMLS CUI [1,2])
C1705178 (UMLS CUI [1,3])
C0028661 (UMLS CUI [1,4])
Pain, Prescriptions, Non-drug, Usage
Item
8.3 Actually Used
boolean
C0030193 (UMLS CUI [1,1])
C0033082 (UMLS CUI [1,2])
C0457083 (UMLS CUI [1,3])
Pain, Prescriptions, Non-drug, Heating Pads
Item
8.4 Heating Pad
boolean
C0030193 (UMLS CUI [1,1])
C0033082 (UMLS CUI [1,2])
C0181154 (UMLS CUI [1,3])
Pain, Prescriptions, Non-drug, Heating/Cooling Pads, Circulating-Liquid
Item
8.5 K pad
boolean
C0030193 (UMLS CUI [1,1])
C0033082 (UMLS CUI [1,2])
C0181440 (UMLS CUI [1,3])
Pain, Prescriptions, Non-drug, Ice Bags
Item
8.6 Ice pack
boolean
C0030193 (UMLS CUI [1,1])
C0033082 (UMLS CUI [1,2])
C0181264 (UMLS CUI [1,3])
Pain, Prescriptions, Non-drug, Transcutaneous Electric Nerve Stimulation
Item
8.7 TENS
boolean
C0030193 (UMLS CUI [1,1])
C0033082 (UMLS CUI [1,2])
C0040654 (UMLS CUI [1,3])
Pain, Prescriptions, Non-drug, Physical therapy
Item
8.8 Physical Therapy
boolean
C0030193 (UMLS CUI [1,1])
C0033082 (UMLS CUI [1,2])
C0949766 (UMLS CUI [1,3])
Pain, Prescriptions, Non-drug, Other
Item
8.9.1 Other
boolean
C0030193 (UMLS CUI [1,1])
C0033082 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Pain, Prescriptions, Non-drug, Other
Item
8.9.2 Other: describe:
text
C0030193 (UMLS CUI [1,1])
C0033082 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Item Group
9. Did you contact the patient’s doctor today regarding the pain?
C0030193 (UMLS CUI-1)
C0332158 (UMLS CUI-2)
C0031831 (UMLS CUI-3)
Pain, Contact with, Physicians
Item
9.1 Did you contact the patient’s doctor today regarding the pain? If yes, check all that apply
boolean
C0030193 (UMLS CUI [1,1])
C0332158 (UMLS CUI [1,2])
C0031831 (UMLS CUI [1,3])
Pain, Changing
Item
9.2 To report a change in the pain.
boolean
C0030193 (UMLS CUI [1,1])
C0392747 (UMLS CUI [1,2])
Adjust medications or medication dose, as appropriate
Item
9.3 To discuss the need for an increased amount of medication.
boolean
C1735490 (UMLS CUI [1])
Change of medication, Patient need for (contextual qualifier); Change - procedure, Drug Administration Routes, Patient need for (contextual qualifier)
Item
9.4 To discuss the need for a change in drug or route of administration.
boolean
C0580105 (UMLS CUI [1,1])
C0686904 (UMLS CUI [1,2])
C4319952 (UMLS CUI [2,1])
C0013153 (UMLS CUI [2,2])
C0686904 (UMLS CUI [2,3])
Adverse effects, Discussion (communication)
Item
To discuss a side effect of the medication, e.g. nausea.
boolean
C0879626 (UMLS CUI [1,1])
C2584313 (UMLS CUI [1,2])
Item Group
10. Please identify any barriers/problems to providing this patient with optimum pain relief. (Check all that apply.)
C0451615 (UMLS CUI-1)
C2698651 (UMLS CUI-2)
C0033213 (UMLS CUI-3)
Pain relief, Problem, Nursing staff, Time
Item
10.1 Nursing staff time.
boolean
C0451615 (UMLS CUI [1,1])
C0033213 (UMLS CUI [1,2])
C0028698 (UMLS CUI [1,3])
C0040223 (UMLS CUI [1,4])
Pain relief, Problem, Nurses, expertise
Item
10.2 Knowledge of nurses.
boolean
C0451615 (UMLS CUI [1,1])
C0033213 (UMLS CUI [1,2])
C0028661 (UMLS CUI [1,3])
C0870520 (UMLS CUI [1,4])
Pain relief, Problem, Physicians, expertise
Item
10.3 Knowledge of physicians.
boolean
C0451615 (UMLS CUI [1,1])
C0033213 (UMLS CUI [1,2])
C0031831 (UMLS CUI [1,3])
C0870520 (UMLS CUI [1,4])
Pain relief, Problem, Knowledge, Patients; Pain relief, Problem, Knowledge, Family
Item
10.4 Knowledge of patient or family.
boolean
C0451615 (UMLS CUI [1,1])
C0033213 (UMLS CUI [1,2])
C0376554 (UMLS CUI [1,3])
C0030705 (UMLS CUI [1,4])
C0451615 (UMLS CUI [2,1])
C0033213 (UMLS CUI [2,2])
C0376554 (UMLS CUI [2,3])
C0015576 (UMLS CUI [2,4])
Pain relief, Problem, Prescribes medications, Inadequate (qualifier)
Item
10.5 Inadequate medications ordered.
boolean
C0451615 (UMLS CUI [1,1])
C0033213 (UMLS CUI [1,2])
C3166216 (UMLS CUI [1,3])
C0205412 (UMLS CUI [1,4])
Pain relief, Problem, cooperation, Physicians
Item
10.6 Physician cooperation.
boolean
C0451615 (UMLS CUI [1,1])
C0033213 (UMLS CUI [1,2])
C0392337 (UMLS CUI [1,3])
C0031831 (UMLS CUI [1,4])
Pain relief, Problem, Patient Non-Compliance
Item
10.7 Patient cooperation in taking medications.
boolean
C0451615 (UMLS CUI [1,1])
C0033213 (UMLS CUI [1,2])
C1321605 (UMLS CUI [1,3])
C0376405 (UMLS CUI [1,4])
Item Group
11. Nurses frequently are required to make decisions about the patient’s pain. Please indicate any decisions you made regarding the patient’s pain?
C0030193 (UMLS CUI-1)
C0679006 (UMLS CUI-2)
Decision, Pain
Item
11.1 If the patient had pain.
boolean
C0679006 (UMLS CUI [1,1])
C0030193 (UMLS CUI [1,2])
Decision, How Much Pain Felt
Item
11.2 How much pain the patient had.
boolean
C0679006 (UMLS CUI [1,1])
C4526619 (UMLS CUI [1,2])
Decision, Pain, Pharmaceutical Preparations
Item
11.3 What meds to give.
boolean
C0679006 (UMLS CUI [1,1])
C0030193 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,3])
Decision, Pain, Pharmaceutical Preparations, When (temporal qualifier)
Item
11.4 When to give the medications.
boolean
C0679006 (UMLS CUI [1,1])
C0030193 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,3])
C1948054 (UMLS CUI [1,4])
Item Group
12. Nurses sometimes experience conflicts in managing the patient’s pain. Indicate any of the ethical/professional conflicts.
C0002766 (UMLS CUI-1)
C0009671 (UMLS CUI-2)
Item
12.1 You sometimes experience
text
C0002766 (UMLS CUI [1,1])
C0009671 (UMLS CUI [1,2])
C1998882 (UMLS CUI [1,3])
Pain management, Conflict (Psychology), Sometimes
Code List
12.1 You sometimes experience
CL Item
Concern about over medication. (1)
CL Item
Concern about under medicating. (2)
CL Item
Feeling that the patient didn’t get adequate pain relief. (3)
CL Item
Concern about addiction. (4)
CL Item
Concern about respiratory depression.  (5)
CL Item
Knowing the patient is in pain and won’t admit it. (6)
CL Item
Doubting that the pain is real.  (7)
CL Item
Conflicts with the physician.  (8)
CL Item
Conflicts with the patient or family. (9)
Item
12.2 You experienced with this patient
text
C0002766 (UMLS CUI [1,1])
C0009671 (UMLS CUI [1,2])
C0030705 (UMLS CUI [1,3])
Pain management, Conflict (Psychology), Sometimes
Code List
12.2 You experienced with this patient
CL Item
Concern about over medication. (1)
CL Item
Concern about under medicating. (2)
CL Item
Feeling that the patient didn’t get adequate pain relief. (3)
CL Item
Concern about addiction. (4)
CL Item
Concern about respiratory depression.  (5)
CL Item
Knowing the patient is in pain and won’t admit it. (6)
CL Item
Doubting that the pain is real.  (7)
CL Item
Conflicts with the physician.  (8)
CL Item
Conflicts with the patient or family. (9)
Item Group
13. Please provide the following demographic data
C0011298 (UMLS CUI-1)
C0028661 (UMLS CUI-2)
Nurses, Age
Item
13.1 your age
integer
C0028661 (UMLS CUI [1,1])
C0001779 (UMLS CUI [1,2])
Item
13.2 Gender
text
C0028661 (UMLS CUI [1,1])
C0079399 (UMLS CUI [1,2])
Nurses, Gender
Code List
13.2 Gender
CL Item
male (1)
CL Item
female (2)
Item
13.3 Number of years in nursing
integer
C0028661 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
C0014003 (UMLS CUI [1,3])
C0439234 (UMLS CUI [1,4])
Nurses, Gender
Code List
13.3 Number of years in nursing
Item
13.4 Areas of practice
text
C0028661 (UMLS CUI [1,1])
C1521738 (UMLS CUI [1,2])
C0028811 (UMLS CUI [1,3])
Nurses, Gender
Code List
13.4 Areas of practice
CL Item
Med/Surg  (1)
CL Item
Obstetrics  (2)
CL Item
Oncology  (3)
CL Item
Orthopedics  (4)
CL Item
Pediatrics (5)
CL Item
Geriatrics  (6)
CL Item
OR/PAR  (7)
CL Item
ER (8)
CL Item
ICU (9)
Item
13.5 Your work setting
text
C0028661 (UMLS CUI [1,1])
C0162579 (UMLS CUI [1,2])
Nurses, Gender
Code List
13.5 Your work setting
CL Item
Hospital  (1)
CL Item
Home care (2)
CL Item
Hospice  (3)
CL Item
Outpatient/clinic/office (4)
Item Group
14. Description of the patient you identified to answer the above questions:
C0030705 (UMLS CUI-1)
Patient, Age
Item
14.1 age
integer
C0030705 (UMLS CUI [1,1])
C0001779 (UMLS CUI [1,2])
Item
14.2 Gender
text
C0030705 (UMLS CUI [1,1])
C0079399 (UMLS CUI [1,2])
Patient, Gender
Code List
14.2 Gender
CL Item
male (1)
CL Item
female (2)
Patient, Diagnosis
Item
14.3 Medical diagnosis
text
C0030705 (UMLS CUI [1,1])
C0011900 (UMLS CUI [1,2])
Item
14.4 Pain type
text
C0030705 (UMLS CUI [1,1])
C0030193 (UMLS CUI [1,2])
C0332307 (UMLS CUI [1,3])
Patient, Pain, Type - attribute
Code List
14.4 Pain type
CL Item
acute (1)
CL Item
chronic (2)
Item
14.5 Location of the patient
text
C0030705 (UMLS CUI [1,1])
C0450429 (UMLS CUI [1,2])
Patient, Pain, Type - attribute
Code List
14.5 Location of the patient
CL Item
Hospital inpatient (1)
CL Item
Hospice inpatient  (2)
CL Item
Home care (3)
CL Item
Home hospice  (4)
CL Item
Outpatient/clinic/office  (5)
CL Item
Other (6)
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