Our long-term goal is to first assess and ultimately manage pain after lung cancer surgery using computer
technologies to minimize pain assessment barriers and thereby support clinical pain management processes.
The first step in assuring high quality pain management is appropriate pain assessment. However, the barriers
to pain assessment are among the causes for unrelieved pain. The lack of time-efficient comprehensive pain
assessment tools and patients' difficulties in completing the tools are among the most known barriers to
assessing pain in Turkey. Recent studies show that Americans are able to use computers to report their pain.
A computerized format for pain assessment called PAINReportIt®, published in 2003, is the first interactive
software extension of the 1970 McGill Pain Questionnaire. This innovative method can provide pain
measurement items to responders in serial display screens accompanied by pop-up screens. It has been
tested in English-, Spanish-, and Mandarin Chinese-speaking adults, but it has not been tested among Turkish-
speaking adults. Furthermore, there are not any tablet-based pain assessment tools being used in hospitals or
clinics in Turkey. Therefore, to establish our potential for collaboration, we used a committee approach with 3
bilingual translators to independently translate PAINReportIt® from English to Turkish, reconcile differences,
and agree on an integrated version. We now propose a three-component study to validate and facilitate
implementation of the Turkish- PAINReportIt® in Turkey: (1) a qualitative study to assess patients' interpretation
of the Turkish-PAINReportIt® items and instructions among 20 Turkish lung cancer outpatients who will
participate in cognitive (think-aloud) interviews to validate the Turkish-PAINReportIt®, (2) an 8-member focus
group with lung cancer surgeons and surgical nurses to discuss the issues and benefits they would anticipate if
the Turkish-PAINReportIt® were implemented in research studies and cancer care, and (3) a longitudinal study
to profile post-thoracotomy pain recovery among 80 Turkish lung cancer patients who will be asked to
complete the tool on an Internet-enabled tablet daily on postoperative days 1 to 4 and at their 2-week
postoperative follow-up visit. Patients will complete a usability and acceptability questionnaire to share their
opinions about using Turkish-PAINReportIt® to report their pain. The specific aims are to (1) describe the
meanings attributed to the Turkish-PAINReportIt® items and instructions by Turkish patients who are post-
thoracotomy for lung cancer treatment, (2) identify the technical and human (patient, nurse, and physician)
factors that could be barriers or facilitators to use the Turkish-PAINReportIt®, (3) characterize the pain
(location, intensity, quality, pattern) they experience longitudinally after surgery when pain is expected to
decrease as their recovery progresses. We expect to discover barriers that can be addressed and facilitators
for successful adoption in cancer research and practice in Turkey. Successful use of the tablet-based pain tool
could lead to improved pain control for the Turkish people diagnosed annually with lung and other cancers.
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