Effectiveness of pain management in hospital in the home programs

Alternative health care delivery models such as HITH facilitate the care of patients requiring acute treatments in their own homes. There are over 570 Diagnostic Related Groups managed in HITH programs and many of these are known to have associated physical pain. The impact of the home environment on patients’ experience of pain or how pain is managed is poorly understood. The purpose of this presentation is to
present the background and preliminary findings of a study that aims to increase our understanding of the issues related to providing optimal pain management for acute care patients who are transferred to Hospital in the Home. This knowledge will enable the development of effective practice guidelines to improve patient outcomes. More specifically, the aims are:
• To identify whether patients are transferred to HITH in pain or develop
   significant pain while in the program
• To identify the frequency and intensity of pain experienced by patients in 3      HITH programs.
• To describe patients’ experience of pain in the home environment.
• To investigate whether patients receive adequate pain relief once                      transferred to HITH.
• To explore the strategies patients use to manage pain at home.

The study will be carried out over 12 months in three HITH units in Victoria: Box Hill Hospital, Alfred Hospital and Epworth Hospital. The design is a descriptive survey of patients’ experience of pain and pain management using a modified version of The American Pain Society’s Patient Outcome Questionnaire. 360 consecutive surgical patients transferred to HITH care in the three participating programs will be interviewed by telephone between 48 and 72 hours of admission to the program.

The findings of this study will identify issues in providing optimum pain management for patients receiving acute care in non-traditional treatment environments.

Wildlife management in Australasia : perceptions of objectives and priorities

The aim of this study was to examine the values and attitudes held by Australasian wildlife managers as they relate to wildlife management issues, and to gain some insight into possible future directions and priorities for Australasian wildlife management. During December 2002 – February 2003, 138 questionnaires were completed by members of the Australasian Wildlife Management Society (AWMS) and registrants of the 2002 AWMS annual conference. Threatened species management, threatened communities/habitats, and management of introduced species were the issues rated as needing the highest priority for the Australasian Wildlife Management Society. Issues such as animal rights, genetically modified organisms and timber harvesting on public lands were the lowest-rating issues. Respondents expressed a strong belief in managing and controlling wildlife to achieve wildlife management objectives, a strong belief that wildlife should be protected and that wildlife managers should minimise the pain and suffering of individual animals, and a belief that resources should be directed towards conserving wildlife populations rather than protecting individual animals from non-threatened populations. While respondents held a strong belief that it is important to consult the community when developing wildlife management policies and programs, there was little support for a comanagerial approach where the community has a significant role to play in decision-making processes.