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Context: Caregiver satisfaction with palliative care is a crucial indicator of its effectiveness. In light of the lack of validated or reliable Italian instruments, the Post Mortem Questionnaire-Short Form (QPM-SF), a self-report questionnaire, has been developed to assess home and inpatient hospice care., Objectives: The present study was designed to evaluate the psychometric properties of QPM-SF and assess for differences in quality of palliative care between hospice and home care settings., Methods: A total of 584 caregivers of terminal cancer patients completed QPM-SF one month after the death of the care recipient. To assess test-retest reliability, a subgroup of 50 caregivers completed the questionnaire a second time, one month later., Results: QPM-SF showed good internal consistency and temporal stability and a four-factor structure: "Integrated home care," "Hospice," "Physical care-Information-Global evaluation," and "Needs.", Conclusion: QPM-SF may be considered a valid, reliable, and well-accepted self-report instrument for examining and implementing palliative care interventions., (Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.)

According to American Pain Society (APS), assessment of quality of pain management must consider not only improvement of symptoms but also patients' satisfaction with care. To this purpose, Patient Outcome Questionnaire (APS-POQ) was made. Aim of the study was to analyze reliability and construct validity of the Italian version of the questionnaire. The tool was administered to 322 hospitalized adults. Results showed positive psychometric properties of the Italian version of APS-POQ, particularly for the sections assessing intensity and interference of pain, and satisfaction with pain management.

Unlabelled: Pain assessment in elderly people may be complex due to the occurrence of neurodegenerative disorders, which often impair the ability to verbally report pain to hospital staff Several tools have been developed to assess pain behaviors in patients unable to communicate. The Italian version of the Non-Communicative Patient's Pain Assessment Instrument (NOPPAIN) has shown good preliminary qualities in the clinical setting., Aim: Aim of the paper is to analyze the psychometric properties of the Italian version of the NOPPAIN in a training setting., Methods: 142 hospital staff members of the Medical Department of Vicenza Hospital assessed with NOPPAIN 5 videotapes, portraying different levels of pain intensity. Inter-rater reliability (nonparametric Kendall's W) and construct validity were examined., Results: A significant inter-rater agreement was found overall (Kendall's W = 0.89, p < 0.01) and for each of the 5 videos; inter-rater agreement was high both in the total score and in the main sections of the tool. NOPPAIN scores correctly discriminated between the different levels of pain intensity., Conclusion: The results confirm interrater reliability and construct validity of the Italian version of the NOPPAIN.

Background and Aims: Although pain in the elderly is a common and important problem, it is frequently underestimated and undertreated. Pain assessment in elderly people is often more difficult than in the general population, because of the occurrence of dementia and other cognitive impairments that may compromise the ability to communicate the presence and the intensity of pain to hospital staff. Recently, several observational tools have been developed in order to assess pain behaviors in non-communicative patients. The aim of the present study was to verify if the Italian version of the Non- Communicative Patient's Pain Assessment Instrument (NOPPAIN) could be used in a hospital setting., Methods: Sixty severely demented patients (MMSE /=23, language test score >/=4) were selected on the basis of their cognitive status and language skills. NOPPAIN forms were filled in at the same time by two nursing staff members after patients' daily care activities; behavioral indicators of the affective state and communicative patients' reports of pain were also collected., Results: Significant interrater agreement was found in the subscores of the four main sections of the NOPPAIN and also in the total score. In addition, in cognitively intact patients there was a moderate (about 0.50) but significant correlation between NOPPAIN ratings and pain self-reports. A positive correlation between pain scores and negative affective state scores was also found, especially in cognitively impaired patients., Conclusions: The preliminary data of the present study support the reliability and validity of the Italian version of the NOPPAIN, which appears to be an easy-to-use tool in the assessment of pain in hospitalized non-communicative patients.

The aims of this study were to survey the knowledge and attitudes of Italian health care professionals toward pain and develop a valid instrument to assess pain knowledge of physicians and nurses. A 21-item questionnaire on a Likert scale was given to 4,961 health professionals in 20 hospitals in Italy who volunteered to participate in the study. The results were analyzed psychometrically in three phases: the Principal Component Analysis phase identified two components, of which only the one that had 10 items about pain knowledge and attitudes (PAK) was studied; the Homogeneity Analysis revealed its acceptable internal reliability (Cronbach's alpha=0.72) and confirmed the Likert equidistance of the item options response; and the Confirmatory Factor Analysis proved that it had a very good construct validity. A standardized score was calculated on the PAK questionnaire using the final 10 selected items, considering 100% as the best level of knowledge of pain management and 0% as the worst. The standardized mean score on the whole sample was equal to 52.6% (95% Confidence Interval: 52.3%-53.0%). There was a statistically significant difference (P<0.001) in percentage score between physicians (56.5%) and nurses (51.3%). Knowledge was best among physicians in Anesthesiology and Emergency; this was followed by doctors in Medicine and then surgeons. The knowledge of nurses was almost constant. This scale fills a void by providing a validated instrument for testing the general knowledge about pain treatment of hospital staff. It is brief and can easily be administered to a considerable number of people.

The various stages of the campaign "Towards a pain-free hospital", carried out at St. Bortolo Hospital in Vicenza, Italy, are described. They concerned: measuring pain prevalence, patients' beliefs, staff education, giving patients information, daily pain measurement, preparing pain treatment protocols, assessing patient satisfaction. The methods for carrying out the various initiatives and the data collected are reported.

This study is part of the project, "Towards a Pain-Free Hospital," which aims at improving the approach and treatment of the patient in pain. The objective of the study was to evaluate the knowledge and attitudes of doctors and nurses on the wards of a 1000-bed general hospital located in a rather densely-populated, industrialized area of Italy regarding the following topics: attention paid to pain, the use of analgesic drugs, and pain in children. In total, 669 nurses and 225 doctors completed a 16-item questionnaire evaluating knowledge and beliefs about pain. The overall percentage of correct answers was 61% (9.7/16). The score varied among the different wards and ranged from 48% (7.8/16) to 76% (12.3/16). Physicians scored 65% and nurses 59% (p < 0.001). The percentage of correct answers varied widely among the different items (from 30% to 96%). From these results, we conclude that there are still significant knowledge deficits and erroneous beliefs that may hamper treatment of the patient in pain. These results will help in conducting educational programs aimed at improving pain treatment in the different departments of the hospital.

This article outlines the project entitled "Towards a Pain Free Hospital" which aims to make both citizens and health sector workers more aware of the problem of pain in hospitalised patients. The project is already under way in some countries and is being implemented in others. It has been introduced into the local Health Authority Hospital of Vicenza for the first time in Italy and will later be introduced into other Italian hospitals. The article deals with the various initiatives which make up the project and the methods used to involve those assisting the patient in pain.