Confirmatory Factor Analysis of the Analgesic Adverse Drug Event Measure.

Background and Purpose: The Analgesic Adverse Drug Event Measure (AADEM) measures how people respond when they experience analgesic adverse drug events (ADEs). The purpose of this study was to confirm the underlying constructs of the AADEM: attributed ADE, consulted provider, sought care, and continued/discontinued analgesic. Methods: A cross-sectional instrumentation design was used. Three hundred and thirty-two adults who self-reported an analgesic ADE responded to the online AADEM. Confirmatory factor analysis and reliability testing were conducted. Results: Model fit was adequate across all indexes. Internal consistency for the full AADEM was low, while subscale internal consistency was generally acceptable probably due to three significant negative correlations and two positive correlations between the latent factors. Conclusions: The results supported the construct validity of the AADEM. Advanced practice nurses and other primary care providers can use the AADEM to investigate analgesic ADEs. Greater insight into how people respond to an analgesic ADE via the use of the AADEM may help prevent future analgesic ADEs.

Admission criteria and academic performance in medical school.

BACKGROUND: Different variables have been used to predict the academic performance of students in medical schools. The aim of this study was to assess the effect of demographics, admission system, and high-school background on the academic performance of medical students. METHODS: We conducted this longitudinal cohort study on 808 students admitted to the Faculty of. Medicine at the University of Jordan (Amman, Jordan), in the years 2012 and 2013. Admission pathway, and academic performance data were collected and analyzed. RESULTS: A total of 808 students [i.e., 426 (52.7%) females, and 382(47.3%) males] were identified. Admitted students were holding 17 different types of high school degrees, and were accepted through 6 different quota pathways (open competition [National unified admission], underprivileged ["Makrumah"], parallel, children of university staff, international students, and others). Students admitted through the open competition and the underprivileged quota(Makrumah) were more likely to graduate on time and had higher graduation grades while students admitted through the parallel, international and others quota were more likely to fail and had lower graduation grades. Regarding highs school degrees, the students that were more likely to graduate were those with IB and the Jordanian high school degrees. The highest graduation GPA was for IB students followed by SAT, IGCSE as well as Jordanian and Syrian high school degrees respectively. IB, Jordanian, Kuwaiti and IGSC high school grades were significantly correlated with the graduation GPA. CONCLUSIONS: Admission criteria such as type of high school degree and grades as well as admission pathways can predict the likelihood to graduate and the graduation GPA of medical students. Open competition and underprivileged admission pathways as well as IB, IGCSE and Jordanian high school degrees seem to be better predictors of student performance in the medical school.

Barriers and Facilitators of Pain Self-Management Among Patients with Cancer: An Integrative Review.

BACKGROUND: Defining the main barriers and facilitators of cancer pain self-management are essential to improve patients' overall quality of life. AIM: The main purpose of this review was to identify the main barriers and facilitators for cancer pain self-management. METHOD: An integrative review guided by the five-stages framework that was identified by Souza et al. (2010) was used: (1) preparing the guiding question; (2) searching or sampling the literature; (3) data collection; (4) critical analysis of the studies; and (5) discussion of results. A comprehensive literature review was conducted using the electronic databases of PubMed/MEDLINE, CINAHL, Scopus, and Psych INFO. RESULTS: Twenty-two studies were identified. The main facilitators that foster the process of cancer pain self-management were supportive ambiances including family caregivers as well as health care providers, active participation of patients with cancer in health care including self-discovery and self-awareness, acquiring pain knowledge, and using a pain diary. The main barriers include concerns regarding the use of pain medications, knowledge deficit, negative beliefs and attitudes, unsupportive ambiance, and psychological distress. Some patients' characteristics could be related to these barriers such as age, sex, race, marital status, educational level, level of pain, and presence of comorbidity. CONCLUSIONS: Patients with cancer pain experience multiple barriers and facilitators when attempting to take on an active role in managing their pain.

Philosophical Assumptions Used in Research on Barriers for Effective Cancer Pain Management: A Scoping Review.

Cancer pain is one of the most common symptoms in cancer patients and often has a negative impact on patients' functional status and quality of life. Despite the available guidelines for effective pain management, factors such as barriers to cancer pain management still exist. The lens or philosophical assumptions used to guide cancer pain management research is a crucial but often overlooked component of high-quality research. Therefore, the purpose of this scoping review was to classify and map the available evidence and identify the knowledge gap regarding using a philosophical assumption to address the barriers of pain management among patients with cancer. Absence of clear philosophical assumptions in the qualitative research and generally a theoretical quantitative research may contribute to the slow progress in identifying and addressing barriers to cancer pain management. Therefore, the hermeneutic circle was suggested to address the main barriers of cancer pain management, focusing on the dialectic approach between the participants including researchers, cancer patients, and their family caregivers, health care providers, and policymakers. Understanding and possible solutions of the problem could be obtained through fusion of the horizons; in which the participants past and present horizons emerge. Then the collaborative efforts between the participants may yield effective strategies to overcome cancer pain barriers to improve the quality of cancer pain management.