Implementing a pediatric leukemia intervention for procedural pain: The impact on staff

Over 3 years, we prospectively examined the impact of a family-oriented, combined psychologic-pharmacologic intervention for procedural pain in pediatric leukemia on the attitudes and beliefs of multidisciplinary staff. Medical, nursing, and psychosocial staff (N = 61) in a pediatric oncology treatment center provided questionnaire data 6 months before the protocol opened (Time 1), 6 months after patient accrual began (Time 2), and 18 months after the intervention began (Time 3). The Questionnaire on Procedural Pain (QPP) and the Maslach Burnout Inventory (MBI) were dependent measures. There were significant increases over time in the perceived efficacy of psychological and pharmacologic interventions for procedural pain and for impact of the program as an effective and feasible resource. Staff enthusiasm for the program declined between Time 1 and 2, but increased significantly between Time 2 and 3, suggesting the importance of a longer-term perspective for understanding program implementation. Significant decreases over time in staff depersonalization were also found. We discuss the data with regard to their generalizability to the process of introducing programmatic change in practice. 1996