Judy Watt-Watson's research while affiliated with University of Toronto and other places

Publications (101)

Article
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Background Continuing Professional Development is an important means of improving access to effective patient care. Although pain content has increased significantly in pre-licensure programs, little is known about how post-licensure health professionals advance or maintain competence in pain management. Aims To investigate Canadian health profess...
Article
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Background National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited w...
Article
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Background Women with physical disabilities are faced with challenges in many aspects of life: education, work, income, relationships, as well as their general health. These women are at a greater risk of developing heart disease. This study aimed to explore the cardiac pain experiences of women with physical disabilities and heart disease in a Can...
Article
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Competency-based education is now considered the best approach for pain educational programs provided for pre and post-graduate healthcare providers (HCPs).To demonstrate learners’ progression, an assessment tool that aligns with this educational approach and targets different HCPs is needed. A Pain Competence Assessment Tool (PCAT) was developed b...
Poster
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The overall goal of this research program is to develop and systematically evaluate a digital health intervention (at heart) for women with heart disease.
Article
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Background: Chronic pain is a growing public health concern affecting 1.5 million people in Canada. In particular, it is a concern among the expanding immigrant population, because immigrant groups report higher pain intensity than non-immigrants. In 2011, the Indian population became the largest visible minority group and continues to be the faste...
Article
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Introduction More women experience cardiac pain related to coronary artery disease and cardiac procedures compared with men. The overall goal of this programme of research is to develop an integrated smartphone and web-based intervention (HEARTPA♀N) to help women recognise and self-manage cardiac pain. Methods and analysis This protocol outlines t...
Article
ABSTRACT Background: With coronary heart disease affecting over 2.4 million Canadians, annual cardiac and major vascular surgery rates are on the rise. Unrelieved postoperative pain is among the top five causes of hospital readmission following surgery; little is done to address this postoperative complication. Barriers to effective pain assessment...
Article
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Background: Despite the same surgical approach, up to 40% of patients develop chronic postsurgical pain (CPSP) following cardiac surgery, whereas the rest are chronic pain free. This variability suggests that CPSP is controlled partially through genetics, but the genes for CPSP are largely unknown. Aims: The aim of this study was to identify potent...
Article
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Several interprofessional education programs have been developed to enhance primary care providers’ (PCPs) competency in pain management. This project aims to develop a valid and reliable competency-based assessment tool, suitable for all professions, to evaluate the impact of these programs. To develop a new pain competence assessment tool (PCAT),...
Article
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Introduction Approximately 400 000 Americans and 36 000 Canadians undergo cardiac surgery annually, and up to 56% will develop chronic postsurgical pain (CPSP). The primary aim of this study is to explore the association of pain-related beliefs and gender-based pain expectations on the development of CPSP. Secondary goals are to: (A) explore risk f...
Article
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Objective: The study objective was to determine use of pain-related health care resources and associated direct and indirect costs over a two-year period in cardiac surgery patients who developed chronic post-surgical pain (CPSP). Methods: This multicentric observational prospective study recruited patients prior to cardiac surgery; these patients...
Article
Despite innovations in research, reports continue to demonstrate a high prevalence of poorly managed chronic non-cancer pain (CNCP) patients. Inadequate knowledge among clinicians is one of the reasons behind this incomplete knowledge transfer. As a result, many educational interventions are now directed towards enhancing clinicians’ pain knowledge...
Article
Objective: The challenges of moving the pain education agenda forward are significant worldwide, and resources, including online, are needed to help educators in curriculum development. Online resources are available but with insufficient evaluation in the context of prelicensure pain education. Therefore, this pre-post study examined the impact o...
Article
Symptom recognition and self-management is instrumental in reducing the number of deaths related to coronary artery disease (CAD) in women. The purpose of this study was to synthesize qualitative research evidence on the self-management of cardiac pain and associated symptoms in women. Seven databases were systematically searched, and the concepts...
Article
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Background: There is a growing societal need for health professional competency in pain care. The University of Toronto Centre for the Study of Pain-Interfaculty Pain Curriculum (UTCSP-IPC) has been offered since 2002. Content and process have been updated annually. As well, participating health professions programs have advanced their pain teachin...
Article
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The delivery of effective pain management can be complex, requiring collaborative, team approaches that exceed the expertise of any one profession. Interprofessional collaboration is increasingly recognized as a core skill for all clinicians and is beginning to be required by some accrediting bodies for medical, nursing, pharmacy, physician assista...
Article
Background: Cardiac pain is considered the primary indicator of coronary artery disease (CAD). Existing reviews lack appropriate numbers of women or sex-based subgroup analyses, or both; thus, the benefits of self-management (women with cardiac pain actively participating in their own care and treatment) remain uncertain. Methods: Using methods...
Article
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Objective To describe the current evidence related to the self-management of cardiac pain in women using the process and methodology of evidence mapping. Design and setting Literature search for studies that describe the self-management of cardiac pain in women greater than 18 years of age, managed in community, primary care or outpatient settings...
Technical Report
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This document is a summary of guidelines that have recommendations on treatment or assessment of pain in patients with cancer or other diseases often requiring palliative care. It is available on the Cancer Care Ontario website at https://www.cancercareontario.ca/guidelines-advice/types-of-cancer/32371
Article
Background Inguinal hernia repair is a common ambulatory surgery after which many patients experience moderate to severe post-operative pain. Limited research has examined the effect of education interventions to reduce pain after ambulatory surgery. Purpose This trial evaluated the effectiveness of an individualized Hernia Repair Education Interv...
Article
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Purpose: To explore associations between HRQL, marital status, and comorbid disorders in men and women following cardiac surgery. Method: A secondary analysis was completed using data from a randomized controlled trial in which 416 individuals (23% women) scheduled for elective coronary artery bypass graft and/or valve surgery were recruited bet...
Article
Objective.: Although the University of Toronto Centre for the Study of Pain has successfully implemented an Interfaculty Pain Curriculum since 2002, we have never formalized the process in a design model. Therefore, our primary aim was to develop a model that provided an overview of dynamic, interrelated elements that have been important in our ex...
Article
Background: Tens of thousands of cardiac and vascular surgeries (CaVS) are performed on seniors in Canada and the United Kingdom each year to improve survival, relieve disease symptoms, and improve health-related quality of life (HRQL). However, chronic postsurgical pain (CPSP), undetected or delayed detection of hemodynamic compromise, complicati...
Article
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Aim: To aggregate, interpret and synthesise findings from qualitative studies to further our knowledge regarding patients' pre- and postoperative experiences when participating in an enhanced recovery after surgery (ERAS) program. Background: Numerous quantitative studies have documented benefits of participation in ERAS programs. Randomised con...
Article
Aims: To determine key factors that stimulate and drive the ongoing interests of leaders in the field of pain to continue to work for change and to explore how they use their own experiences in their teaching. Background: The assessment and management of acute and chronic pain remains a challenge and the pain education of pre-licensure/undergrad...
Article
Aims and objectives: To compare the prevalence and severity of pain in men and women during the first year following cardiac surgery and to examine the predictors of persistent postoperative pain 12 months post surgery. Background: Persistent pain has been documented after cardiac surgery, with limited evidence for differences between men and wo...
Article
Background: Relevant discharge information about the use of analgesic medication and other strategies may help patients to manage their pain more effectively and prevent postoperative persistent pain. Aims: To examine patients' pain characteristics, analgesic intake and the impact of an educational pain management booklet intervention on postope...
Article
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Ineffective assessment and management of pain is a significant problem. A gap in prelicensure health science program pain content has been identified for the improvement of pain care in the United States. Through consensus processes, an expert panel of nurses, who participated in the interdisciplinary development of core competencies in pain manage...
Article
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Background: Cardiac surgery is a common intervention that involves several pain-sensitive structures, and intense postoperative pain is a predictor of persistent pain. Aims: To describe pain characteristics (i.e. intensity, location, interference, relief) and analgesic intake preoperatively and across postoperative days 1 to 4 after cardiac surg...
Article
As the two principal research investigators, we are pleased that our large, long-term, multicentre study on persistent postcardiac surgery pain was published in CMAJ.1 However, we strongly take issue with the Editor’s comment in the April 15 print synopsis version regarding the data in the full-text article. We point out the editor’s misunderstandi...
Article
Background: Cardiac pain and/or discomfort arising from acute coronary syndromes (ACS) can often be severe and anxiety-provoking. Cardiac pain, a symptom of impaired myocardial perfusion, if left untreated, may lead to further myocardial hypoxia, which can potentiate myocardial damage. Evidence suggests that once ACS patients are stabilized, their...
Article
The Evidence-Based Practice Identification and Change (EPIC) strategy is a multifaceted knowledge translation intervention. Although the intervention promoted evidence-based practice, the process of delivering the intervention components is not well understood. The purpose of this study was to determine the construct validity of the Process Evaluat...
Article
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Background: Persistent postoperative pain continues to be an underrecognized complication. We examined the prevalence of and risk factors for this type of pain after cardiac surgery. Methods: We enrolled patients scheduled for coronary artery bypass grafting or valve replacement, or both, from Feb. 8, 2005, to Sept. 1, 2009. Validated measures w...
Article
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Background: Ontario has introduced strategies over the past decade to reduce wait times and length of stay and improve access to physiotherapy for orthopaedic and other patients. The aim of this study is to explore patients' experiences of joint replacement care during a significant system change in their care setting. Methods: A secondary analy...
Article
SUMMARY The continuing high prevalence of pain, both acute and persistent, is a public health problem. Improving pain curricula for health professionals is essential if we are to change the current ineffective practices related to pain prevention and management. An important question for all educators is whether our graduates are sufficiently compe...
Article
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Objective The objective of this project was to develop core competencies in pain assessment and management for prelicensure health professional education. Such core pain competencies common to all prelicensure health professionals have not been previously reported. Methods An interprofessional executive committee led a consensus-building process t...
Article
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Although unrelieved pain continues to represent a significant problem, prelicensure educational programs tend to include little content related to pain. Standards for professional competence strongly influence curricula and have the potential to ensure that health science students have the knowledge and skill to manage pain in a way that also allow...
Article
To determine the effect of conservative versus usual intrapartum intravenous (IV) fluid management for low-risk women receiving epidural analgesia on weight loss in breastfed newborns. A randomized controlled trial. A tertiary perinatal center in a large urban setting. Women experiencing uncomplicated pregnancies who planned to have epidural analge...
Article
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Regular pain assessment can lead to decreased incidence of pain and shorter durations of mechanical ventilation and stays in the intensive care unit. To document knowledge and perceptions of pain assessment and management practices among Canadian intensive care unit nurses. A self-administered questionnaire was mailed to 3753 intensive care unit nu...
Article
Hypertensive disorders of pregnancy are associated with maternal and perinatal health risk. Some studies have demonstrated blood pressure reduction from the use of relaxation therapies, although previous study in pregnancy was limited. We undertook a RCT to determine the effects of guided imagery relaxation on BP and anxiety in hypertensive women d...
Article
Most total knee arthroplasty (TKA) recipients experience pain following the procedure. Patients are provided with medications to manage pain but there is little information regarding their usage of analgesics after hospital discharge. This study investigated analgesic usage in recent TKA recipients. A qualitative descriptive approach was taken to p...
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points 1 – 6 1. The management of pain frequently requires healthcare professionals (HCPs) to work together; thus, educational preparation should afford them opportunities to learn about the management of pain together. 2. Survey data suggest that most HCPs’ curricula do not provide opportunities for learners to come together to learn about pain an...
Article
The purpose of this study was to identify factors that predispose individuals to nonischemic chest pain following successful percutaneous coronary intervention (PCI). We prospectively followed, for 6 months, a cohort of 110 patients who underwent PCI. We determined baseline factors associated with post PCI pain via nonlinear mixed model regression;...
Article
Refractory angina (RFA) is a debilitating disease characterized by cardiac pain resistant to conventional treatments for coronary artery disease including nitrates, calcium-channel and β-adrenoceptor blockade, vasculoprotective agents, percutaneous coronary interventions, and coronary artery bypass grafting. The mortality rate of patients living wi...
Article
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The present article describes educational innovation processes and design of a web-based pain interprofessional resource for prelicensure health science students in universities across Canada. Operationalization of educational theory in design coupled with formative evaluation of design are discussed, along with strategies that support collaborativ...
Article
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BACKGROUND⁄ Pain-related misbeliefs among health care professionals (HCPs) are common and contribute to ineffective postoperative pain assessment. While standardized patients (SPs) have been effectively used to improve HCPs' assessment skills, not all centres have SP programs. The present equivalence randomized controlled pilot trial examined the e...
Article
This study explored patients' narratives of technology in heart surgery and recovery. A narrative inquiry was conducted with a sample of 16 individuals. Interviews were completed 2 to 4 days after transfer from cardiovascular intensive care, and 4 to 6 weeks after discharge. Participants completed journals between these 2 time periods. Discharge an...
Article
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To investigate critical care nurses' current practice and knowledge related to pain assessment and management for critically ill adults able and unable to self-report pain. Cross sectional self-report survey. Survey response rate was 57%. Though more respondents used formal pain assessment tools often or routinely for patients able to self-report c...
Article
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This paper examines theoretical, pedagogical, and technological differences between two technologies that have been used in undergraduate interprofessional health sciences at the University of Toronto. One, a learning management system, WebCT 2.0, supports online coursework. The other, a Knowledge Building environment, Knowledge Forum 2.0, supports...
Article
Background: Hypertension occurs in nearly 10 percent of pregnancies, and is associated with higher risk of infant and maternal morbidity and mortality than in normal pregnancies. Previous studies have suggested that relaxation therapies reduce blood pressure in nonpregnant adults. The objectives of this pilot randomized trial were to provide preli...
Article
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Unrelieved acute and persistent pain is a widespread global problem for divergent patient groups across the lifespan. Although pain education has been identified as a strategy to improve ineffective pain management practices (1), recent evidence supports the continuing lack of pain content in health science curricula, particularly for prelicensure...
Article
Inadequate knowledge among health care providers is a key barrier to good pain management, and nurses have a major role to provide education to patients. The purpose of this study was to identify nurses' learning needs to prepare patients for managing pain before and after discharge home from cardiac surgery. The overall aim is to develop a pain ed...
Article
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The use of opioids for chronic noncancer pain (CNCP) remains controversial. Despite a number of randomized controlled trials showing efficacy and safety in the short term, long-term data are limited. To survey a selected cohort of patients with intractable CNCP with regard to long-term efficacy and safety of opioids. The present study reports long-...
Article
Individuals with coronary artery disease undergo coronary artery bypass graft (CABG) surgery to relieve symptoms, improve quality of life, and reduce early death. Pain is the most prevalent symptom identified by persons after CABG surgery. The objective of the study was to compare the prevalence and severity of pain and pain-related interference wi...
Article
In this narrative inquiry, we examined patients' experiential accounts of technology in open-heart surgery and recovery. A convenience sample of sixteen individuals was recruited from a preoperative clinic at a regional centre for cardiac services in Canada. Each participated in two interviews following transfer from cardiovascular intensive care a...
Article
The Evidence-Based Practice Identification and Change (EPIC) intervention is a complex multifaceted knowledge translation strategy that combines the use of evidence and continuous quality improvement to change health care professional practices. However, there is no measure to evaluate the fidelity (degree to which the intervention was implemented...
Article
Contributors' biographies. Foreword 1 - Professor Judy Watt-Watson, University of Toronto, Canada. Foreword 2 - Professor Kim Manley, Head of Practice Development, Royal. College of Nursing. Preface. Acknowledgement. 1 Introduction to advancing practice in pain management (Eloise Carr and Martin Christensen). 2 Nurse-led femoral nerve block service...
Article
Coronary artery bypass graft (CABG) surgery is performed more frequently in individuals who are older and sicker than in previous years. Increased patient acuity and reduced hospital length of stays leave individuals ill prepared for their recovery. To test the feasibility of a peer support program and determine indicators of the effects of peer su...
Article
Heart disease is a major cause of illness, disability and death worldwide with high personal, community and healthcare costs. Social support affects psychological and physical morbidity, mortality, and adjustment to chronic disease. Peer support, a specific type of social support, has been shown to be an effective intervention for a variety of popu...
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The present exploratory, descriptive study aimed to determine the designated time for mandatory pain content in curricula of major Canadian universities for students in health science and veterinary programs before being licensed. Major Canadian university sites (n=10) were chosen where health science faculties included at least medicine (n=10) and...
Article
Refractory angina (RFA) is a debilitating disease characterized by severe, unremitting cardiac pain (1,2). This pain or discomfort, by definition, is resistant to all conventional treatments for coronary artery disease (CAD) including nitrates, calcium channel and beta-adrenoceptor blockade, vasculoprotective agents, percutaneous coronary intervent...