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Cunha M, Silva M, Sousa V, Vaz R, Azevedo MJ, Zão A. Age-Related Variations in Breast Cancer Complications: Insights from Physical Medicine and Rehabilitation Clinical Practice. Cureus 2024; 16:e59745. [PMID: 38841007 PMCID: PMC11152361 DOI: 10.7759/cureus.59745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Background Breast cancer patients often experience complications related to the disease or its treatment. With the rising average life expectancy, age is becoming less of a factor in treatment decisions for this condition. This study aims to evaluate differences in breast cancer complications among various age groups in patients referred to a hospital's physical medicine and rehabilitation (PMR) department. Methodology A retrospective study was conducted among all breast cancer patients evaluated in a PMR department between November 2019 and March 2021. Data were collected from patients' clinical files. SPSS® version 24 (IBM Corp., Armonk, NY, USA) was used for data analysis. Results We assessed 85 patients with a mean age of 56 years, finding that shoulder pain was the primary referral reason, reported by 85.9% of patients, followed by lymphedema in 32% of cases. Patients aged 56-65 years exhibited greater deficits in shoulder mobility compared to those between 66 and 75 years old, as well as greater functional limitations compared to other age groups. Most patients reported symptoms post-surgery, with an average delay of 24 months in PMR consultation. Despite this, nearly all patients (89.3%) reported clinical improvement following interventions. Conclusions We found that individuals in the 56-65-year age group were more prone to develop functional and shoulder mobility limitations. Despite delayed consultation, the majority of patients experienced clinical improvement, highlighting the intervention effectiveness of PMR interventions. These findings suggest that age alone may not be a determining factor in the reported breast cancer sequelae, implying the influence of other contributing factors in patient management. Further research is needed to elucidate the underlying mechanisms contributing to the diverse burden of disease sequelae observed across different age groups and to devise tailored interventions.
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Affiliation(s)
- Mafalda Cunha
- Physical Medicine and Rehabilitation, Unidade Local de Saúde Alto Ave, Guimarães, PRT
| | - Marco Silva
- Physical Medicine and Rehabilitation, Unidade Local de Saúde Alto Ave, Guimarães, PRT
| | - Vitor Sousa
- Physical Medicine and Rehabilitation, Unidade Local de Saúde Alto Ave, Guimarães, PRT
| | - Rui Vaz
- Physical Medicine and Rehabilitation, Unidade Local de Saúde Alto Ave, Guimarães, PRT
| | - Maria João Azevedo
- Physical Medicine and Rehabilitation, Unidade Local de Saúde Alto Ave, Guimarães, PRT
| | - Ana Zão
- Physical Medicine and Rehabilitation, Unidade Local de Saúde de Santo António, Porto, PRT
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Díaz-Fernández Á, Ortega-Martínez AR, Cortés-Pérez I, Ibáñez-Vera AJ, Obrero-Gaitán E, Lomas-Vega R. Transcultural Adaptation and Psychometric Validation of the Spanish Version of the Pain Attitudes and Beliefs Scale for Physiotherapists. J Clin Med 2023; 12:6045. [PMID: 37762985 PMCID: PMC10531514 DOI: 10.3390/jcm12186045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Low back pain (LBP) is one of the main musculoskeletal pain conditions, and it affects 23-28% of the global population. Strong evidence supports the absence of a direct relationship between the intensity of pain and tissue damage, with psychosocial factors also playing a crucial role. In this context, the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) is a useful tool for evaluating physiotherapists' treatment orientations and beliefs regarding the management of low back pain (LBP). It helps identify practitioners who may benefit from additional education in modern pain neuroscience. However, there is not a Spanish validation of this scale for physiotherapists. Thus, the aims of this study were to translate and culturally adapt the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) into Spanish and to evaluate its psychometric properties. This validation study used three convenience samples of physiotherapists (PTs) (n = 22 for the pilot study, n = 529 for the validity study and n = 53 for assessing the instrument's responsiveness). The process of translating and adapting the PABS-PT into Spanish followed international guidelines and produced a satisfactory pre-final version of the questionnaire. Factor analysis confirmed the two-factor structure of the original version, with the biomedical (BM) factor explaining 39.4% of the variance and the biopsychosocial (BPS) factor explaining 13.8% of the variance. Cronbach's alpha values were excellent for the BM factor (0.86) and good for the BPS factor (0.77), indicating good internal consistency. Test-retest reliability was excellent for both factors, with intraclass correlation coefficients (ICCs) of 0.84 for BM and 0.82 for BPS. The standard error of measurement (SEM) was acceptable for both factors (3.9 points for BM and 2.4 points for BPS). Concurrent validity was moderate and in the expected direction and had significant correlations with the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and Revised Neurophysiology Pain Questionnaire (R-NPQ). Sensitivity to change was demonstrated by significant improvements in both factors after an educational intervention, with medium-to-large effect sizes. The PABS-PT also showed good discriminative ability, as it was able to distinguish between physiotherapists with and without pain education. Cut-off values for the BM and BPS factors were determined. In conclusion, the translated and adapted Spanish version of the PABS-PT demonstrated good psychometric properties and can be reliably used to assess the attitudes and beliefs of Spanish-speaking physiotherapists regarding LBP. The questionnaire is recommended for use in clinical and educational research in the Spanish language context.
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Affiliation(s)
- Ángeles Díaz-Fernández
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaen, Spain (R.L.-V.)
| | - Ana Raquel Ortega-Martínez
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaen, Spain (R.L.-V.)
- Department of Psychology, University of Jaen, Campus las Lagunillas, 23071 Jaen, Spain
| | - Irene Cortés-Pérez
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaen, Spain (R.L.-V.)
| | | | - Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaen, Spain (R.L.-V.)
| | - Rafael Lomas-Vega
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaen, Spain (R.L.-V.)
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3
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Park YJ, Lee MK. Effects of nurse-led nonpharmacological pain interventions for patients with cancer: A systematic review and meta-analysis. J Nurs Scholarsh 2021; 54:422-433. [PMID: 34847285 DOI: 10.1111/jnu.12750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/10/2021] [Accepted: 11/18/2021] [Indexed: 01/05/2023]
Abstract
PURPOSE The purposes of this study were to review the types of nurse-led nonpharmacological pain interventions (NPI) offered to cancer patients and/or family caregivers, and to determine a comprehensive and robust estimate of the effect size of nurse-led NPI for cancer patients on various pain-related outcomes. DESIGN Systematic review and meta-analysis. Studies assessing nurse-led NPIs targeting cancer patients and published between January 2008 and December 2020 were identified by searching multiple literature databases, including MEDLINE® , EMBASE, Google Scholar, Cochrane Library, ProQuest Medical Library, and CINAHL® . METHODS This review was conducted in accordance with the Preferred Reporting Item for Systematic Reviews and Meta-analyses guidelines. The selected randomized clinical trials were independently assessed for methodological quality. The effect sizes (ESs) of treatment were presented as standardized mean differences (Hedges' g) and 95% confidence intervals (CIs). FINDINGS A meta-analysis was performed to analyze data from 22 randomized clinical trials. Three types of nurse-led NPI were offered, mainly to cancer patients but also to some caregivers: music, physical, and psycho-educational interventions. The dose and duration of nonpharmacological interventions varied widely. The study participants ranged in age from 44.1 to 67.3 years. Meta-analysis indicated that, although these interventions had small effects in long-term (g = 0.24, 95% CI: 0.06-0.43, p = 0.011) to medium effects in short-term (g = 0.43, 95% CI: 0.32-0.53, p < 0.001), they significantly reduced patients' pain, increased their knowledge of pain management, reduced barriers to pain management and pain coping, and improved other physical and emotional symptoms. The significance of the ES differed according to the type of intervention, with psycho-educational and physical NPIs having a significant but medium short-term ES, whereas music NPI had a significant but large short-term ES. Only psycho-educational NPIs had significant long-term effects. CONCLUSION The combined ES showed that these nurse-led NPIs were significantly effective in both the short and long-term. Types of intervention as a potential moderator were associated with short-term and long-term effects of nonpharmacological interventions on patient outcomes. CLINICAL RELEVANCE Research-tested interventions should be provided to help patients cope effectively with pain.
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Affiliation(s)
- Youn Jin Park
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
| | - Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
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Simonsmeier BA, Flaig M, Simacek T, Schneider M. What sixty years of research says about the effectiveness of patient education on health: a second order meta-analysis. Health Psychol Rev 2021; 16:450-474. [PMID: 34384337 DOI: 10.1080/17437199.2021.1967184] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although meta-analyses have examined the association between patient education and health, the validity and quality of this evidence have not been comprehensively assessed. This second order meta-analysis combined previous meta-analyses that examined the effectiveness of patient education on health outcomes as an overall weighted grand mean d¯¯. Further, measures of methodological quality, meaningful variability across first order meta-analyses, and evidence for publication bias were examined. Forty meta-analyses were identified, investigating 156 associations between patient education and health summarizing data from over 776 studies including more than 74.947 patients. Quantitative analyses showed that patient education positively affects health outcomes with d¯¯ = 0.316 (95% CI [0.304, 0.329]). Summarizing data exclusively from randomized controlled trials indicated a causal effect. Patient education was effective for patients with neoplasms, diabetes, mental and behavioral disorders, diseases of the circulatory system, the respiratory system, and the musculoskeletal system. Patient education was effective in the reduction of medication use, pain, and visits to medical facilities, and significantly improved physiological, physical, psychological outcomes, and patients' general function. Overall, the findings reveal firm evidence for the effectiveness of patient education on health outcomes. However, theory-based interventions are lacking and need to be implemented to enable a successful transfer from theory to practice.
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Affiliation(s)
| | - Maja Flaig
- University of Tübingen, Tübingen, Germany
| | - Thomas Simacek
- Department of Educational Psychology, University of Trier, Trier, Germany
| | - Michael Schneider
- Department of Educational Psychology, University of Trier, Trier, Germany
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5
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Klein I, Kalichman L, Chen N, Susmallian S. A pilot study evaluating the effect of early physical therapy on pain and disabilities after breast cancer surgery: Prospective randomized control trail. Breast 2021; 59:286-293. [PMID: 34340163 PMCID: PMC8342784 DOI: 10.1016/j.breast.2021.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/08/2021] [Accepted: 07/16/2021] [Indexed: 12/24/2022] Open
Abstract
Background Morbidity of the shoulders after breast cancer (BC) surgery is a common side effect that includes; persistent pain, function limitation, and decreased range of motion (ROM). This study examines the effect of early physical therapy (PT) and patient's education on these morbidities. Methods A prospective, randomized clinical trial was conducted at a single medical center from October 2018 until April 2019. Women scheduled for breast cancer surgery were divided into intervention or control as standard care. The intervention included a PT treatment that included exercise instructions from the first postoperative day. Pain levels, upper limb function, ROM, and complications were measured. Results The study includes 157 women (mean age, 52.2 ± 12.9). Early PT reduced pain levels at the first month (NPRS 1.5 ± 1.2) and six months (NPRS 0.5 ± 0.8), compared with control (NPRS 2.1 ± 1.4, 1.0 ± 1.2), p = 0.019 and p = 0.011, respectively. Subdivision of the sample into small and extensive surgeries revealed additional positive effect for the intervention six months postoperatively on functional disabilities, p = 0.004 and p = 0.032 respectively. No complications attributable to the intervention were recorded. Conclusions Early PT and patient education reduces pain levels, and may improve function disabilities, without causing postoperative complications, although a larger study is needed to achieve unequivocal results. In breast cancer surgeries frequently delay the start of physical activities, arguing that it involves complications. The shoulder after breast surgery may provoke prolonged pain, disabilities, and prolongs recovery time. Physical therapy given the day after surgery, does not cause postoperative complications. Early onset of exercise regarding function and pain during recovery, may help reduce pain levels.
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Affiliation(s)
- Ifat Klein
- Department of Physical Therapy, Assuta Medical Center, Tel Aviv, Israel; Department of Physical Therapy. Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Leonid Kalichman
- Department of Physical Therapy. Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Noy Chen
- Department of Physical Therapy, Assuta Medical Center, Tel Aviv, Israel
| | - Sergio Susmallian
- Department of Surgery, Assuta Medical Center, Tel Aviv, Israel; Faculty of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel.
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Assessment Tools of Patient Competences: The Spanish Version of the R-NPQ and Three Practical Cases in Women with Breast Cancer and Persistent Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094463. [PMID: 33922314 PMCID: PMC8122815 DOI: 10.3390/ijerph18094463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 12/04/2022]
Abstract
Persistent pain following treatment for breast cancer (PPBCT) is a prevalent and complex clinical issue. Education together with physiotherapy have been shown to lessen pain and disability in chronic pain. Although the evaluation of the patient’s competences is a major part of the educational program, the published educational programs rarely describe the tools used to assess competences, especially regarding those related to decision-making and problem-solving. The aim of this study was to provide two competences assessment tools: the cross-cultural adaptation and validation of the Spanish version of the Revised Neurophysiology of Pain Questionnaire (R-NPQ) and practical cases of women with PPBCT. The Spanish cross-cultural adaptation was conducted following recognized criteria. Measurement properties testing included an analysis of construct validity (known-groups approach), reliability (internal consistency and test-retest reliability), responsiveness, interpretability, and feasibility. To promote a tool that would allow evaluation of the educational program competences, a group of experts developed three cases extracted from real contexts by means of an iterative process. A total of 80 women with PPBCT (mean age 56 years) and 81 physiotherapy students (mean age 20 years) participated in the measurement properties analysis. The three developed cases were presented to the same 80 women with PPBCT before and after the educational program. As we expected, students showed a significantly higher score (p < 0.001) than did women with PPBCT in the R-NPQ questionnaire, with a large effect size (d = 2.49), demonstrating good construct validity. The Cronbach alpha was 0.90 (95% CI, 0.87–0.92) and the intraclass correlation coefficient was 0.82 (95% CI, 0.73–0.88). A large effect size (5.2) was found, as we expected, between baseline and post-treatment scores, suggesting adequate responsiveness. In addition, identifying and analyzing, decision making, communicating needs, knowing how to manage, and problem-solving skills were evaluated through the three practical cases. Most women (88.75%) reached the highest level in the assessment rubric of the proposed practical cases. The Spanish R-NPQ is a comprehensible, valid, reliable, and responsive tool for Spanish women with PPBCT. The practical cases are a useful competence assessment tool and were well accepted by women with PPBCT. Further studies are needed to investigate more competence assessment tools and to investigate whether the achievement of different levels of competences has an effect on health behaviors.
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7
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Physical Therapy Evaluation and Management of Cancer-Related Low Back Pain: A Perspective. REHABILITATION ONCOLOGY 2020. [DOI: 10.1097/01.reo.0000000000000162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Söderlund Schaller A, Dragioti E, Liedberg GM, Larsson B. Are patient education and self-care advantageous for patients with head and neck cancer? A feasibility study. Nurs Open 2019; 6:1528-1541. [PMID: 31660181 PMCID: PMC6805323 DOI: 10.1002/nop2.361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/19/2019] [Accepted: 07/10/2019] [Indexed: 01/01/2023] Open
Abstract
AIM This study evaluates whether patient education and individually self-care reduces pain and improves QoL, mood and sleep during and after radiotherapy treatment for patients with head and neck cancer. DESIGN A longitudinal, two-armed feasibility study design was performed. METHODS Sixty-four participants with curative intent were included in the study. All participants answered questions about pain three times a week and completed a survey questionnaire about pain, QoL, psychological aspects and barriers towards pain management at baseline, at 4 weeks and at 10 weeks. Thirty-four of the participants attended in two education sessions on pain based on their beliefs about pain and received individualized self-care instructions based on their weekly rating of pain. RESULT This study did not find any significant group differences for the pain, QoL, mood and sleep.
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Affiliation(s)
- Anne Söderlund Schaller
- Pain and Rehabilitation Centre and Department of Medical and Health SciencesLinköping UniversityLinköpingSweden
| | - Elena Dragioti
- Pain and Rehabilitation Centre and Department of Medical and Health SciencesLinköping UniversityLinköpingSweden
| | - Gunilla M. Liedberg
- Division of Occupational Therapy, Department of Social and Welfare StudiesFaculty of Health Sciences, Campus Norrkoping, Linköping UniversityLinköpingSweden
| | - Britt Larsson
- Pain and Rehabilitation Centre and Department of Medical and Health SciencesLinköping UniversityLinköpingSweden
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Prevost V, Heutte N, Leconte A, Licaj I, Delorme C, Clarisse B. Effectiveness of a therapeutic patient education program in improving cancer pain management: EFFADOL, a stepped-wedge randomised controlled trial. BMC Cancer 2019; 19:673. [PMID: 31286871 PMCID: PMC6615097 DOI: 10.1186/s12885-019-5836-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/14/2019] [Indexed: 01/29/2023] Open
Abstract
Background Despite numerous guidelines, nearly one of two patients with cancer pain remains undertreated, thereby affecting their quality of life. Active patient involvement through Therapeutic Patient Education (TPE) is considered as a relevant strategy to overcoming hurdles in pain management. The aim of the EFFADOL study is to assess the effectiveness of a TPE program in improving cancer pain management. Methods/design The EFFADOL study is a stepped-wedge randomised controlled trial. A total of 260 cancer patients with unbalanced background pain will be randomised over the institutional level, i.e. stepped-wedge cluster design. Six clusters will be formed, one at the regional level of “Basse-Normandie” for patients receiving the educational approach by health providers already trained to TPE. Then, five additional centers will be gradually included at the national level, making it possible to compare the “conventional” management of pain (before medical staff training to TPE) with the educational approach (after being trained). The main study parameter is pain interference on daily life assessed with the self-administrated and validated Brief Pain Inventory questionnaire. Secondary objectives comprised the evaluation of patients’ adherence to pain education program, the description of pain intensity, pain relief, analgesic adherence and pain emotional impact. Educational dimension of the program will be evaluated through the patients’ acquisition of knowledge and skills about their pain and treatment as well as their self-efficacy to participate actively in pain management. The patient’s feeling of pain changes will be measured. Finally, the satisfaction of participants and educators will be reported. We hypothetise active involvement of patients in TPE will lead to an improved pain management compared to standard care. Discussion Analyzing the impact of a TPE program in cancer pain patients will improve their pain management and quality of life. We expect that the dissemination of our project educational approach through the French territory will be accompanied by long term change in clinical practices with mutual benefit to patients and caregiver-educators. Trial registration NCT03297723, registered: 09/28/2017. Protocol version: Version n°1.1 dated from 2016/09/08.
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Affiliation(s)
- Virginie Prevost
- University of Normandy, 14000, Caen, France. .,UMR 1086 INSERM « ANTICIPE », Centre François Baclesse, 14000, Caen, France.
| | - Natacha Heutte
- Clinical Research Department, Centre François Baclesse, 14000, Caen, France
| | - Alexandra Leconte
- Clinical Research Department, Centre François Baclesse, 14000, Caen, France
| | - Idlir Licaj
- UMR 1086 INSERM « ANTICIPE », Centre François Baclesse, 14000, Caen, France.,Clinical Research Department, Centre François Baclesse, 14000, Caen, France
| | - Claire Delorme
- Bayeux Hospital, 14400, Bayeux, France.,Regional Pain Network for Lower Normandy, 14400, Bayeux, France
| | - Bénédicte Clarisse
- Clinical Research Department, Centre François Baclesse, 14000, Caen, France
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10
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Prevost V, Delorme C, Heutte N, Leconte A, Bechet C, Licaj I, Bignon R, Bisson C, Cauchin S, Gicquère M, Grach MC, Guillaumé C, Le Garrec J, Ropartz MC, Roux N, Sep Hieng V, Le Chevalier A, Clarisse B. Evaluation of patients' needs to design and assess a patient education program in cancer pain. J Pain Res 2019; 12:1813-1823. [PMID: 31239759 PMCID: PMC6560184 DOI: 10.2147/jpr.s197920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/10/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: Patient education constitutes a relevant strategy to improve pain management. In the field of therapeutic patient education (TPE), we aimed 1) to assess pain impact in cancer patients, 2) to identify patients' educative needs in pain management, and 3) to refine research criteria for its future evaluation. Patients and methods: Pain intensity, relief and interference were assessed in 75 cancer patients with unbalanced background pain. Self-assessment questionnaire evaluated i) patients' pain management and ii) their knowledge and needs in TPE. Results: Most patients experienced pain for more than 6 months and 41.6% reported adequate pain relief. Understanding pain and pain management were major patients' preferences (>58%). Most patients declared they knew their pain treatments, but fewer than half of them were able to name them. However, education concerning pain treatment was considered as essential in <30% of patients. Almost all patients (97.1%) stated pain education as beneficial, with a preference for individualized sessions (41.2%). In addition, the assessment criteria for its future evaluation were refined. Conclusion: Targeted population mainly concerned patients with persistent pain. Only half of patients reported pain relief despite antalgics. Patient education was declared as beneficial for almost all participants. Practice implications: Tailoring a pain TPE on patients' needs has the potential to help them to optimally manage their pain daily.
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Affiliation(s)
- V Prevost
- UMR 1086 Inserm ANTICIPE (Interdisciplinary Research Unit for Cancer Treatment and Prevention) and University of Normandy , Caen, France
| | - C Delorme
- Pain Assessment and Treatment Centre, Bayeux Hospital , Bayeux, France.,Regional Pain Network for Lower Normandy , Bayeux, France
| | - N Heutte
- Clinical Research Unit, Centre François Baclesse, Caen, France
| | - A Leconte
- Clinical Research Unit, Centre François Baclesse, Caen, France
| | - C Bechet
- Pharmacie de la Croix d'Or , Paris, France
| | - I Licaj
- Clinical Research Unit, Centre François Baclesse, Caen, France
| | - R Bignon
- Regional Pain Network for Lower Normandy , Bayeux, France.,Pain and Palliative Care Unit, Lisieux Hospital , Lisieux, France
| | - C Bisson
- Pain Assessment and Treatment Centre, Bayeux Hospital , Bayeux, France.,Regional Pain Network for Lower Normandy , Bayeux, France
| | - S Cauchin
- Regional Pain Network for Lower Normandy , Bayeux, France.,Pain Assessment and Treatment Consultation, Alençon-Mamers Intercommunal Hospital , Alençon, France
| | - M Gicquère
- Regional Pain Network for Lower Normandy , Bayeux, France.,Pain and Palliative Care Unit, Centre François Baclesse, Caen, France
| | - M C Grach
- Regional Pain Network for Lower Normandy , Bayeux, France.,Pain and Palliative Care Unit, Centre François Baclesse, Caen, France
| | - C Guillaumé
- Regional Pain Network for Lower Normandy , Bayeux, France.,Pain and Palliative Care Unit, University Hospital , Caen, France
| | - J Le Garrec
- Regional Pain Network for Lower Normandy , Bayeux, France.,Pain Assessment and Treatment Consultation, Alençon-Mamers Intercommunal Hospital , Alençon, France
| | - M C Ropartz
- Regional Pain Network for Lower Normandy , Bayeux, France.,Pain Assessment and Treatment Centre, Avranches-Granville Hospital , Avranches, France
| | - N Roux
- Regional Pain Network for Lower Normandy , Bayeux, France.,Pain and Palliative Care Unit, University Hospital , Caen, France
| | - V Sep Hieng
- Regional Pain Network for Lower Normandy , Bayeux, France.,Pain and Palliative Care Unit, Lisieux Hospital , Lisieux, France
| | - A Le Chevalier
- Regional Pain Network for Lower Normandy , Bayeux, France.,Pain Assessment and Treatment Centre, Avranches-Granville Hospital , Avranches, France
| | - B Clarisse
- Clinical Research Unit, Centre François Baclesse, Caen, France
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Abstract
OBJECTIVES Uncontrolled pain in advanced cancer is a common problem and has significant impact on individuals' quality of life and use of healthcare resources. Interventions to help manage pain at the end of life are available, but there is limited economic evidence to support their wider implementation. We conducted a case study economic evaluation of two pain self-management interventions (PainCheck and Tackling Cancer Pain Toolkit [TCPT]) compared with usual care. METHODS We generated a decision-analytic model to facilitate the evaluation. This modelled the survival of individuals at the end of life as they moved through pain severity categories. Intervention effectiveness was based on published meta-analyses results. The evaluation was conducted from the perspective of the U.K. health service provider and reported cost per quality-adjusted life-year (QALY). RESULTS PainCheck and TCPT were cheaper (respective incremental costs -GBP148 [-EUR168.53] and -GBP474 [-EUR539.74]) and more effective (respective incremental QALYs of 0.010 and 0.013) than usual care. There was a 65 percent and 99.5 percent chance of cost-effectiveness for PainCheck and TCPT, respectively. Results were relatively robust to sensitivity analyses. The most important driver of cost-effectiveness was level of pain reduction (intervention effectiveness). Although cost savings were modest per patient, these were considerable when accounting for the number of potential intervention beneficiaries. CONCLUSIONS Educational and monitoring/feedback interventions have the potential to be cost-effective. Economic evaluations based on estimates of effectiveness from published meta-analyses and using a decision modeling approach can support commissioning decisions and implementation of pain management strategies.
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12
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Prevost V, Clarisse B, Heutte N, Leconte A, Bisson C, Bignon R, Cauchin S, Feuillet M, Gehanne S, Gicquère M, Grach MC, Guillaumé C, Le Gal C, Le Garrec J, Lecaer F, Lepleux I, Millet AL, Ropartz MC, Roux N, Sep Hieng V, Van Delook C, Bechet C, Le Chevalier A, Delorme C. [Elaboration and evaluation of a therapeutic education program in cancer pain management]. Bull Cancer 2018; 105:1074-1083. [PMID: 30327192 DOI: 10.1016/j.bulcan.2018.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 07/10/2018] [Accepted: 08/27/2018] [Indexed: 10/28/2022]
Abstract
Pain, one of the most feared symptoms for patients with cancer, remains insufficiently alleviated and impairs quality of life. Therapeutic patient education (TPE) is a relevant approach to this problem while allowing patients to develop skills to better manage their pain. In the "Basse-Normandie" French region, the management of pain relies on two organized networks, thus allowing proximity and accessibility for all concerned. In this context, our team has begun a broad five-step research program that is part of a regional health policy: (1) training in TPE of 10 doctor/nurse pairs; (2) identification of educational expectations of patients and their relatives in the field of cancer pain; (3) design and optimization of a TPE program dedicated to cancer pain; (4) regional pilot study aiming to assess the feasibility, quality and transferability of the program; (5) evaluation of the TPE program by interventional comparative randomization at the national level. This article aims to present the program which originality and strengths are based on collaborative work between health stakeholders. Objectives, methodology and expected results of the research phase (stages 2, 4, 5) are notably developed. The main expected outcomes are to prove the effectiveness of the program in improving the knowledge and skills of patients in the field of pain cancer in order to promote their adherence to treatment and, consequently, to enable them to better manage it. The long-term objective is to disseminate the educational approach by modifying practices that provide a mutual benefit for caregivers and patients.
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Affiliation(s)
- Virginie Prevost
- Université de Caen Normandie, UMR 1086 Inserm, unité de recherche interdisciplinaire pour la prévention et le traitement des cancers « ANTICIPE », 14000 Caen, France; Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France.
| | - Bénédicte Clarisse
- Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France
| | - Natacha Heutte
- Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France; Normandie université, UNIROUEN, CETAPS EA 3832, 76130 Mont-Saint-Aignan, France
| | - Alexandra Leconte
- Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France
| | - Cécile Bisson
- Centre hospitalier, 14400 Bayeux, France; Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France
| | - Rachel Bignon
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 14100 Lisieux, France
| | - Sonia Cauchin
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier intercommunal Alençon-Mamers, 61000 Alençon, France
| | - Maryline Feuillet
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 50000 Saint-Lô, France
| | - Sylvie Gehanne
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 50000 Saint-Lô, France
| | - Maud Gicquère
- Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France; Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France
| | - Marie-Christine Grach
- Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France; Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France
| | - Cyril Guillaumé
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; CHU, 14000 Caen, France
| | - Christine Le Gal
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 61200 Argentan, France
| | - Joelle Le Garrec
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier intercommunal Alençon-Mamers, 61000 Alençon, France
| | - Franck Lecaer
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 61100 Flers, France
| | - Isabelle Lepleux
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 50100 Cherbourg, France
| | - Anne-Laure Millet
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 61100 Flers, France
| | - Marie-Claude Ropartz
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 50400 Avranches-Granville, France
| | - Nathalie Roux
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; CHU, 14000 Caen, France
| | - Virith Sep Hieng
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 14100 Lisieux, France
| | - Carole Van Delook
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 61200 Argentan, France
| | | | - Aline Le Chevalier
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 50400 Avranches-Granville, France
| | - Claire Delorme
- Centre hospitalier, 14400 Bayeux, France; Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France
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Eaton LH, Brant JM, McLeod K, Yeh C. Nonpharmacologic Pain Interventions: A Review of Evidence-Based Practices for Reducing Chronic Cancer Pain
. Clin J Oncol Nurs 2018; 21:54-70. [PMID: 28524909 DOI: 10.1188/17.cjon.s3.54-70] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pain is a common issue for patients with cancer and can be challenging to manage effectively. Healthcare professionals need to be knowledgeable about evidence-based nonpharmacologic interventions.
. OBJECTIVES This systematic review critically appraises the strength and quality of the empirical evidence for nonpharmacologic interventions in reducing chronic cancer pain.
. METHODS Intervention studies were critically appraised and summarized by an Oncology Nursing Society Putting Evidence Into Practice team of RNs, advanced practice nurses, and nurse scientists. A level of evidence and a practice recommendation was assigned to each intervention.
. FINDINGS Based on evidence, recommended interventions to reduce chronic cancer pain are celiac plexus block for pain related to pancreatic and abdominal cancers and radiation therapy for bone pain. Although psychoeducational interventions are considered likely to be effective, the effective components of these interventions and their dose and duration need to be determined through additional research.
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Koh SJ, Keam B, Hyun MK, Ju Seo J, Uk Park K, Oh SY, Ahn J, Lee JY, Kim J. Cancer Pain Management Education Rectifies Patients’ Misconceptions of Cancer Pain, Reduces Pain, and Improves Quality of Life. PAIN MEDICINE 2018; 19:2546-2555. [DOI: 10.1093/pm/pny039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Su-Jin Koh
- Department of Hematology and Oncology, Ulsan University College of Medicine and Ulsan University Hospital, Ulsan, Republic of Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Kyung Hyun
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Jeong Ju Seo
- Department of Quality & Patient Safety, Cheil Orthopedic Hospital Seoul, Republic of Korea
| | - Keon Uk Park
- Department of Hematology/Oncology, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University Hospital, Busan, Republic of Korea
| | - Jinseok Ahn
- Department of Quality & Patient Safety, Cheil Orthopedic Hospital Seoul, Republic of Korea
| | - Ja Youn Lee
- National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea
| | - JinShil Kim
- College of Nursing, Gachon University, Incheon, Korea
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Miyashita M. Editorial Special Issue: Pain Management. Asia Pac J Oncol Nurs 2018; 5:245-247. [PMID: 29963585 PMCID: PMC5996587 DOI: 10.4103/apjon.apjon_22_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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16
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Ciucă A, Băban A. Psychological factors and psychosocial interventions for cancer related pain. ACTA ACUST UNITED AC 2017; 55:63-68. [PMID: 28186958 DOI: 10.1515/rjim-2017-0010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Indexed: 11/15/2022]
Abstract
The present paper is aimed at briefly presenting psychological factors involved in cancer related pain and what psychosocial interventions are efficient in reducing it. Cancer related pain is a complex experience and the most integrative and recommended approach is the biopsychosocial model. It has been proved that chronic pain is more strongly related to psychological factors than to treatment or illness related factors. Psychological factors influencing pain experience can be intuitively grouped starting with awareness of pain (i.e., attentional factor), then with evaluation of pain (i.e., cognitive factors) which is leading to feelings (i.e., emotional factors), and behaviours (i.e., coping strategies) regarding pain. Psychosocial interventions (i.e., skill based and education based interventions) have strong evidence that is effective in reducing cancer related pain.
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17
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Ehrlich O, Walker RK. Pain and social processes for hospice cancer patients: An integrative review. Eur J Oncol Nurs 2016; 25:83-89. [DOI: 10.1016/j.ejon.2016.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 09/25/2016] [Accepted: 10/05/2016] [Indexed: 12/01/2022]
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18
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Hochstenbach LM, Zwakhalen SM, Courtens AM, van Kleef M, de Witte LP. Feasibility of a mobile and web-based intervention to support self-management in outpatients with cancer pain. Eur J Oncol Nurs 2016; 23:97-105. [DOI: 10.1016/j.ejon.2016.03.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 02/16/2016] [Accepted: 03/27/2016] [Indexed: 10/21/2022]
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Santos Salas A, Fuentes Contreras J, Armijo-Olivo S, Saltaji H, Watanabe S, Chambers T, Walter L, Cummings GG. Non-pharmacological cancer pain interventions in populations with social disparities: a systematic review and meta-analysis. SUPPORTIVE CARE IN CANCER : OFFICIAL JOURNAL OF THE MULTINATIONAL ASSOCIATION OF SUPPORTIVE CARE IN CANCER 2015. [PMID: 26556211 DOI: 10.1007/s00520‐015‐2998‐9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Global advances in pain relief have improved the quality of life of cancer populations. Yet, variation in cancer pain outcomes has been found in populations with social disparities compared to mainstream groups. Populations with social disparities bear an inequitable distribution of resources such as ethnic minorities, low income individuals, and women in vulnerable circumstances. RESEARCH PURPOSE A systematic review and meta-analysis of the effect of non-pharmacological cancer pain interventions in cancer populations with social disparities of income, ethnicity, or gender. METHODS Randomized controlled trials, controlled trials, and before and after studies were targeted through comprehensive multidatabase searches. Two reviewers independently screened titles/abstracts for potentially relevant studies and reviewed the full text of relevant articles for inclusion. Data were extracted from included studies by one reviewer and verified by another reviewer. Four reviewers independently completed quality assessment. Studies were grouped by intervention. Effects were evaluated for heterogeneity and pooled. RESULTS The search found 5219 potential records. Full text of 26 reports was evaluated. Three randomized controlled trials (RCTs) met inclusion criteria, targeting ethnic minorities and underserved populations and/or women. Interventions included education, coaching, and online support groups. Studies found no significant differences in pain reduction between intervention and control groups or between ethnic minorities and their counterparts. A high risk of bias was found in all studies. Meta-analysis found no statistically significant difference on pain intensity among underserved groups, ethnic minorities, or between ethnic minorities and white counterparts. CONCLUSION Results show the need to examine supportive care interventions particularly in populations with social disparities.
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Affiliation(s)
- Anna Santos Salas
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Jorge Fuentes Contreras
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Católica del Maule, Avda. San Miguel 3605, Talca, Chile
| | - Susan Armijo-Olivo
- Research Centre Faculty of Rehabilitation Medicine, 3-62 Corbett Hall, University of Alberta, 8205 114 Street, Edmonton, AB, T6G 2G4, Canada
| | - Humam Saltaji
- School of Dentistry, University of Alberta, 5-476 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Sharon Watanabe
- Department of Symptom Control and Palliative Care, Cross Cancer Institute and Division of Palliative Care Medicine, Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Room 2001, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada
| | - Thane Chambers
- John W. Scott Health Sciences Library, University of Alberta Libraries, Edmonton, AB, T6G 2R7, Canada
| | - Lori Walter
- UBC Okanagan Library, The University of British Columbia, Okanagan Campus, 3333 University Way, Kelowna, BC, V1V 1V7, Canada
| | - Greta G Cummings
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
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20
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Santos Salas A, Fuentes Contreras J, Armijo-Olivo S, Saltaji H, Watanabe S, Chambers T, Walter L, Cummings GG. Non-pharmacological cancer pain interventions in populations with social disparities: a systematic review and meta-analysis. Support Care Cancer 2015; 24:985-1000. [PMID: 26556211 DOI: 10.1007/s00520-015-2998-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/26/2015] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Global advances in pain relief have improved the quality of life of cancer populations. Yet, variation in cancer pain outcomes has been found in populations with social disparities compared to mainstream groups. Populations with social disparities bear an inequitable distribution of resources such as ethnic minorities, low income individuals, and women in vulnerable circumstances. RESEARCH PURPOSE A systematic review and meta-analysis of the effect of non-pharmacological cancer pain interventions in cancer populations with social disparities of income, ethnicity, or gender. METHODS Randomized controlled trials, controlled trials, and before and after studies were targeted through comprehensive multidatabase searches. Two reviewers independently screened titles/abstracts for potentially relevant studies and reviewed the full text of relevant articles for inclusion. Data were extracted from included studies by one reviewer and verified by another reviewer. Four reviewers independently completed quality assessment. Studies were grouped by intervention. Effects were evaluated for heterogeneity and pooled. RESULTS The search found 5219 potential records. Full text of 26 reports was evaluated. Three randomized controlled trials (RCTs) met inclusion criteria, targeting ethnic minorities and underserved populations and/or women. Interventions included education, coaching, and online support groups. Studies found no significant differences in pain reduction between intervention and control groups or between ethnic minorities and their counterparts. A high risk of bias was found in all studies. Meta-analysis found no statistically significant difference on pain intensity among underserved groups, ethnic minorities, or between ethnic minorities and white counterparts. CONCLUSION Results show the need to examine supportive care interventions particularly in populations with social disparities.
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Affiliation(s)
- Anna Santos Salas
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Jorge Fuentes Contreras
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Católica del Maule, Avda. San Miguel 3605, Talca, Chile
| | - Susan Armijo-Olivo
- Research Centre Faculty of Rehabilitation Medicine, 3-62 Corbett Hall, University of Alberta, 8205 114 Street, Edmonton, AB, T6G 2G4, Canada
| | - Humam Saltaji
- School of Dentistry, University of Alberta, 5-476 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Sharon Watanabe
- Department of Symptom Control and Palliative Care, Cross Cancer Institute and Division of Palliative Care Medicine, Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Room 2001, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada
| | - Thane Chambers
- John W. Scott Health Sciences Library, University of Alberta Libraries, Edmonton, AB, T6G 2R7, Canada
| | - Lori Walter
- UBC Okanagan Library, The University of British Columbia, Okanagan Campus, 3333 University Way, Kelowna, BC, V1V 1V7, Canada
| | - Greta G Cummings
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
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Lanitis S, Mimigianni C, Raptis D, Sourtse G, Sgourakis G, Karaliotas C. The Impact of Educational Status on the Postoperative Perception of Pain. Korean J Pain 2015; 28:265-74. [PMID: 26495081 PMCID: PMC4610940 DOI: 10.3344/kjp.2015.28.4.265] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 06/25/2015] [Accepted: 07/02/2015] [Indexed: 11/05/2022] Open
Abstract
Background Postoperative (PO) pain interferes with the recovery and mobilization of the surgical patients. The impact of the educational status has not been studied adequately up to now. Methods This prospective study involved 400 consecutive general surgery patients. Various factors known to be associated with the perception of pain including the educational status were recorded as was the preoperative and postoperative pain and the analgesia requirements for the 1st PO week. Based on the educational status, we classified the patients in 3 groups and we compared these groups for the main outcomes: i.e. PO pain and PO analgesia. Results There were 145 patients of lower education (junior school), 150 patients of high education (high school) and 101 of higher education (university). Patients of lower education were found to experience more pain than patients of higher education in all postoperative days (from the 2nd to the 6th). No difference was identified in the type and quantity of the analgesia used. The subgroup analysis showed that patients with depression and young patients (< 40 years) had the maximum effect. Conclusions The educational status may be a significant predictor of postoperative pain due to various reasons, including the poor understanding of the preoperative information, the level of anxiety and depression caused by that and the suboptimal request and use of analgesia. Younger patients (< 40), and patients with subclinical depression are mostly affected while there is no impact on patients over 60 years old.
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Affiliation(s)
- Sophocles Lanitis
- 2nd Surgical Department and Unit of Surgical Oncology "Korgialenio-Benakio", Red Cross Athens General Hospital, Greece
| | - Christina Mimigianni
- Department of Anaesthesiology "Korgialenio-Benakio", Red Cross Athens General Hospital, Greece
| | - Demetris Raptis
- 2nd Surgical Department and Unit of Surgical Oncology "Korgialenio-Benakio", Red Cross Athens General Hospital, Greece
| | - Gionous Sourtse
- 2nd Surgical Department and Unit of Surgical Oncology "Korgialenio-Benakio", Red Cross Athens General Hospital, Greece
| | - George Sgourakis
- 2nd Surgical Department and Unit of Surgical Oncology "Korgialenio-Benakio", Red Cross Athens General Hospital, Greece
| | - Constantine Karaliotas
- 2nd Surgical Department and Unit of Surgical Oncology "Korgialenio-Benakio", Red Cross Athens General Hospital, Greece
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Song Y, Oh M, Park S, Park M, Kim K, Lee U, Park M. The Methodological Quality of Systematic Reviews and Meta-Analyses on the Effectiveness of Non-pharmacological Cancer Pain Management. Pain Manag Nurs 2015; 16:781-91. [DOI: 10.1016/j.pmn.2015.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 06/10/2015] [Accepted: 06/10/2015] [Indexed: 01/08/2023]
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Prevost V, Delorme C, Grach MC, Chvetzoff G, Hureau M. Therapeutic Education in Improving Cancer Pain Management: A Synthesis of Available Studies. Am J Hosp Palliat Care 2015; 33:599-612. [PMID: 25991567 DOI: 10.1177/1049909115586394] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This literature review aims to synthesize available studies and to update findings in order to obtain a current, comprehensive estimate of the benefits of pain education. Forty-four original articles obtained from the PubMed database were analyzed to investigate which protocols could be most effective in improving pain management. Recent studies indicate a growing interest in evaluating patients' skills and attitudes; these include satisfaction with cancer pain treatment, patient-reported improvement, and patient participation-all of which could be dependable benchmarks for evaluating the effectiveness of educational programs. Besides pain measurement, recent studies advance support for the importance of assessing newly developed outcome criteria. In this sense, patients' active participation and decision making in their pain management are probably the most relevant goals of pain education.
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Affiliation(s)
- Virginie Prevost
- INSERM U1086, Cancers et Préventions and Université de Caen Basse-Normandie EA 3936, Caen, France Centre Régional de Lutte Contre le Cancer François Baclesse, Caen, France
| | - Claire Delorme
- Centre Régional de Lutte Contre le Cancer François Baclesse, Caen, France Centre d'Etude et de Traitement de la Douleur et Réseau Régional Douleur en Basse-Normandie, Bayeux, France
| | | | - Gisèle Chvetzoff
- Centre Régional de Lutte Contre le Cancer Léon Bérard, Lyon, France
| | - Magalie Hureau
- Centre Régional de Lutte Contre le Cancer Léon Bérard, Lyon, France Direction de la Recherche Clinique et de l'Innovation, Centre Léon Bérard, Lyon, France
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Butow P, Smith A'B. Systematic reviews of pain and online interventions for cancer patients show evidence of mixed efficacy and highlight need for more rigorously designed research. PATIENT EDUCATION AND COUNSELING 2015; 98:267-268. [PMID: 25628051 DOI: 10.1016/j.pec.2015.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, NSW Australia.
| | - Allan 'Ben' Smith
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, NSW Australia
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Adam R, Bond C, Murchie P. Educational interventions for cancer pain. A systematic review of systematic reviews with nested narrative review of randomized controlled trials. PATIENT EDUCATION AND COUNSELING 2015; 98:269-282. [PMID: 25483575 DOI: 10.1016/j.pec.2014.11.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 10/08/2014] [Accepted: 11/08/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Educational interventions are one approach to improving cancer pain management. This review aims to determine whether educational interventions can improve cancer pain management and to characterize components of cancer pain educational interventions. METHODS Medline, EMBASE, CINAHL, and Cochrane databases were searched. Systematic reviews that assessed educational interventions to improve cancer pain management were included. Randomized controlled trials (RCTs) were identified from each review. A narrative approach was taken to summarizing the nature and components of interventions. RESULTS Eight systematic reviews and 34 randomized controlled trials (RCTs) were reviewed. Interventions targeting patients can achieve small to moderate reductions in pain intensity. Interventions targeting professionals can improve their knowledge but most trials have not assessed for resultant patient benefits. All interventions included at least one of seven core components: improving knowledge about the nature of cancer pain; aiding communication about cancer pain; enhancing pain assessment; improving analgesic prescribing; tackling barriers to analgesic non-adherence; teaching non-pharmacological pain management strategies; and promoting re-assessment. CONCLUSIONS Cancer pain educational interventions can improve pain outcomes. They are complex heterogeneous interventions which often contain a combination of active components. PRACTICE IMPLICATIONS Suggestions are made to aid the development of future interventions.
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Affiliation(s)
- Rosalind Adam
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
| | - Christine Bond
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | - Peter Murchie
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
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