1
|
Liu MT, Liang SY, Chao TC, Tseng LM, Rosenberg J. The Behavioral Adaptations and Barriers of Patients Employing Non-Pharmacological Strategies for Cancer Pain Management-A Qualitative Study. Healthcare (Basel) 2023; 11:2911. [PMID: 37998403 PMCID: PMC10671318 DOI: 10.3390/healthcare11222911] [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: 10/16/2023] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 11/25/2023] Open
Abstract
The use of non-pharmacological strategies to complement pharmacological approaches can enhance cancer pain management by promoting patient autonomy and increasing management effectiveness. This study aimed to explore the required behavioral adaptations and situational barriers that cancer patients encounter when utilizing non-pharmacological strategies to manage pain. We adopted an exploratory-descriptive qualitative research approach, purposive sampling, and semi-structured interview guidelines to conduct face-to-face interviews with 18 cancer patients experiencing moderate or severe levels of worst pain. Data were analyzed using inductive content analysis to explore patients' experiences. Five themes described the behavioral adaptations of patients using non-pharmacological strategies to deal with cancer pain: finding complementary therapies, utilizing assistive skills, adapting to assistive skills, diverting attention, and seeking help. Situational barriers faced by patients include being in the workplace or in a climate-affected environment. Behavioral adaptation is necessary for non-pharmacological strategies to coping with cancer pain. The behavioral skills can help the patients to overcome situational barriers to engagement with these strategies. Thus, health professionals are expected to help the patients acquire adequate behavioral adaptation and skills for self-pain management, and assess the effectiveness of the strategies.
Collapse
Affiliation(s)
- Man-Ting Liu
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei 112, Taiwan
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, 407, Section 2, Jianfu Road, Shangwu Village, Sanxing Township, Yilan 266, Taiwan
| | - Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei 112, Taiwan
| | - Ta-Chung Chao
- Oncology Department, Taipei Veterans General Hospital, 201, Sec. 2, Shipai Road, Beitou, Taipei 112, Taiwan
| | - Ling-Ming Tseng
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
- Department of General Surgery, Taipei Veterans General Hospital, 201, Sec. 2, Shipai Road, Beitou, Taipei 112, Taiwan
| | - John Rosenberg
- School of Health, University of the Sunshine Coast, Caboolture, QLD 4059, Australia;
| |
Collapse
|
2
|
Wang JH, Wang LW, Liang SY, Rosenberg J, Wang TJ, Wu SF, Liu CY. Relationship between prescribed opioids, pain management satisfaction, and pain intensity in oncology outpatients. Support Care Cancer 2022; 30:3233-3240. [PMID: 34977980 DOI: 10.1007/s00520-021-06722-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pain is the most severe and commonest symptom for patients with cancer. Patients' pain management satisfaction is an essential indicator of quality care and further affects their willingness to seek care. PURPOSE This study aimed to examine the correlations between patients' prescribed opioids, pain management satisfaction, and pain intensity. METHODS This study adopted a cross-sectional correlation design, recruited a total of 123 patients with cancer pain through convenience sampling, and used two research scales, namely the Chinese version of the Pain Treatment Satisfaction Scale and the Brief Pain Inventory-Short Form. RESULTS The findings indicated that the correlations of prescribed opioid dosage with pain management satisfaction (r = - .10, p > .05) and pain intensity (worst pain, least pain, average pain, and pain right now; r = - .05 to .01, p > .05) were nonsignificant. The correlations of pain management satisfaction with pain intensity (r = .24 to .32, p < .01), pain interference (r = .32, p < .01), and pain relief (r = - .25, p < .01) were all significant, but that with the worst pain (r = .06, p > .05) was nonsignificant. CONCLUSIONS Medical professionals providing cancer pain management should focus on medicines strategies and individuals' pain relief requirements. In particular, patients with the worst pain require extra investigations into their needs, and their satisfaction with their level of pain should be further evaluated.
Collapse
Affiliation(s)
- Jia-Hua Wang
- Changhua Nursing Home, Ministry of Health and Welfare, No 1, Hugang Rd, Changhua City, Changhua Country, 500040, Taiwan
| | - Ling-Wei Wang
- Department of Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shipai Road, Beitou, Taipei, 112, Taiwan
| | - Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei, 112, Taiwan.
| | - John Rosenberg
- School of Nursing, University of the Sunshine Coast, 80-106 Tallon Street, Caboolture, QLD, 4059, Australia
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei, 112, Taiwan
| | - Shu-Fang Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei, 112, Taiwan
| | - Chieh-Yu Liu
- College of Human Development and Health, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Peitou, Taipei, 112, Taiwan
| |
Collapse
|
3
|
Su WC, Chuang CH, Chen FM, Tsai HL, Huang CW, Chang TK, Hou MF, Wang JY. Effects of Good Pain Management (GPM) ward program on patterns of care and pain control in patients with cancer pain in Taiwan. Support Care Cancer 2021; 29:1903-1911. [PMID: 32803728 PMCID: PMC7892517 DOI: 10.1007/s00520-020-05656-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The undertreatment of cancer pain is a global issue although many international guidelines and various studies bloom to explore the approaches in pain management. However, there is no standard care for cancer pain in routine practices. To set up a standardized procedure for improving cancer pain management in Taiwan, the Good Pain Management (GPM) program is explored to provide treatments following the US National Cancer Care Network (NCCN) Adult Cancer Pain Guideline. METHOD Patients diagnosed with moderate-to-severe cancer pain were eligible and randomized into the GPM or control arm and observed the first 48 h to evaluate the effects of pain management between 2 arms. Pain control, adequacy of treatments, patient satisfaction, and quality of life (QoL) of eligible patients were analyzed. Ad hoc analyses based on the pain medication category were also conducted. RESULT Fifty-one patients were enrolled, with 26 and 25 assigned to the GPM and control arms, respectively. Significant differences among the GPM and control arms were found including a greater decrease in the mean numerical rating scale (NRS) score in the GPM arm (- 4.6 vs. - 2.8), a lower proportion of moderate-to-severe pain in the GPM arm (23.2% vs. 39.8%), and a higher pain management index (PMI) score in the GPM arm (0.64 points vs. 0.33 points) (all p < 0.05). Ad hoc analyses revealed that the patient subgroups using strong opioids showed better patient satisfaction in GPM arm when compared with the same subgroup in the control arm. CONCLUSION In summary, our study demonstrated that the implementation of a standardized pain assessment and management approach (GPM ward program) showed significant improvements on pain relief, decreased the portion of moderate-to-severe cancer pain, and increased patient satisfaction in the 1st 48 h after admission. The implementation of the GPM approach in the cancer ward may provide sooner and better improvement of cancer pain management for patients who suffered moderate-to-severe cancer pain. TRIAL REGISTRATION ClinicalTrials.gov (Identifier: NCT03155516).
Collapse
Affiliation(s)
- Wei-Chih Su
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan
| | - Chieh-Han Chuang
- Department of Surgery and ICU, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
- Division of Breast Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fang-Ming Chen
- Division of Breast Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiang-Lin Tsai
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan
- Department of Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Ching-Wen Huang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan
- Department of Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Tsung-Kun Chang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan
| | - Ming-Feng Hou
- Division of Breast Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jaw-Yuan Wang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.
| |
Collapse
|
4
|
Cancer pain management needs and perspectives of patients from Chinese backgrounds: a systematic review of the Chinese and English literature. Palliat Support Care 2018; 16:785-799. [DOI: 10.1017/s1478951517001171] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractObjectiveMore than half of all cancer patients experience unrelieved pain. Culture can significantly affect patients’ cancer pain-related beliefs and behaviors. Little is known about cultural impact on Chinese cancer patients’ pain management. The objective of this review was to describe pain management experiences of cancer patients from Chinese backgrounds and to identify barriers affecting their pain management.MethodA systematic review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they reported pain management experiences of adult cancer patients from Chinese backgrounds. Five databases were searched for peer-reviewed articles published in English or Chinese journals between1990 and 2015. The quality of included studies was assessed using Joanna Briggs Institution's appraisal tools.ResultsOf 3,904 identified records, 23 articles met criteria and provided primary data from 6,110 patients. Suboptimal analgesic use, delays in receiving treatment, reluctance to report pain, and/or poor adherence to prescribed analgesics contributed to the patients’ inadequate pain control. Patient-related barriers included fatalism, desire to be good, low pain control belief, pain endurance beliefs, and negative effect beliefs. Patients and family shared barriers about fear of addiction and concerns on analgesic side effects and disease progression. Health professional–related barriers were poor communication, ineffective management of pain, and analgesic side effects. Healthcare system–related barriers included limited access to analgesics and/or after hour pain services and lack of health insurance.Significance of resultsChinese cancer patients’ misconceptions regarding pain and analgesics may present as the main barriers to optimal pain relief. Findings of this review may inform health interventions to improve cancer pain management outcomes for patients from Chinese backgrounds. Future studies on patients’ nonpharmacology intervention-related experiences are required to inform multidisciplinary and biopsychosocial approaches for culturally appropriate pain management.
Collapse
|
5
|
Wang CH, Lee SYC. Undertreatment of caner pain. ACTA ACUST UNITED AC 2015; 53:58-61. [PMID: 26063333 DOI: 10.1016/j.aat.2015.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 05/06/2015] [Indexed: 11/30/2022]
Abstract
Pain is a burdensome symptom that can commonly exist chronically along the cancer trajectory. Uncontrolled pain will impact on cancer patients' quality of life, even further negatively affect cancer survivors' employment. Based on systemic reviews of studies for past 10 years, the paper reported that although there is enormous advancement on the knowledge of cancer pain and pain management, studies still documented undertreatment of cancer pain globally. Additionally, pain distress a significant portion of cancer survivors. The pain in cancer survivors distinct from the pain related with cancer, instead emphasize on pain related with cancer treatment, such as neuropathic pain, muscular syndrome. Evidence-based pain management with common pain problems in cancer survivors is lacking. Further studies are needed to understand the pain in cancer survivors and to develop effective strategies in helping cancer survivors to manage their pain.
Collapse
Affiliation(s)
- Cheng-Hsu Wang
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
| | - Shiu-Yu C Lee
- Chang Gung Memorial Hospital, Clinic of Internal Medicine, Division of Hematology-Oncology, Department of Internal Medicine, Keelung, Taiwan
| |
Collapse
|
6
|
Liang SY, Wu SF, Chao TC, Tseng LM, Wu WW, Wang TJ, Lu YY. The Impact of Pain on the Quality of Life of Taiwanese Oncology Patients. Pain Manag Nurs 2015; 16:128-36. [DOI: 10.1016/j.pmn.2014.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 05/23/2014] [Accepted: 05/27/2014] [Indexed: 11/12/2022]
|
7
|
Opioid-taking self-efficacy affects the quality of life of Taiwanese patients with cancer pain. Support Care Cancer 2014; 23:2113-20. [DOI: 10.1007/s00520-014-2575-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 12/18/2014] [Indexed: 11/26/2022]
|
8
|
Vandenbossche J, Richards H, Francke S, Van Den Bergh A, Lu CC, Franc MA. The effect ofUGT2B7*2polymorphism on the pharmacokinetics of OROS® hydromorphone in Taiwanese subjects. J Clin Pharmacol 2014; 54:1170-9. [DOI: 10.1002/jcph.305] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 04/01/2014] [Indexed: 11/06/2022]
Affiliation(s)
| | - Henry Richards
- Janssen Research and Development; L.L.C.; Titusville NJ USA
| | | | - An Van Den Bergh
- Johnson & Johnson Pharmaceutical Research and Development; Beerse Belgium
| | - Chih Cherng Lu
- Department of Anesthesiology; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
| | | |
Collapse
|
9
|
Liang SY, Chen KP, Tsay SL, Wu SF, Chuang YH, Wang TJ, Tung HH, Cheng SF. Relationship Between Belief about Analgesics, Analgesic Adherence and Pain Experience in Taiwanese Cancer Outpatients. Asian Pac J Cancer Prev 2013; 14:713-6. [DOI: 10.7314/apjcp.2013.14.2.713] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|