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Karassava H, Agorgianitis L, Mavrommatis E. The Genesis of Multidisciplinary Health Professionals Teams for Pain Management. A History from the Hellenic Antiquity to Modern Palliative Medicine. Acta Med Acad 2024; 53:114-118. [PMID: 38984701 PMCID: PMC11237910 DOI: 10.5644/ama2006-124.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 04/04/2024] [Indexed: 07/11/2024] Open
Abstract
The aim of our article is to highlight the history of pain management. The multidisciplinary team (MDT) concept in confronting pain was first conceptualized by the Hippocratics, and has evolved through time and become a trend in medicine over recent decades. Documentary research was conducted to unveil the story of the evolution of MDTs. From the early 1950's the idea of an MDT approach to deal with various types of pain was sporadically introduced in medicine. Studies encouraged health institutions to support this concept by providing health professionals with training, alongside the necessary facilities and resources. Specialized care programs started with Dame Cicely Mary Strode Saunders as one of the pioneers. CONCLUSIONS: Team work and continuous interdisciplinary treatment of pain have rendered MDTs essential for health systems. Barriers in flexibility, information flow and personal issues give rise to the need for better organization and training. Pain and terminal disease palliation call for MDTs, and educated leaders to run them. Present and future health MDTs are considered necessary in all medical fields.
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Affiliation(s)
- Heleni Karassava
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Loukas Agorgianitis
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Huang X, Lu J, Huang R, Lu Q, Luo Y, Huang X, An L, Chen Y. Effects of multidisciplinary team continuous care model on psychological behavior and quality of life in children with β-thalassemia major. Am J Transl Res 2024; 16:905-915. [PMID: 38586087 PMCID: PMC10994799 DOI: 10.62347/obwd7382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/11/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To explore the effects of a multidisciplinary team (MDT) continuous care model on psychological behavior and quality of life in children with β-thalassemia major (β-TM). METHODS A retrospective study was conducted on 90 children with β-TM who were hospitalized in the Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for Nationalities from October 2021 to May 2022. According to nursing methods, the children were divided into a routine group and an experimental group, with 45 cases in each group. The routine group was intervened with routine nursing approaches, and the experimental group was intervened with the MDT continuous nursing mode on the basis of the control group. The psychological behavior [Positive and Negative Affect Scale for Children (PANAS-C)], quality of life (QoL) [Pediatric Quality of Life Inventory TM (PedsQLTM)] and satisfaction were compared between the two groups before and 6 months after intervention. The hemoglobin level and ferritin level of children after 3 months and 6 months of intervention were measured. The occurrence of complications and nursing satisfaction were recorded. The prognostic factors were further analyzed. RESULTS After the intervention, the positive emotion score, QoL score, hemoglobin level, satisfaction score in the experimental group were all higher than those in the conventional group, and the negative emotion score and ferritin level in the experimental group were all lower than those in the conventional group (all P < 0.05). The results of Cox analysis showed that the use of iron-removing drugs and arrhythmia/heart rate failure were risk factors affecting the prognosis of children with β-TM, while the MDT continuous nursing mode was a protective factor (all P < 0.05). CONCLUSION The MDT continuous care model can effectively promote mental health in children with β-TM, improve their quality of life, medical satisfaction, ameliorate the degree of anemia in children, reduce the incidence of complications and improve the prognosis; thus, it is worthy of wide clinical application.
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Affiliation(s)
- Xiuping Huang
- Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Jian Lu
- Center for Reproductive Medicine, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Rongxian Huang
- Department of Pediatrics, Baise People’s HospitalBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Qingmei Lu
- School of Nursing, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yanni Luo
- Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Xiaoxiao Huang
- Pediatric Intensive Care Unit, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Liqiao An
- Pediatric Intensive Care Unit, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yuke Chen
- Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
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Yang Y, Cui M, Zhao X, Wang S, Wang Y, Wang X. Cancer pain intensity and perceived social support in palliative care: 1-week prospective study. BMJ Support Palliat Care 2024; 13:e894-e897. [PMID: 37402542 PMCID: PMC10850825 DOI: 10.1136/spcare-2023-004236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/08/2023] [Indexed: 07/06/2023]
Abstract
OBJECTIVES Pain is a complex and multidimensional experience affected by psychosocial factors. Perceived social support (PSS) has been considered as a positive psychosocial resource for effective regulation of cancer patients' well-being. Our study examined the relationship between PSS and pain intensity under 1-week palliative care. METHODS A prospective study was conducted of terminal cancer inpatients (N=84) recruited from the hospice ward. Pain intensity was assessed on admission and 1 week later, and patients completed self-report questionnaires assessing PSS at admission. The repeated designed analysis of variance was used to explore the correlate of PSS with cancer pain. RESULTS Pain intensity decreased after 1 week (t=2.303, p=0.024), and 47.62% gained pain relief. For pain intensity, there was a significant PSS group×time interaction effect detected (F=4.544, p=0.036). Pain intensity in the high PSS group was significantly reduced 1 week later (p=0.008), while the change of pain intensity was not significant in the low PSS group (p=0.609). CONCLUSIONS PSS at admission predicted the 1-week development of pain intensity. Identifying PSS of terminal cancer patients leads to early interventions that are more effective in improving pain management of palliative care.
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Affiliation(s)
- Yilong Yang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Meng Cui
- Hospice Ward, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xinxin Zhao
- Hospice Ward, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Simeng Wang
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Yumei Wang
- Hospice Ward, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaohe Wang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
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Zhou M, Lu C, Yuan F. A Cross-Sectional Survey of Physicians' Knowledge and Awareness of Chronic Pain Associated with Rheumatoid Arthritis in Rheumatology Departments in Zhejiang Province, China. Int J Gen Med 2023; 16:5281-5288. [PMID: 38021058 PMCID: PMC10656835 DOI: 10.2147/ijgm.s432366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To assess physicians' knowledge and awareness of chronic pain associated with rheumatoid arthritis (RA) in Rheumatology departments throughout Zhejiang province to improve chronic pain relief in RA patients. Methods A cross-sectional questionnaire survey was conducted onsite and online among rheumatologists in tertiary and secondary hospitals across Zhejiang province, China. The questionnaire inquired about rheumatoid arthritis-related pain cognition, pain assessment, pain management protocols, and medication choice. Results Among the 150 questionnaires included, 98 were from tertiary hospitals, and 52 were from secondary hospitals. There was no difference in rheumatologists' perceptions of chronic pain in RA patients between tertiary and secondary hospitals. About 55.1% of rheumatologists from tertiary hospitals and 44.2% of rheumatologists from secondary hospitals utilized unstandardized pain assessment scales. About 46.9% of rheumatologists in tertiary hospitals and 36.5% of rheumatologists in secondary hospitals favored the numerical rating scale (NRS). About 87.8% of rheumatologists in tertiary hospitals and 71.7% of rheumatologists in secondary hospitals conducted pain assessment within 4 hours of admission. About 66.3% of rheumatologists working in tertiary hospitals and 32.7% of rheumatologists practicing in secondary hospitals believed their hospitals had pain departments. For RA patients who complained of pain for the first time, secondarily, or repeatedly, 48%, 26%, and 36.7% of rheumatologists preferred nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and opioid analgesics, respectively. For RA patients with mild, moderate, or severe pain, 74%, 6%, and 16% of rheumatologists preferred NSAIDs, glucocorticoids, and opioid analgesics, respectively. Conclusion The assessment and treatment of chronic pain associated with RA are not standardized. For management, more rheumatologists preferred NSAIDs and glucocorticoids.
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Affiliation(s)
- Meiju Zhou
- Department of Rheumatology and Immunology, Zhejiang Hospital, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Ci Lu
- Department of Rheumatology and Immunology, Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Fang Yuan
- Department of Rheumatology and Immunology, Zhejiang Hospital, Hangzhou, Zhejiang Province, People’s Republic of China
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Porzio G, Capela A, Giusti R, Lo Bianco F, Moro M, Ravoni G, Zułtak-Baczkowska K. Multidisciplinary approach, continuous care and opioid management in cancer pain: case series and review of the literature. Drugs Context 2023; 12:dic-2022-11-7. [PMID: 37077766 PMCID: PMC10108666 DOI: 10.7573/dic.2022-11-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/10/2023] [Indexed: 04/21/2023] Open
Abstract
Underlying cancer pain has heterogenous aetiologies and mechanisms. It requires detailed and comprehensive pain assessment, combined with personalized treatment. A multidisciplinary team is essential to providing the best management of cancer pain at every disease stage, improving the quality of life and outcomes in patients with cancer. This narrative literature review emphasizes the value of providing all patients with multidisciplinary pain management in their preferred care setting. Real-life experiences are also reported to witness the efforts of physicians to properly manage cancer pain. This article is part of the Management of breakthrough cancer pain Special Issue: https://www.drugsincontext.com/special_issues/management-of-breakthrough-cancer-pain.
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Affiliation(s)
| | - Andreia Capela
- Centro Hospitalar Vila Nova de Gaia, Espinho; Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Arcozelo – Vila Nova de Gaia, Portugal
| | - Raffaele Giusti
- Medical Oncology Unit, Sant’Andrea Hospital of Rome, Sapienza University of Rome, Rome, Italy
| | - Francesca Lo Bianco
- Medical Oncology Unit, Sant’Andrea Hospital of Rome, Sapienza University of Rome, Rome, Italy
| | - Mirella Moro
- Medical Oncology Unit, Sant’Andrea Hospital of Rome, Sapienza University of Rome, Rome, Italy
| | - Giulio Ravoni
- Tuscany Tumor Association, Home Care Service, Florence, Italy
| | - Katarzyna Zułtak-Baczkowska
- Zakład Zdrowia Publicznego, Wydział Nauk o Zdrowiu, Pomorski Uniwersytet Medyczny w Szczecinie, Stettin, Poland
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Yu Z, Li W, Shangguan X, Cai Y, Gao Q, Wang X, Chen Y, Liu D, Zhang C. Knowledge, Practices, and Perceived Barriers in Cancer Pain Management at Oncology Units: A Cross-Sectional Survey of Medical Staff in China. J Pain Res 2022; 15:159-169. [PMID: 35087286 PMCID: PMC8789229 DOI: 10.2147/jpr.s339377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/30/2021] [Indexed: 01/24/2023] Open
Abstract
Background Patients and Methods Results Conclusion
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Affiliation(s)
- Zaoqin Yu
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China
| | - Wei Li
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China
| | - Xiaofang Shangguan
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China
| | - Yuanxuan Cai
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China
| | - Qianyan Gao
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China
| | - Ximin Wang
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China
| | - Yuan Chen
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China
| | - Dong Liu
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China
- Correspondence: Dong Liu; Chengliang Zhang Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of ChinaTel/Fax +86-27-83663643; +86-27-83663519 Email ;
| | - Chengliang Zhang
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China
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Zhu S, Zhu H, Zhang X, Liu K, Chen Z, Yang X, Sun C, Xie W, Xu Q, Li W, Pang D, Cui Y, Wang H. Care needs of dying patients and their family caregivers in hospice and palliative care in mainland China: a meta-synthesis of qualitative and quantitative studies. BMJ Open 2021; 11:e051717. [PMID: 34740931 PMCID: PMC8573656 DOI: 10.1136/bmjopen-2021-051717] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 10/12/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate the care needs of dying patients and their family caregivers in hospice and palliative care in mainland China. METHODS A search for English and Chinese quantitative and qualitative studies was performed using the following English databases: PubMed (Medline), CINAHL and PsycINFO, as well as Chinese databases: SinoMed and CNKI. The records were independently screened by two reviewers and critiqued using Joanna Briggs Institute Critical Appraisal tools. All quantitative data were transformed into qualitative data, which were converted into textual descriptions. Due to the diversity of included studies, a three-step analysis was performed: narrative summary, thematic analysis and presentation of integrated results in a narrative form. The qualitative findings were pooled using the meta-aggregation approach. RESULTS The literature search identified 2964 papers after removing duplicates, from which 18 were included (9 quantitative and 9 qualitative studies). All studies were conducted in mainland China. Quantitative studies involved cross-sectional surveys, and qualitative studies involved interviews for data collection. Two synthesised results of patients' needs were identified, including needs to be comfortable and experience a good death. Another two synthesised results of family caregivers' needs included needs to care for and improve the quality of life of patients, and to care for themselves well. CONCLUSION This study identified that patients and family caregivers have an increasing demand for professional care at the end of life. Professionals, especially nurses, should enact a patients' demand-centred practice to overcome the challenges of organisation, education, emotion and communication to provide high-quality end-of-life care.
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Affiliation(s)
- Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xintong Zhang
- Emergency, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Kouying Liu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zumei Chen
- China Jiliang University Hospital, Hangzhou, Zhejiang, China
| | - Xiaowen Yang
- Nanjing Medical University Library, Nanjing, Jiangsu, China
| | - Changxian Sun
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
- Jiangsu Vocational Institute of Commerce, Nanjing, Jiangsu, China
| | - Weiping Xie
- Department of Respiratory and Critical Care Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weiying Li
- LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Dong Pang
- School of Nursing, Peking University, Beijing, China
- Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Peking University Health Science Centre, Beijing, China
| | - Yan Cui
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Wang
- Department of Respiratory and Critical Care Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Practice, Knowledge, and Attitude of Health Care Providers regarding Cancer Pain Management: A National Survey. Pain Res Manag 2021; 2021:1247202. [PMID: 34471442 PMCID: PMC8405340 DOI: 10.1155/2021/1247202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/12/2021] [Indexed: 12/24/2022]
Abstract
Background A lack of knowledge and inadequate practices of health care providers (HCPs) are the main obstacles to effective cancer pain management (CPM). The main objective of the study was to evaluate the CPM knowledge, CPM practice, and attitudes towards pharmacists' participation and advanced methods in CPM of physicians, nurses, and pharmacists in China. Methods An open online survey was adopted using social media software (WeChat) as the platform to conduct a nationwide survey of HCPs involved in CPM in public medical institutions at all levels in China from March to June 2019. Results A total of 1279 physicians, 2267 nurses, and 1466 pharmacists participated in the survey. Among the three types of professionals, nurses had the highest level of practical ability (61.63 ± 28.99) and best attitudes towards pharmacists' participation and advanced methods in CPM (72.05 ± 33.71) and physicians had the best mastery of CPM-related knowledge (69.60 ± 28.45), while pharmacists performed the worst in these three aspects (50.04 ± 26.69, 61.49 ± 28.95, and 62.07 ± 36.46, respectively). Only 19.69% of the hospitals had a pharmacist to tumor patient ratio ≥1 : 50. Hierarchical analysis showed that passing a good pain management (GPM) ward program and participating in advanced training had positive impacts on the scores of all three parts in the three professions (ptrend <0.05). Conclusions HCPs' levels of practice, knowledge, and attitudes towards pharmacists and advanced methods of CPM were average in China; however, pharmacists had the worst performance, which demonstrates a need for further improvement. Furthermore, GPM ward programs and advanced trainings are helpful for improving CPM levels.
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