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Shrestha S, Sapkota S, Teoh SL, Kc B, Paudyal V, Lee SWH, Gan SH. Comprehensive assessment of pain characteristics, quality of life, and pain management in cancer patients: a multi-center cross-sectional study. Qual Life Res 2024:10.1007/s11136-024-03725-w. [PMID: 39105961 DOI: 10.1007/s11136-024-03725-w] [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: 06/19/2024] [Indexed: 08/07/2024]
Abstract
INTRODUCTION Pain is the most common complaint among cancer patients, significantly impairing their health-related quality of life (HRQOL). There is limited evidence on the characteristics of pain among cancer patients in Nepal with low-resource settings. OBJECTIVES The primary objective of this study was to evaluate the clinical characteristics of pain, factors influencing pain intensity, and the association of pain severity with quality of life (QoL) among cancer patients. Secondary objectives included investigating perceived barriers to pain management and medication adherence among these patients. METHODS This multi-center, cross-sectional study enrolled adult patients (over 18 years old) with reported cancer diagnoses experiencing pain. Socio-demographic characteristics (e.g., age, gender, educational status), clinical characteristics (e.g. cancer diagnosis, staging), and pain characteristics (e.g., duration, type, location, medicines used for pain management, etc.) were recorded. Outcomes were assessed using the Numeric rating scale (NRS), Pain management Index, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire, Barriers Questionnaire II, Medication Adherence Rating Scale, and Hospital Anxiety and Depression Scale. RESULTS Four hundred and eight patients participated in the study. The mean ± SD age was 54.87 ± 15.65, with 226 patients (55.4%) being female. The most common cancer diagnoses were cervical (17.6%), lung (11.8%), and colon/rectum (12.0%) cancers. The most common pain locations were the head and neck (27.0%); a majority (55.6%) reported pain duration of more than 3 months. Nociceptive pain was reported by 42.4% of patients; the mean ± SD of NRS was 4.31 ± 2.69, with 32.4% of patients experiencing moderate pain. Patients with mixed pain type (B = 1.458, p < 0.001) or pain in multiple sites (B = 1.175, p < 0.001), lower Karnofsky Performance Status (KPS) (B = -1.308, p < 0.001), and specific cancer diagnoses such as prostate (B = -2.045, p = 0.002), pancreatic (B = 1.852, p = 0.004), oesophageal (B = 1.674, p = 0.012), and ovarian cancer (B = 1.967, p = 0.047), experienced varying degrees of increased NRS score. The combined chemotherapy and radiotherapy treatment modality was associated with a lower NRS score (B = -0.583, p = 0.017). A significant inverse relationship was observed between pain severity and global health status/QoL (B = -37.36, p < 0.001. Key barriers to pain management included moderate perceptions of physiological effects, communication issues between doctors and patients, and concerns about the harmful effects of pain medicine. The prevalence of non-adherence to pain medications was 13.97%. CONCLUSION In conclusion, this study highlights the multi-faceted nature of pain management and QoL for cancer patients in Nepal with low-resource settings. These findings underscore the multifactorial nature of pain perception in cancer patients, with mixed pain types, pain in multiple sites, lower KPS, and specific cancer diagnoses, all contributing significantly to pain severity. Additionally, pain severity was associated with declining QoL. These findings contribute valuable insights into the complex aspects of cancer pain and its broader implications for the well-being of patients, offering a foundation for targeted interventions and improved pain management strategies in the context of cancer care in low-resource settings.
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Affiliation(s)
- Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia.
| | - Simit Sapkota
- Department of Clinical Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Bagmati Province, Nepal
- Department of Clinical Oncology, Civil Service Hospital, Minbhawan, Kathmandu, Bagmati Province, Nepal
| | - Siew Li Teoh
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia
| | - Bhuvan Kc
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
- College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Vibhu Paudyal
- School of Pharmacy, College of Medical and Dental 21 Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham Edgbaston, Birmingham, B15 2TT, UK
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well Being Cluster, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Siew Hua Gan
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia
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Ali Alaswami H, Al Musalami AA, Al Saadi MH, AlZaabi AA. Identifying Barriers to Effective Cancer Pain Management in Oman: Implications for Palliative Care. Curr Oncol 2024; 31:2963-2973. [PMID: 38920709 PMCID: PMC11202896 DOI: 10.3390/curroncol31060225] [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: 03/21/2024] [Revised: 05/19/2024] [Accepted: 05/21/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Effective cancer pain management is essential for improving the quality of life of patients. However, the use of analgesics is often suboptimal due to various patient-related barriers. This study aims to explore the perceptions, knowledge, and attitudes toward analgesic use among cancer patients in Oman, which may influence their pain management strategies. METHODS In a cross-sectional study, we assessed 68 cancer patients undergoing pain management at an inpatient cancer clinic of a tertiary hospital in Oman from a pool of 154 eligible participants. The Barriers Questionnaire (BQ) and the Patient Pain Questionnaire (PPQ), both Arabic versions, were administered to evaluate the patients' barriers to cancer pain management. The study period and the criteria for patient selection are specified. RESULTS With a participation rate of 44.2% and a female-to-male ratio of 2.28:1, the mean score on the BQ was 2.52 (SD 0.84), indicating a moderate level of perceived barriers. Patients' scores suggested notable barriers, with older patients exhibiting reluctance toward analgesics for fear of masking symptoms and female patients expressing greater concerns about developing drug tolerance. CONCLUSION The findings highlight significant attitudinal barriers to effective cancer pain management in Oman, notably a prevalent fear of medication tolerance. The study stresses on the need for targeted patient education and the correction of misconceptions. It also points to the influence of cultural and religious beliefs on patient responses, advocating for the implementation of culturally sensitive, evidence-based pain management guidelines, and the support of multidisciplinary palliative care teams.
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Affiliation(s)
- Husain Ali Alaswami
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman (M.H.A.S.)
| | | | - Muaeen Hamed Al Saadi
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman (M.H.A.S.)
| | - Adhari Abdullah AlZaabi
- Human and Clinical Anatomy Department, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
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Makhlouf SM, Ahmed S, Bennett MI. Libyan Healthcare Professionals', Patients' and Caregivers' Perceptions and Religious Beliefs about Cancer Pain and its Management: A Descriptive Qualitative Study. JOURNAL OF RELIGION AND HEALTH 2023; 62:1897-1919. [PMID: 36810722 PMCID: PMC10133376 DOI: 10.1007/s10943-023-01763-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 05/15/2023]
Abstract
Cancer pain remains a significant problem worldwide. It is often undertreated and presents in about half of cancer patients. Although several guidelines and pharmacological interventions for cancer pain management (CPM) exist, inadequate assessment and undertreatment of cancer pain are well-documented globally, especially in developing countries, including Libya. Perceptions, cultural and religious beliefs of healthcare professionals (HCP), patients, and caregivers about cancer pain and opioids are reported as barriers to CPM globally. This qualitative descriptive study aimed to explore Libyan HCPs', patients', and caregivers' views and religious beliefs about CPM and involved semi-structured interviews with 36 participants: 18 Libyan cancer patients, 6 caregivers, and 12 Libyan HCPs. Thematic analysis was used to analyse the data. Patients, caregivers, and newly qualified HCPs were concerned about poor tolerance and drug addiction. HCPs perceived a lack of policies and guidelines, pain rating scales, and professional education and training as CPM barriers. Some patients were unable to pay for medicines if they faced financial difficulties. Instead, patients and caregivers emphasised religious and cultural beliefs for managing cancer pain, including the use of the Qur'an and cautery. Our results suggest that religious and cultural beliefs, lack of knowledge and training in CPM among HCPs, and economic and Libyan healthcare system-related factors negatively affect CPM in Libya.
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Affiliation(s)
- Salim M Makhlouf
- School of Medicine, Academic Unit of Palliative Care, LIHS, Leeds Institute of Health Sciences, University of Leeds, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK.
| | - Shenaz Ahmed
- School of Medicine, Academic Unit of Palliative Care, LIHS, Leeds Institute of Health Sciences, University of Leeds, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK
| | - Michael I Bennett
- School of Medicine, Academic Unit of Palliative Care, LIHS, Leeds Institute of Health Sciences, University of Leeds, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK
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The Effect of Remote-Based Monitoring and Education Program on Cancer Pain Management in an Outpatient Pain Clinic. Pain Manag Nurs 2022; 23:742-751. [PMID: 35701331 DOI: 10.1016/j.pmn.2022.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/09/2022] [Accepted: 04/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Pain is one of the most feared consequences of cancer for patients and their families. Many barriers may hinder optimal pain management. AIM Examine the effect of remote-based monitoring and education program on cancer pain management, patient-related barriers, and level of adherence to pain medication. METHODS A sample of 134 patients was assigned to two groups; 68 in the intervention group and 66 in the control. The intervention group received three educational sessions by telephone. Both groups completed questionnaires at baseline and one month after the initial visit. RESULTS Significant differences were found between the groups in the levels of pain right now (p = .030), pain at its least (p = .016), and in the percentage of achieved pain relief (p = .048). Moreover, the intervention group experienced lower levels of interference with their general activity (p = < .001), mood (p = .011), and normal work (p = .004) post-intervention. The Attitudinal Barriers differences were statistically significant in the total mean (p = < .001), and the subscales of physiological effects (p = < .001), fatalism (p = < .001), communication (p = < .001), harmful effects (p = < .001). Participants in the intervention group exhibited higher adherence levels (p = .001). CONCLUSIONS Patients suffering from cancer-related pain can benefit from remote-based monitoring and education programs to improve pain management outcomes, overcome barriers, and increase adherence. Further research is needed to investigate the different available educational methods and long-term effects.
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Almasri BM, McDonald DD. Philosophical Assumptions Used in Research on Barriers for Effective Cancer Pain Management: A Scoping Review. Pain Manag Nurs 2021; 22:634-644. [PMID: 34261599 DOI: 10.1016/j.pmn.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/29/2022]
Abstract
Cancer pain is one of the most common symptoms in cancer patients and often has a negative impact on patients' functional status and quality of life. Despite the available guidelines for effective pain management, factors such as barriers to cancer pain management still exist. The lens or philosophical assumptions used to guide cancer pain management research is a crucial but often overlooked component of high-quality research. Therefore, the purpose of this scoping review was to classify and map the available evidence and identify the knowledge gap regarding using a philosophical assumption to address the barriers of pain management among patients with cancer. Absence of clear philosophical assumptions in the qualitative research and generally a theoretical quantitative research may contribute to the slow progress in identifying and addressing barriers to cancer pain management. Therefore, the hermeneutic circle was suggested to address the main barriers of cancer pain management, focusing on the dialectic approach between the participants including researchers, cancer patients, and their family caregivers, health care providers, and policymakers. Understanding and possible solutions of the problem could be obtained through fusion of the horizons; in which the participants past and present horizons emerge. Then the collaborative efforts between the participants may yield effective strategies to overcome cancer pain barriers to improve the quality of cancer pain management.
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Vanneste L, Lefebvre T, Tack L, Van Eygen K, Cool L, Schofield PA, Boterberg T, De Rijdt T, Verhaeghe A, Verhelle K, Debruyne PR. Pain medication adherence in patients with cancer: a pragmatic review. PAIN MEDICINE 2021; 23:782-798. [PMID: 33502510 DOI: 10.1093/pm/pnab010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Adherence to pain medication in patients with cancer is crucial for successful pain therapy. This review aimed to investigate: the rate of adherence, which factors influence adherence, whether adherence differs in diverse patient populations, whether there are methods to improve adherence, and the relationship between adherence and pain relief. METHODS This review was performed following the PRISMA guidelines. MEDLINE/Pubmed, Embase, Web Of Science, Cochrane and ClinicalTrials.gov were searched. All types of studies investigating adherence of patients with cancer, factors influencing adherence, and methods to improve adherence to pain medication were included. They were first screened on title and abstract and thereafter on full text. Selected articles were subjected to a quality assessment according to the PRISMA checklist. From included articles, study characteristics and outcomes were extracted. RESULTS Out of 795 articles, 18 were included. Different methods were used to measure adherence, which led to adherence rates ranging from 8.9% to 82.0%. White Americans and men were found to be more adherent than African Americans and women. Due to various barriers, adherence is often suboptimal. Fear of addiction, physiological and harmful effects, tolerance, and disease progression are common concerns. Interventions, such as pain education booklets, pain consults, and specialised nurses, may be beneficial to increase the adherence. Lower adherence rates were associated with lower pain relief. CONCLUSION Adherence of cancer patients to pain medication is suboptimal. Health care workers should focus on barriers to increase the adherence in order to obtain a better pain relief.
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Affiliation(s)
- Lorenz Vanneste
- Hospital Pharmacy, General Hospital Groeninge, Kortrijk, Belgium.,Department of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium.,Faculty of Pharmaceutical Sciences, Catholic University Leuven, Leuven, Belgium
| | - Tessa Lefebvre
- Department of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium.,Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Laura Tack
- Department of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium.,Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Koen Van Eygen
- Department of Haematology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | - Lieselot Cool
- Department of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | | | - Tom Boterberg
- Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Thomas De Rijdt
- Hospital Pharmacy, University Hospitals Leuven, Leuven, Belgium.,Department of Pharmaceutical and Pharmacological Sciences, Catholic University Leuven, Leuven, Belgium
| | - Anne Verhaeghe
- Hospital Pharmacy, General Hospital Groeninge, Kortrijk, Belgium
| | - Katy Verhelle
- Hospital Pharmacy, General Hospital Groeninge, Kortrijk, Belgium
| | - Philip R Debruyne
- Department of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium.,Positive Ageing Research Institute (PARI), Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
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Makhlouf SM, Pini S, Ahmed S, Bennett MI. Managing Pain in People with Cancer-a Systematic Review of the Attitudes and Knowledge of Professionals, Patients, Caregivers and Public. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:214-240. [PMID: 31119708 PMCID: PMC7076060 DOI: 10.1007/s13187-019-01548-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Cancer pain is a common symptom experienced by patients, caused either by the disease or its treatment. Morphine remains the most effective and recommended treatment for cancer pain. However, cancer patients still do not receive appropriate management for their pain, and under-treatment is common. Lack of knowledge and negative attitudes towards cancer pain and analgesia among professionals, patients and family caregivers are reported as one of the most common barriers to effective cancer pain management (CPM). To systematically review research on the nature and impact of attitudes and knowledge towards CPM, a systematic literature search of 6 databases (the Cochrane library, MEDLINE, PsycINFO, CINAHL, Web of Science and EMBASE) was undertaken in July 2018. Additionally, hand-searching of Google, Google Scholar and reference lists was conducted. The inclusion criteria were adult (18-65 years of age), studies which included attitudes and knowledge towards CPM, studies written in English, published literature only and cross-sectional design. Included studies were critically appraised by two researchers independently using the Joanna Briggs Institute Analytical Cross Sectional Studies Assessment (JBI-ACSSA). A total of 36 studies met the inclusion criteria. The main finding was that among professionals, patients, caregivers and the public there were similar attitudinal barriers to effective CPM. The most commonly cited barriers were fear of drug addiction, tolerance of medication and side effects of opioids. We also found differences between professional groups (physicians versus nurses) and between different countries based on their potential exposure to palliative care training and services. There are still barriers to effective CPM, which might result in unrelieved cancer pain. Therefore, more educational programmes and training for professionals on CPM are needed. Furthermore, patients, caregivers, and the public need more general awareness and adequate level of knowledge about CPM.
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Affiliation(s)
- Salim M Makhlouf
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK.
| | - Simon Pini
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK
| | - Shenaz Ahmed
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK
| | - Michael I Bennett
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK
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Darawad M, Alnajar MK, Abdalrahim MS, El-Aqoul AM. Cancer Pain Management at Oncology Units: Comparing Knowledge, Attitudes and Perceived Barriers Between Physicians and Nurses. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:366-374. [PMID: 29288475 DOI: 10.1007/s13187-017-1314-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Pain is a major symptom that causes suffering among patients diagnosed with cancer. Identifying physicians' and nurses' knowledge, attitudes, and their perceived barriers of cancer pain management is considered an essential step in improving cancer pain relief. The purposes of this study are to compare physicians' and nurses' knowledge and attitudes toward cancer pain management (CPM) and describe their perceived barriers to CPM at oncology units. A descriptive cross-sectional design was utilized to obtain data through self-report questionnaire. The total number of sample size was 207 participants (72 physicians and 135 nurses). Findings revealed that both physicians and nurses had fair knowledge and attitudes toward CPM. Physicians had significantly higher knowledge and better attitudes than nurses (62.3 vs. 51.5%, respectively). Physicians were knowledgeable about pharmacological pain management and opioid addiction but had negative attitudes toward pain assessment. Nurses' knowledge was better in regard of CPM guidelines, while they had poor knowledge about pharmacological pain management and opioid addiction. Physicians and nurses perceived knowledge deficit, lack of pain assessment, opioid unavailability, and lack of psychological interventions as the most common barriers to CPM. It is recommended to integrate recent evidence-based guidelines about CPM in oncology units that aim to improve practice. Offering continuing education courses in hospitals guided by pain teams is another essential recommendation for effective CPM.
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Affiliation(s)
- Muhammad Darawad
- Clinical Nursing Department, School of Nursing-The University of Jordan, Amman, 11942, Jordan.
| | - Malek Khalel Alnajar
- Clinical Nursing Department, School of Nursing-The University of Jordan, Amman, 11942, Jordan
| | - Maysoon S Abdalrahim
- Clinical Nursing Department, School of Nursing-The University of Jordan, Amman, 11942, Jordan
| | - Aqel Mohammad El-Aqoul
- King Hussein Cancer Center, Queen Rania Al-Abdullah Street, P.O. Box 1269, Al-Jubeiha, Amman, 11941, Jordan
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Hamieh NM, Akel R, Anouti B, Traboulsi C, Makki I, Hamieh L, Tfayli A. Cancer-Related Pain: Prevalence, Severity and Management in a Tertiary Care Center in the Middle East. Asian Pac J Cancer Prev 2018; 19:769-775. [PMID: 29582633 PMCID: PMC5980854 DOI: 10.22034/apjcp.2018.19.3.769] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Despite pain awareness and the development of treatment guidelines, cancer-related pain assessment and management remain suboptimal. Our objectives were to estimate the prevalence and severity of pain and its interference with daily activities, and evaluate adequacy of treatment in cancer patients in Lebanon. Methods: A total of 400 cancer patients aged 18 and above were interviewed at the American University of Beirut Medical Center surgical and medical oncology floors, outpatient clinics and chemotherapy units from March 2016-February 2017. The subjects covered were socio-demographics, clinical data, and presence of pain in the past month with use of the Brief Pain Inventory questionnaire. Descriptive statistics were conducted using t-test, chi-square and Fischer’s exact tests. Pearson’s correlation coefficients were used to examine relationships between pain severity and pain interference. Logistic regression was employed to determine risk factors for pain. Results: The majority of participants were Lebanese (76.0%), females (62.7%), married (80.2%), of Muslim faith (64.2%), of urban residence (85.8%), and with insurance plans (81.3%). Most had breast cancer (38.8%), were stage 4 (52.7%) and underwent a combination of surgery and systemic therapy (55.1%). The prevalence of pain in the past month was 29.8%. Among patients with pain, the highest proportion had moderate pain (37.8%) and around 46% received inadequate treatment. Conclusion: More awareness about cancer-related pain is needed to improve pain management and encourage referral to palliative care and pain specialists early-on in diagnosis of disease.
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Affiliation(s)
- Nadine M Hamieh
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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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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Lou F, Shang S. Attitudes towards pain management in hospitalized cancer patients and their influencing factors. Chin J Cancer Res 2017; 29:75-85. [PMID: 28373756 PMCID: PMC5348478 DOI: 10.21147/j.issn.1000-9604.2017.01.09] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate patients’ attitudes towards cancer pain management and analyze the factors influencing these attitudes. Methods The self-developed Demographic and Disease-Related Information Questionnaires, Pain Management Barriers Questionnaire-Taiwan form (BQT), and Pain Knowledge Questionnaire were administered to 363 pairs of hospitalized cancer patients and their caregivers from the oncology departments of 7 hospitals in Beijing, China. Results The average patient score for attitudes towards pain management was 2.96±0.49. The dimension scores indicated good attitudes in three areas (scores <2.5), “Desire to be good” (2.22±1.04), “Fatalism” (2.08±0.81) and “Religious fatalism” (1.86±1.00), and poor attitudes in six areas (scores ≥2.5), “Tolerance” (3.83±0.96), “Use of analgesics as needed (p.r.n.)” (3.73±1.01), “Addiction” (3.44±1.05), “Disease progression” (3.28±1.26), “Distraction of physicians” (3.16±1.07) and “Side effects” (2.99±0.68). Two factors were entered into the regression equation: the caregivers’ attitudes towards cancer pain management and the patients’ pain knowledge. These two factors explained 23.2% of the total variance in the patients’ average scores for their attitudes towards cancer pain management.
Conclusions The patients’ attitudes towards cancer pain management were poor and could be influenced by the caregivers’ attitudes and the patients’ pain knowledge, and thus need to be improved.
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Affiliation(s)
- Fangli Lou
- Department of Fundamental Nursing, Peking University School of Nursing, Beijing 100191, China
| | - Shaomei Shang
- Department of Fundamental Nursing, Peking University School of Nursing, Beijing 100191, China
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Cleary J, Silbermann M, Scholten W, Radbruch L, Torode J, Cherny N. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in the Middle East: a report from the Global Opioid Policy Initiative (GOPI). Ann Oncol 2013; 24 Suppl 11:xi51-9. [DOI: 10.1093/annonc/mdt503] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Kwon JH, Hui D, Chisholm G, Hong WT, Nguyen L, Bruera E. Experience of barriers to pain management in patients receiving outpatient palliative care. J Palliat Med 2013; 16:908-14. [PMID: 23758527 DOI: 10.1089/jpm.2012.0610] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient-reported barriers are an important obstacle to cancer pain management. For effective pain management, exploring patient-reported barriers and related factors is important. OBJECTIVES The study's objective is to determine factors associated with patient-reported barriers to cancer pain management. METHOD We conducted a secondary analysis of data from a prospective observational study examining opioid adherence in palliative care outpatients. We evaluated the association between high score on patient-reported barriers to cancer pain management, on the Barriers Questionnaire II (BQ-II), and patients' race, sex, smoking history, pain intensity, opioid dose, and depression. RESULTS Of 196 patients evaluated (median age 55 years), 147 (75%) were white, 41 (21%) had gastrointestinal cancer, and 121 (62%) were receiving anticancer treatment when data were collected. The median pain score was 4 (interquartile range [IQR] 3-7); 98% were receiving strong opioids; and 63% were satisfied with their pain medication. The median Edmonton symptom assessment scale (ESAS) depression score was 1 (IQR 0-3). Mean (SD) BQ-II scores were 1.8 (0.9) for physiologic effects, 1.6 (0.9) for fatalism, 0.9 (0.9) for communication, 2.3 (1.1) for harmful effects, and 1.7 (0.8) in total. Only racial differences were associated with high total BQ-II score in multivariable analysis (R2=0.05, overall F test significance=0.02). Pain related factors including opioids dose, pain intensity, and satisfaction were not associated with high BQ-II score. CONCLUSION Patients receiving palliative care expressed low barriers to pain control. There were minimal associations of BQ-II score with demographics and clinical factors.
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Affiliation(s)
- Jung Hye Kwon
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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Al Khalaileh M, Al Qadire M. Barriers to cancer pain management: Jordanian nurses' perspectives. Int J Palliat Nurs 2012; 18:535-6, 538-40. [DOI: 10.12968/ijpn.2012.18.11.535] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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