Pain survey effective for educating cancer patients

Sep 26 2012

By Piriya Mahendra, medwireNews Reporter

Surveying cancer patients on their knowledge about how to manage their pain is an effective way to target them for educational intervention, researchers say.

Tone Rustøen (Oslo University, Norway) and team assessed the efficacy of the 6-week Pro-Self Pain Control program, an educational intervention comprising home visits by oncology intervention nurses that was shown to improve knowledge and attitudes in US cancer patients, in a Norwegian population.

The program consists of a palliative care nurse measuring patients' knowledge of pain management to tailor an educational intervention that shows them how to manage their pain and side effects, how to use a weekly pillbox, as well as how to communicate with their physician about unrelieved pain and prescription changes.

Speaking to medwireNews, Rustøen remarked: "The main thing here is that we measure their knowledge level of pain management initially and we guide caregivers based on this knowledge level. I think it is really important that we don't give the same information to everybody before finding out what their level of knowledge is on an individual basis."

She added: "It is very important to give cancer patients knowledge so that they can better handle their pain, pain intensity, and also any possible side effects they might have."

Rustøen and team found no significant differences between patients receiving and not receiving (controls) the intervention with regard to demographic and clinical characteristics. As reported in the Journal of Pain and Symptom Management, patients in both groups reported a worst pain score of 5.1 (on a numerical rating scale of 1 to 10, where 10 represents worst pain) that lasted approximately 10 hours a day.

Analysis of a pain questionnaire administered to the patients that consisted of agree/disagree answers to statements such as: "Cancer pain can be relieved," "Patients are often given too much pain medicine," and "It is better to give pain medicines around the clock rather than only when needed" showed that significant group x time interactions were found for all nine single item scores and the total PES component score.

Compared with the control group, intervention patients showed a significant increase in knowledge for all the single item scores and for the total score.

Analysis of the simple effects within each group showed significant improvements in scores for all individual items and for the total PES score only for patients in the intervention group, at 76 versus 54 for the control group.

Patients in the control group were given a booklet about cancer pain management and were seen by a nurse as frequently as the intervention patients were. However, the focus of their visits was on monitoring patients' adherence levels.

Commenting on the level of resources that would be required to implement such an intervention into daily practice, Rustøen said: "I think that if you have well-educated nurses who will help patients and caregivers that is a very good use of resources because it's much more expensive to hospitalize patients."

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