2.50
Hdl Handle:
http://hdl.handle.net/10755/164670
Category:
Abstract
Type:
Presentation
Title:
IMPROVING CANCER PAIN MANAGEMENT USING AHCPR CANCER PAIN GUIDELINES
Author(s):
Thomas, Mary; Douglas, Marilyn; Rao, Stephen; Elliott, Jan; Fahey, Kathleen; Miaskowski, Christine
Author Details:
Mary Thomas, RN, MS, AOCN, University of California San Francisco, San Francisco, California, USA; Marilyn Douglas, RN, DNSc, FAAN; Stephen Rao, PhD; Jan Elliott, RN, MS, AOCN; Kathleen Fahey, RN, MS, AOCN; Christine Miaskowski, RN, PhD, FAAN
Abstract:
Ineffective cancer pain management (PM) remains a significant problem. Patient’s attitudinal barriers (ABs) can be a significant obstacle to effective PM. The purpose of this study was to test the effectiveness of two interventions (standardized versus individualized education) to ameliorate ABs toward PM on improving pain, functional status and quality of life (QOL). Cancer pain was conceptualized as multidimensional in nature (Ahles); to be effective, PM should also be multidimensional. A convenience sample of 288 adults with pain related to cancer/treatment participated. After completing baseline questionnaires, subjects were stratified by pain severity and concurrent chemo/radiation therapy, and then randomized into three groups: Control (usual care), Education (AHCPR booklet and PM video), or Coaching (same as education group, plus four structured telephone calls by a PM clinical nurse specialist addressing ABs and PM strategies). The coaching intervention was based on self-regulation theory (Miller & Brown) using motivational interviewing techniques; calls occurred over a six-week time period. Questionnaires were re-administered 12 weeks after randomization. Instruments with established reliability and validity were used to measure the study’s dependent variables: Brief Pain Inventory (pain severity, pain relief, pain-related interference with function); Barriers Questionnaire (ABs); Functional Assessment of Cancer Therapy-General (QOL); and SF-36 (functional status). Results were analyzed by addressing the effects of time and group on the dependent variables using repeated measures ANOVA. The sample was predominantly male (88%), veteran (85%), middle aged, and had a variety of cancer types; over 30% were receiving concurrent cancer therapy. Patients in the coaching group demonstrated less pain, improved pain relief and emotional well-being, and less interference with function from pain; however, these results were not statistically significant. Lack of achieving statistical significance may be due to any of the following: a small effect size, loss of many subjects to death or progressive illness while on study, time between assessments, and diminished ability to strictly adhere to the attention control call format when subjects voiced significant problems warranting intervention. Attitudinal barriers are prevalent in cancer patients and this coaching intervention may be an effective strategy in improving PM. However, other methods are needed to test its effectiveness.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
30th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Orlando, Florida, USA
Sponsors:
Funding Sources: Veterans Affairs, Health Services Research and Development Service, NRI 97-026-1.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleIMPROVING CANCER PAIN MANAGEMENT USING AHCPR CANCER PAIN GUIDELINESen_GB
dc.contributor.authorThomas, Maryen_US
dc.contributor.authorDouglas, Marilynen_US
dc.contributor.authorRao, Stephenen_US
dc.contributor.authorElliott, Janen_US
dc.contributor.authorFahey, Kathleenen_US
dc.contributor.authorMiaskowski, Christineen_US
dc.author.detailsMary Thomas, RN, MS, AOCN, University of California San Francisco, San Francisco, California, USA; Marilyn Douglas, RN, DNSc, FAAN; Stephen Rao, PhD; Jan Elliott, RN, MS, AOCN; Kathleen Fahey, RN, MS, AOCN; Christine Miaskowski, RN, PhD, FAANen_US
dc.identifier.urihttp://hdl.handle.net/10755/164670-
dc.description.abstractIneffective cancer pain management (PM) remains a significant problem. Patient’s attitudinal barriers (ABs) can be a significant obstacle to effective PM. The purpose of this study was to test the effectiveness of two interventions (standardized versus individualized education) to ameliorate ABs toward PM on improving pain, functional status and quality of life (QOL). Cancer pain was conceptualized as multidimensional in nature (Ahles); to be effective, PM should also be multidimensional. A convenience sample of 288 adults with pain related to cancer/treatment participated. After completing baseline questionnaires, subjects were stratified by pain severity and concurrent chemo/radiation therapy, and then randomized into three groups: Control (usual care), Education (AHCPR booklet and PM video), or Coaching (same as education group, plus four structured telephone calls by a PM clinical nurse specialist addressing ABs and PM strategies). The coaching intervention was based on self-regulation theory (Miller & Brown) using motivational interviewing techniques; calls occurred over a six-week time period. Questionnaires were re-administered 12 weeks after randomization. Instruments with established reliability and validity were used to measure the study’s dependent variables: Brief Pain Inventory (pain severity, pain relief, pain-related interference with function); Barriers Questionnaire (ABs); Functional Assessment of Cancer Therapy-General (QOL); and SF-36 (functional status). Results were analyzed by addressing the effects of time and group on the dependent variables using repeated measures ANOVA. The sample was predominantly male (88%), veteran (85%), middle aged, and had a variety of cancer types; over 30% were receiving concurrent cancer therapy. Patients in the coaching group demonstrated less pain, improved pain relief and emotional well-being, and less interference with function from pain; however, these results were not statistically significant. Lack of achieving statistical significance may be due to any of the following: a small effect size, loss of many subjects to death or progressive illness while on study, time between assessments, and diminished ability to strictly adhere to the attention control call format when subjects voiced significant problems warranting intervention. Attitudinal barriers are prevalent in cancer patients and this coaching intervention may be an effective strategy in improving PM. However, other methods are needed to test its effectiveness.en_GB
dc.date.available2011-10-27T12:04:53Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:04:53Z-
dc.conference.date2005en_US
dc.conference.name30th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationOrlando, Florida, USAen_US
dc.description.sponsorshipFunding Sources: Veterans Affairs, Health Services Research and Development Service, NRI 97-026-1.-
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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