A Randomized Controlled Trial of Nurse-Administered Behavioral Interventions for Improving Cancer Pain Management in Ambulatory Settings

2.50
Hdl Handle:
http://hdl.handle.net/10755/165746
Category:
Abstract
Type:
Presentation
Title:
A Randomized Controlled Trial of Nurse-Administered Behavioral Interventions for Improving Cancer Pain Management in Ambulatory Settings
Author(s):
Yates, Patsy
Author Details:
Patsy Yates, Associate Professor, Queensland University of Technology, School of Nursing, Queensland, Australia, email: p.yates@qut.edu.au
Abstract:
The presence of behavioral barriers to effective pain management is well documented. Despite this evidence, few controlled studies evaluating nursing interventions for overcoming such barriers have been reported. The purpose of this study was to evaluate the effectiveness of a nurse administered pain management program (PMP) for ambulatory cancer patients. The study is based on Greene's PRECEDE model of health behavior, which identifies three factors as influencing health (pain) behavior: (1) predisposing (beliefs and attitudes), (2) enabling (knowledge and skills), and (3) reinforcing (professional and social support). A randomized, controlled design was used. One hundred eighty nine patients with breast (n = 82), lung (n = 38), colorectal (n = 44), and head and neck (n = 25) cancer who had cancer-related pain in the previous two weeks were consecutively recruited from two hospitals. Intervention group patients received the PMP, which incorporated cognitive-behavioral strategies to facilitate effective pain management behaviors. The PMP was delivered in two interactive sessions one week apart. Patients in the control group received a generalized patient education program of equivalent timeframe. Patients completed a survey on three occasions: one week prior (T0); one month following (T1), and three months following (T2) the intervention. The survey comprised scales with established validity and reliability, including the Barriers Questionnaire, Knowledge and Preparedness, Self-efficacy, Communication. Pain outcomes were assessed using the Brief Pain Inventory, the Hospital Anxiety and Depression Scale, and the EORTC QLQ 30 Scale. Mean differences between T0 and T1 scores were compared using paired t tests. Results suggest the intervention group demonstrated significantly greater reduction in concerns about addiction (p < .01), tolerance to pain medication (p < .01), willingness to tolerate pain (p < .05), "being a good patient" (p < .01), and had a greater increase in expectation of pain relief (p < .01). Patients in the intervention group also reported a greater reduction in anxiety (p < .05), and a greater increase in knowledge (p < .01), although no significant differences were identified for severity of pain, or quality of life. Results suggest that brief structured interventions based on cognitive behavioral techniques may be effective in overcoming behavioral barriers to pain management, although further investigation is required to determine how such strategies may translate to improved pain outcomes.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
27th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Washington, D.C., USA
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.titleA Randomized Controlled Trial of Nurse-Administered Behavioral Interventions for Improving Cancer Pain Management in Ambulatory Settingsen_GB
dc.contributor.authorYates, Patsyen_US
dc.author.detailsPatsy Yates, Associate Professor, Queensland University of Technology, School of Nursing, Queensland, Australia, email: p.yates@qut.edu.auen_US
dc.identifier.urihttp://hdl.handle.net/10755/165746-
dc.description.abstractThe presence of behavioral barriers to effective pain management is well documented. Despite this evidence, few controlled studies evaluating nursing interventions for overcoming such barriers have been reported. The purpose of this study was to evaluate the effectiveness of a nurse administered pain management program (PMP) for ambulatory cancer patients. The study is based on Greene's PRECEDE model of health behavior, which identifies three factors as influencing health (pain) behavior: (1) predisposing (beliefs and attitudes), (2) enabling (knowledge and skills), and (3) reinforcing (professional and social support). A randomized, controlled design was used. One hundred eighty nine patients with breast (n = 82), lung (n = 38), colorectal (n = 44), and head and neck (n = 25) cancer who had cancer-related pain in the previous two weeks were consecutively recruited from two hospitals. Intervention group patients received the PMP, which incorporated cognitive-behavioral strategies to facilitate effective pain management behaviors. The PMP was delivered in two interactive sessions one week apart. Patients in the control group received a generalized patient education program of equivalent timeframe. Patients completed a survey on three occasions: one week prior (T0); one month following (T1), and three months following (T2) the intervention. The survey comprised scales with established validity and reliability, including the Barriers Questionnaire, Knowledge and Preparedness, Self-efficacy, Communication. Pain outcomes were assessed using the Brief Pain Inventory, the Hospital Anxiety and Depression Scale, and the EORTC QLQ 30 Scale. Mean differences between T0 and T1 scores were compared using paired t tests. Results suggest the intervention group demonstrated significantly greater reduction in concerns about addiction (p &lt; .01), tolerance to pain medication (p &lt; .01), willingness to tolerate pain (p &lt; .05), &quot;being a good patient&quot; (p &lt; .01), and had a greater increase in expectation of pain relief (p &lt; .01). Patients in the intervention group also reported a greater reduction in anxiety (p &lt; .05), and a greater increase in knowledge (p &lt; .01), although no significant differences were identified for severity of pain, or quality of life. Results suggest that brief structured interventions based on cognitive behavioral techniques may be effective in overcoming behavioral barriers to pain management, although further investigation is required to determine how such strategies may translate to improved pain outcomes.en_GB
dc.date.available2011-10-27T12:24:10Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:24:10Z-
dc.conference.date2002en_US
dc.conference.name27th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationWashington, D.C., USAen_US
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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