Predictors of High Score Patient-reported Barriers to Controlling Cancer Pain: a Preliminary Report

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2012 Nov 16

PMID 23151648

Citations 10

Authors

Jung Hye Kwon

Sung Yong Oh

Gary Chisholm

Jung-Ae Lee

Jae Jin Lee

Keon Woo Park

Seung-Hyun Nam

Hun Ho Song

Keehyun Lee

Dae Young Zang

Ho Young Kim

Dae Ro Choi

Hyo Jung Kim

Jung Han Kim

Joo Young Jung

Geundoo Jang

Hyeong Su Kim

Ji Yun Won

Eduardo Bruera

Affiliations

Soon will be listed here.

Abstract

Purpose: Pain is one of the most common and devastating symptoms in cancer patients, and misunderstandings on the patient's part can cause major obstacles in pain management.

Method: We evaluated factors associated with patient's high barrier score to managing cancer-associated pain by having 201 patients complete the Korean Barriers Questionnaire II, the Brief Pain Inventory--Korean, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and the Korean Beck Depression Inventory. The Pain Management Index (PMI) was also assessed.

Results: The patients were from nine oncology clinics in university hospitals and a veterans' hospital in South Korea. The median pain score (0-10 scale) was 4, with a median percentage of pain improvement during the last 24 h of 70 %. A total of 150 patients (75 %) received strong opioids, and 177 (88 %) achieved adequate analgesia (positive PMI). Mean scores ± SD for the Barriers Questionnaire II ranged from 1.5 ± 1 to 2.8 ± 1.1, with the harmful effects subscale the highest. In the multiple regression model, depression was significantly associated with total barrier score to pain management (p < 0.0001). Pain reduction was significantly associated with the fatalism subscale.

Conclusions: Depression was associated with high barrier score in patients with cancer pain. Management of cancer pain should include screening for depression, and management of depression could reduce patient-reported barriers to pain management.

Citing Articles

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Edirisinghe N, Makuloluwa P, Amarasekara A, Goonewardena C PLoS One. 2025; 20(1):e0302615.

PMID: 39854378 PMC: 11761611. DOI: 10.1371/journal.pone.0302615.

A Prospective Study to Compare Caregivers' Knowledge and Perception of Cancer Pain with Patients' Pain Assessment and to Evaluate their Quality of Life.

Kumar D, Dey T, Arora M Indian J Palliat Care. 2024; 30(1):41-46.

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Management of pain in the cancer patient.

Dalal S, Bruera E Front Pain Res (Lausanne). 2022; 3:926712.

PMID: 36003830 PMC: 9393289. DOI: 10.3389/fpain.2022.926712.

The Effectiveness of Cancer Pain Management in a Tertiary Hospital Outpatient Pain Clinic in Thailand: A Prospective Observational Study.

Wangnamthip S, Panchoowong S, Donado C, Lobo K, Phankhongsap P, Sriveerachai P Pain Res Manag. 2021; 2021:5599023.

PMID: 34336068 PMC: 8315883. DOI: 10.1155/2021/5599023.

The pattern of change in opioid and adjuvant prescriptions for cancer pain before and after referral to a comprehensive program in the Palliative Care Center in Kuwait.

Al-Ansari A, Abd-El-Gawad W, AboSerea S, ElShereafy E, Ali F, ElSayed M BMC Palliat Care. 2021; 20(1):25.

PMID: 33536013 PMC: 7860188. DOI: 10.1186/s12904-021-00717-2.

References

Yates P, Edwards H, Nash R, Aranda S, Purdie D, Najman J . A randomized controlled trial of a nurse-administered educational intervention for improving cancer pain management in ambulatory settings. Patient Educ Couns. 2004; 53(2):227-37. DOI: 10.1016/S0738-3991(03)00165-4. View

Aaronson N, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez N . The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993; 85(5):365-76. DOI: 10.1093/jnci/85.5.365. View

van den Beuken-van Everdingen M, de Rijke J, Kessels A, Schouten H, van Kleef M, Patijn J . Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 2007; 18(9):1437-49. DOI: 10.1093/annonc/mdm056. View

Gunnarsdottir S, Donovan H, Ward S . Interventions to overcome clinician- and patient-related barriers to pain management. Nurs Clin North Am. 2003; 38(3):419-34, v. DOI: 10.1016/s0029-6465(02)00093-2. View

Kim J, Dodd M, West C, Paul S, Facione N, Schumacher K . The PRO-SELF pain control program improves patients' knowledge of cancer pain management. Oncol Nurs Forum. 2004; 31(6):1137-43. DOI: 10.1188/04.ONF.1137-1143. View

Ward S, Berry P, Misiewicz H . Concerns about analgesics among patients and family caregivers in a hospice setting. Res Nurs Health. 1996; 19(3):205-11. DOI: 10.1002/(SICI)1098-240X(199606)19:3<205::AID-NUR4>3.0.CO;2-O. View

Ward S, Goldberg N, Mueller C, Nolan A, Robbins A, Stormoen D . Patient-related barriers to management of cancer pain. Pain. 1993; 52(3):319-324. DOI: 10.1016/0304-3959(93)90165-L. View

Jacobsen R, Moldrup C, Christrup L, Sjogren P, Hansen O . The Danish Barriers Questionnaire-II: preliminary validation in cancer pain patients. Pain Pract. 2009; 9(4):266-74. DOI: 10.1111/j.1533-2500.2009.00296.x. View

Beck A, Ward C, Mendelson M, Mock J, ERBAUGH J . An inventory for measuring depression. Arch Gen Psychiatry. 1961; 4:561-71. DOI: 10.1001/archpsyc.1961.01710120031004. View

10.

Gilson A, Joranson D, Maurer M . Improving state pain policies: recent progress and continuing opportunities. CA Cancer J Clin. 2007; 57(6):341-53. DOI: 10.3322/CA.57.6.341. View

11.

Laird B, Scott A, Colvin L, McKeon A, Murray G, Fearon K . Pain, depression, and fatigue as a symptom cluster in advanced cancer. J Pain Symptom Manage. 2011; 42(1):1-11. DOI: 10.1016/j.jpainsymman.2010.10.261. View

12.

Valeberg B, Hanestad B, Klepstad P, Miaskowski C, Moum T, Rustoen T . Cancer patients' barriers to pain management and psychometric properties of the Norwegian version of the Barriers Questionnaire II. Scand J Caring Sci. 2008; 23(3):518-28. DOI: 10.1111/j.1471-6712.2008.00639.x. View

13.

Gunnarsdottir S, Serlin R, Ward S . Patient-related barriers to pain management: the Icelandic Barriers Questionnaire II. J Pain Symptom Manage. 2005; 29(3):273-85. DOI: 10.1016/j.jpainsymman.2004.06.015. View

14.

Yun Y, Park Y, Lee E, Bang S, Heo D, Park S . Validation of the Korean version of the EORTC QLQ-C30. Qual Life Res. 2004; 13(4):863-8. DOI: 10.1023/B:QURE.0000021692.81214.70. View

15.

Hong S, Roh S, Kim S, Shin S, Kim C, Choi J . Change in cancer pain management in Korea between 2001 and 2006: results of two nationwide surveys. J Pain Symptom Manage. 2010; 41(1):93-103. DOI: 10.1016/j.jpainsymman.2010.03.025. View

16.

Solano J, Gomes B, Higginson I . A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease. J Pain Symptom Manage. 2006; 31(1):58-69. DOI: 10.1016/j.jpainsymman.2005.06.007. View

17.

Lin C, Ward S . Patient-related barriers to cancer pain management in Taiwan. Cancer Nurs. 1995; 18(1):16-22. View

18.

Edrington J, Sun A, Wong C, Dodd M, Padilla G, Paul S . Barriers to pain management in a community sample of Chinese American patients with cancer. J Pain Symptom Manage. 2008; 37(4):665-75. PMC: 2688466. DOI: 10.1016/j.jpainsymman.2008.04.014. View

19.

Gunnarsdottir S, Donovan H, Serlin R, Voge C, Ward S . Patient-related barriers to pain management: the Barriers Questionnaire II (BQ-II). Pain. 2002; 99(3):385-396. DOI: 10.1016/S0304-3959(02)00243-9. View

20.

Jacobsen R, Sjogren P, Moldrup C, Christrup L . Physician-related barriers to cancer pain management with opioid analgesics: a systematic review. J Opioid Manag. 2007; 3(4):207-14. DOI: 10.5055/jom.2007.0006. View