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Factors That Hinder and Facilitate Cancer Patients' Knowledge About Pain Management-A Qualitative Study
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet, Sweden.ORCID iD: 0000-0002-4108-391x
Oslo Univ Hosp, Norway;Univ Oslo, Norway.
2019 (English)In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 57, no 4, p. 753-760Article in journal (Refereed) Published
Abstract [en]

Context. Pain management education may improve pain control for some patients, whereas individual differences exist. Objectives. To evaluate possible critical components, facilitators, and hindrances for improved knowledge about pain management, in not hospitalized adult oncology patients with pain from bone metastasis participating in a pain management intervention. Methods. This substudy is a qualitative evaluation of the PRO-SELF Pain Control Program, tested in a randomized controlled trial. During six weeks, 87 participants in the intervention group received tailored coaching encounters by a trained oncology nurse. Three encounters for each patient were audio recorded. The encounter between patient's with the largest (n = 12) and lowest (n = 8) change in knowledge about pain management from before to after the intervention was transcribed verbatim and analyzed with qualitative content analysis. Results. The critical components of the intervention were repetition of information, struggling with resistance, use of peer experiences, and keeping track of variations. Facilitators of improvement were patients' trust and preparedness to try new procedures, the patient's self-awareness and body awareness, and taking active role in own care. Difficulties in processing complex information, culturally conditioned behaviors, fear, and lack of knowledge were the most important barriers to the success of the intervention. Conclusion. Education in pain management in cancer patients requires repeated information, allowing time for overcoming resistance related to dysfunctional beliefs and fear. To facilitate the patient's involvement in their pain management, tailored and person-centered education is needed. (C) 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 57, no 4, p. 753-760
Keywords [en]
Cancer pain, PRO-SELF Pain Control Program, interview, barriers, facilitators
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-81843DOI: 10.1016/j.jpainsymman.2018.12.334ISI: 000462027900008PubMedID: 30593908Scopus ID: 2-s2.0-85061056360OAI: oai:DiVA.org:lnu-81843DiVA, id: diva2:1304365
Available from: 2019-04-12 Created: 2019-04-12 Last updated: 2019-08-29Bibliographically approved

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Ekstedt, Mirjam

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