The evaluation of management of pain in elderly cancer patients receiving home-based care : the questionnaire with online system

ABSTRACT

<b>Purpose</b> The research is aimed at the evaluation of management of pain in elderly cancer patients receiving home-based care. <b>Methods</b> A questionnaire of 29 questions was developed and 323 home-care physicians were invited to answer the questionnaire with an online system from January 19 to 25 2011. According to answers from the general physicians, we compared the differences of answers about managements of cancer pain between two groups (>75 years old cancer patients with or without cognitive disorder) by Pearson's chi-square test. <b>Results</b> In a the question “Are patients able to appropriately express their cancer pain?”, the ratio of physicians' answers was different;, positive answers in the patients' group with cognitive disorder was significantly lower than those without cognitive disorder (<i>p</i>=0.0043). In other questions “Do physicians feel difficulty of assessment of analgesic effect of opioids?” and “Do physicians feel difficulty of dose-selection and adjustment of opioids?”, positive answers in patients' group with cognitive disorder were more dominant than those without cognitive disorder (<i>p</i><0.0001 each). Further, in the question “Do physicians feel cancer pain management is well-done?”, positive answers were significantly lower in patients with cognitive disorder than those without cognitive disorder (<i>p</i><0.0001). <b>Conclusion</b> With the analyses of the answers from the physicians, we found that physicians felt difficulty of both the assessment of pain and analgesic effect of opioids in patients with cognitive disorder. It should be required for the physicians to improve pain management, especially to the patients with cognitive disorder.