ABSTRACT
BACKGROUND: Pain is the most common symptom experienced by both cancer and non-cancer patients. A wide variety of barriers may hinder the optimal treatment of cancer and noncancer pain that are related to the health care system, health care providers, and patients. PURPOSE: To explore the barriers to pain management as perceived by patients with cancer and noncancer chronic diseases. METHOD: A descriptive, cross-sectional correlational design was employed to recruit a sample of 200 patients (n = 100 patients with cancer, n= 100 patients with noncancer) from two hospitals in Jordan. Patients filled out an Arabic version of Barriers Questionnaire II (ABQ-II). RESULTS: Harmful effects of medications were the greatest barrier to effective pain management, while fatalism had the lowest mean scores. Age was negatively correlated with physiological effects (r = -0.287, p < .01), communication (r = -0.263, p < .01), harmful effects (r = -0.284, p < .01), and the overall barrier score (r = -0.326, p < .01) among noncancer patients with chronic disease and (p > .05) for patients with cancer. Patients with cancer had higher mean scores (M = 2.12, SD = 0.78) in the fatalism subscale than those with noncancer chronic disease (M = 1.91, SD = 0.68), while patients with noncancer chronic disease had significantly higher mean scores (M = 2.78, SD = 0.78) in the communication subscale than patients with cancer (M = 2.49, SD = 0.65), (t = -2.899, p = .005). CONCLUSION: To improve the quality of care for patients who are in pain, it is recommended to address pain management barriers as they arise.
Subject(s)
Neoplasms , Pain Management , Humans , Female , Male , Cross-Sectional Studies , Middle Aged , Pain Management/methods , Pain Management/standards , Pain Management/statistics & numerical data , Jordan , Neoplasms/complications , Neoplasms/psychology , Adult , Surveys and Questionnaires , Aged , Chronic Disease , Chronic Pain/psychology , Chronic Pain/drug therapy , Cancer Pain/psychology , Cancer Pain/drug therapyABSTRACT
Background: Central Venous Catheters (CVC) are linked with Catheter-related bloodstream infections (CLABSI) or exit-site infections. Dressings may reduce the rate of infection, but they are uncomfortable, do not eliminate the risk of infection, and in some cases become the cause of infection. Aim: This study evaluates the impact of early CVC dressing removal on CLABSI, exit-site infections, and patient quality of life in an oncology setting. Method: A quasi-experimental pilot study was conducted over 15 months at a specialized oncology center. Sixteen patients were divided into control (n=8) and experimental (n=8) groups. The control group received the standard protocol of applying CVC dressings, while the experimental group received a "no-dressing" protocol. Results: There was no statistical significance in the infection rate between the two groups (p=1.0). Two cases developed CLABSIs, one in each group. One patient from the experimental group developed an exit-site infection as well. Patients in the experimental group reported high satisfaction and an improved quality of life. Conclusions: Applying a no-dressing protocol to a wellhealed exit site CVC showed encouraging results in terms of exit-site and bloodstream infections. That is to say; it did not predispose patients to increased risk of infections. Furthermore, patients with no dressing protocol feel more comfortable in their life.
