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1.
Eur J Oncol Nurs ; 52: 101945, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33813183

ABSTRACT

PURPOSE: To examine the effect of an educational intervention intended to improve medical nurses' adherence to breakthrough cancer pain (BTCP) assessment practices and their level of knowledge, attitudes and perceived assessment practices regarding BTCP management. METHODS: Nurses working in a regional hospital were recruited to this quasi-experimental study. The intervention group received a 3-h educational workshop and one session of individual clinical instruction, whilst the control group did not receive any intervention. Chart audits were performed to examine adherence to BTCP assessment practices as the primary outcome. A self-developed questionnaire was used to measure nurses' knowledge, attitudes and perceived assessment practices regarding BTCP management as the secondary outcomes. The chi-square or Fisher's exact test was used to compare the rate of adherence to BTCP assessment practices between groups. A generalised estimating equation was used to compare changes in knowledge, attitudes, and perceived assessment practices between groups over time. RESULTS: One hundred and five nurses completed the study. The chart audits revealed a significantly higher rate of adherence to BTCP assessment practices in the intervention group after the intervention (p < .05). The intervention group exhibited significant positive changes in scores for knowledge (ß = 25.49, p < .001), attitude (ß = 0.98 to 2.81, p < .01), and their perceived assessment practices (ß = 1.33 to 3.14, p < .002) when compared with the control group. CONCLUSIONS: This theory-driven educational intervention significantly improved the medical nurses' adherence to BTCP assessment practices and their level of knowledge attitudes and perceived assessment practices regarding BTCP management.


Subject(s)
Breakthrough Pain/nursing , Cancer Pain/nursing , Education, Nursing/methods , Health Knowledge, Attitudes, Practice , Pain Measurement/nursing , Adult , Clinical Competence , Female , Hong Kong , Humans , Male , Middle Aged , Pain Management/nursing , Surveys and Questionnaires
3.
Pain Manag Nurs ; 16(3): 249-56, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25434499

ABSTRACT

Nonprofessional caregivers frequently experience barriers to using analgesics for pain in patients in home hospice settings, and patients in pain may suffer needlessly. For example, caregiver adherence to the administration of analgesics is lower for as-needed (PRN) regimens than for standard around-the-clock regimens. But little is known about the barriers caregivers experience and the effects of those barriers. Accordingly, we determined caregiver barriers to using analgesics to manage the pain of patients in the home hospice care setting, and how such barriers affected caregiver adherence and patient quality of life. To this end, we measured barriers, caregiver adherence to PRN analgesic regimens, and patient health outcomes (pain, depression, quality of life [QoL]). A 3-day longitudinal design was used. We recruited 46 hospice nonprofessional caregiver-patient dyads from a local community hospice agency. Barriers were measured with the Barrier Questionnaire II. Adherence to the PRN analgesic regimen was obtained with a 3-day pain and medication diary. Patient outcome measures included pain intensity, the Hospital Depression Scale, and the Brief Hospice Inventory for QoL. Barrier scores were moderate to low. Caregivers adhered to PRN analgesic regimens approximately 51% of the time. Higher caregiver adherence to PRN analgesic regimens was associated with lower patient pain intensity and higher patient QoL, but not, surprisingly, with barriers to pain management. Longitudinal studies are now needed to identify factors besides caregiver barriers that may unduly lower caregiver adherence to PRN analgesic regimens.


Subject(s)
Analgesics/therapeutic use , Breakthrough Pain/prevention & control , Caregivers , Hospice Care/methods , Adolescent , Adult , Aged , Analysis of Variance , Breakthrough Pain/nursing , Cancer Pain/nursing , Cancer Pain/prevention & control , Chicago , Female , Guideline Adherence , Home Nursing , Humans , Longitudinal Studies , Male , Middle Aged , Neoplasms/nursing , Pain Management/nursing , Pain Management/standards , Practice Guidelines as Topic , Treatment Outcome , Young Adult
4.
Int J Palliat Nurs ; 20(3): 126-9, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24675538

ABSTRACT

Breakthrough pain is common in patients with cancer and is a significant cause of morbidity in this group of patients. Breakthrough pain is a heterogeneous condition, and so its management needs to be individualised. This paper describes the management of breakthrough pain and, specifically, the recently published guidelines of the European Oncology Nursing Society.


Subject(s)
Breakthrough Pain/nursing , Hospice and Palliative Care Nursing , Nurse's Role , Oncology Nursing , Algorithms , Humans , Nursing Assessment , Pain Management , Pain Measurement , Practice Guidelines as Topic
5.
Eur J Cancer Care (Engl) ; 23(1): 121-8, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24079835

ABSTRACT

Poorly managed cancer pain is well known to profoundly impact the patient's daily life and interfere with quality of life. Nurses who cared for patients with cancer from 12 European countries participated in a survey of breakthrough cancer pain practice. The purpose was to investigate how nurses assess breakthrough cancer pain, use of standardised tools, confidence in supporting patients and awareness of medications. Responses from 1241 participants showed country variations. The majority of the sample was female, Germany had the highest proportion of male nurses (21.0%), followed by Greece (15.8%). A significantly larger proportion of nurses with longer experience and more education (78.8%) used a comprehensive definition of breakthrough cancer pain. Significant variations in training were found; 71% of Finnish nurses had received training compared with 6% of Greek nurses. Training and using a standardised assessment tool was associated with a significant increase in the nurses' perceived ability to distinguish between breakthrough and background pain. Nurses in countries with the highest proportion of training were most confident in supporting patients. In conclusion, there still exists problems with effective management of patients' breakthrough cancer pain, continuing inability to define the difference between background and breakthrough cancer pain leads to poor treatment.


Subject(s)
Breakthrough Pain/nursing , Health Knowledge, Attitudes, Practice , Neoplasms/complications , Oncology Nursing/methods , Pain Management/nursing , Adult , Aged , Breakthrough Pain/diagnosis , Breakthrough Pain/drug therapy , Clinical Competence , Education, Nursing/standards , Europe , Female , Humans , Male , Middle Aged , Neoplasms/nursing , Self Efficacy , Surveys and Questionnaires , Young Adult
6.
Eur J Oncol Nurs ; 18(2): 127-31, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24369817

ABSTRACT

PURPOSE: The overall aim of the project was to update and inform nurses of current best practice based on previously published literature to enable nurses to assess and manage breakthrough cancer pain (BTCP) and thereby to provide optimal management of BTCP. METHODS: The EONS started a project in 2010 by recruiting a working group and a multidisciplinary advisory board to develop guidelines with the purpose of helping oncology nurses understand and recognise BTCP. RESULTS: This paper presents and overview of the guideline. Key recommendations include; using an algorithm for assessment of BTCP, individualise treatment interventions, optimization of analgesia and reassessment of outcomes of interventions. CONCLUSIONS: By implementing the EONS guidelines nurses will utilise the latest available knowledge in clinical practice and the understanding and management of BTCP will improve assessment and overall management of breakthrough pain in cancer patients.


Subject(s)
Breakthrough Pain/nursing , Neoplasms/complications , Oncology Nursing/standards , Pain Management/standards , Practice Guidelines as Topic , Breakthrough Pain/etiology , Breakthrough Pain/therapy , Europe , Evidence-Based Medicine , Female , Humans , Male , Neoplasms/nursing , Pain Measurement , Severity of Illness Index , Societies, Nursing/standards , Treatment Outcome
7.
Int J Palliat Nurs ; 19(11): 528-34, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24263896

ABSTRACT

OBJECTIVE: To gain a better understanding of how registered nurses working in specialist palliative care assess and manage breakthrough cancer pain. METHODS: A mixed-methodology study was undertaken in two stages-this paper reports findings from stage two. Anonymous postal questionnaires, designed based on themes identified in interviews undertaken during stage one, were sent to trained nurses working in ten specialist palliative care services in England. RESULTS: A total of 104 questionnaires were returned. Respondents were experienced nurses mainly working in inpatient settings. Some 82% of the nurses wanted more training on the assessment of breakthrough cancer pain. Although there were inconsistencies around the use of terminology, pain management appeared to be good. CONCLUSION: The use of terminology in the field of breakthrough cancer pain remains variable. However, this does not appear to have a negative impact on patient management, which was broadly in line with recently published consensus recommendations. There is a desire for more education within this area of practice.


Subject(s)
Breakthrough Pain/nursing , Nursing Assessment , Pain Measurement , Palliative Care , Specialties, Nursing , England , Humans , Surveys and Questionnaires
8.
Eur J Oncol Nurs ; 17(4): 402-7, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23276599

ABSTRACT

PURPOSE: To increase our knowledge of how nurses assess breakthrough cancer pain (BTCP); and whether they find it difficult to distinguish BTCP from background pain; how they estimate the impact of BTCP on patients' daily lives, and the factors that nurses consider to induce BTCP. Variations in their use of assessment tools and their ability to distinguish between different types of pain were also examined in terms of the number of years of oncology nursing experience and the practice in different countries. METHODS: In total, 1241 nurses (90% female) who care for patients with cancer, from 12 European countries, completed a survey questionnaire. KEY RESULTS: Half the sample had >9 years of experience in oncology nursing. Although 39% had no pain assessment tool to help them distinguish between types of pain, 95% of those who used a tool found it useful. Furthermore, 37% reported that they had problems distinguishing background pain from BTCP. Movement was identified as the factor that most commonly exacerbated BTCP across all countries. The nurses reported that BTCP greatly interfered with patients' everyday activities, and they rated the patients' enjoyment of life as most strongly affected. The use of tools and the ability to distinguish between different pains varied between European countries and with years of experience in oncology nursing. CONCLUSIONS: The nurses reported that BTCP greatly interfered with patients' lives, and many nurses had problems distinguishing between background pain and BTCP. Nurses require more knowledge about BTCP management, and guidelines should be developed for clinical use.


Subject(s)
Breakthrough Pain/diagnosis , Neoplasms/nursing , Oncology Nursing/methods , Pain Management/methods , Pain Measurement/methods , Activities of Daily Living , Adult , Breakthrough Pain/complications , Breakthrough Pain/nursing , Female , Humans , Male , Middle Aged , Neoplasms/complications , Nursing Assessment , Pain Measurement/statistics & numerical data , Surveys and Questionnaires
9.
Eur J Oncol Nurs ; 17(1): 95-100, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22742829

ABSTRACT

PURPOSE OF THE RESEARCH: Breakthrough cancer pain (BTCP) is a prevalent type of pain in which the nurse can play an important role in improving patients' pain symptoms and overall well-being. Nurses' experience with BTCP (number of patients, and estimates of severity and frequency), the treatment of BTCP (pharmacological and nonpharmacological treatments normally used), ratings of the importance of treatment factors, and reasons given for not advising patients to take strong painkillers are presented in the present paper. METHODS AND SAMPLE: Nurses from 12 European countries, who cared for patients with cancer, took part in a survey. In total 1618 nurses were recruited and 1241 completed the survey questionnaire. KEY RESULTS: Almost 90% of the nurses were female, and 50.4% had >9 years of experience in oncology nursing. The majority of the nurses (47%) said that a patient typically suffered from BTCP 2-3 times a day, and the severity of the pain for the patients was described as severe by 75.5%. In all, 38.4% of the nurses were unaware that medications specifically intended for treatment of BTCP exist, and 57% reported that oral opioids were normally prescribed for BTCP at their workplace. While 38% said they did not use nonpharmacological treatments for BTCP, the most common treatment approach was positional change (used by 76.6%). The treatment varied between the European countries. CONCLUSION: Patients do not receive the appropriate medical treatment for their BTCP. Nurses need better training about BTCP in general, and BTCP assessment and management specifically.


Subject(s)
Breakthrough Pain/nursing , Health Knowledge, Attitudes, Practice , Neoplasms/nursing , Oncology Nursing/methods , Pain Management/nursing , Adolescent , Adult , Aged , Breakthrough Pain/epidemiology , Causality , Comorbidity , Europe , Female , Humans , Male , Middle Aged , Neoplasms/epidemiology , Population Surveillance , Surveys and Questionnaires , Young Adult
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