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Nurses’ willingness to maximize opioid analgesia for severe cancer pain, and its predictor

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Abstract

Goals of work

The effectiveness of cancer pain management (CPM) is influenced by nurses’ willingness to maximize opioid analgesia for severe cancer pain. The purposes of this study were to identify the willingness of nurses to provide maximum-dose opioids whenever needed for CPM and to determine its associated predictors.

Methods

This multicenter study was conducted among the entire total of registered nurses in seven large hospitals in Korea. Its overall response rate was 41.6%, and the data from 930 who responded (40.1%) were analyzed. We utilized a three-step, multidimensional, multiple logistic regression to identify the predictors of nurses’ willingness.

Main results

Only 255 nurses (27.4%) indicated that they recommended the maximum dose of opioids whenever it was needed. The respondents who were more likely to recommend morphine showed the following characteristics: older nurses (odds ratio, OR, 1.57; confidence interval, CI, 1.13–2.19); they knew the effectiveness of opioids for CPM (OR 1.53; CI 1.06–2.20); rarely concerned about a patient’s addiction to opioids (OR 2.16; CI 1.48–3.15), or to a family member’s addiction (OR 1.81; CI 1.20–2.73); prior experience with pain assessment tools (OR 1.62; CI 1.11–2.37); practical experience caring for cancer patients with pain over 51% (OR 1.55; CI 1.09–2.19).

Conclusions

Our multicenter study suggested that in order to improve nurses’ willingness to recommend opioids liberally in CPM: (1) attitudes about fear of opioid addiction must be changed; (2) the efficiency of opioids in CPM must be taught; and (3) implementation of pain assessment tools must be undertaken.

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Acknowledgements

This study was supported by a grant from the 2001 Korean National Cancer Control Program provided by the Ministry of Health and Welfare, Korea. The authors wish to thank all the nurses and patients for their kind cooperation.

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Authors and Affiliations

  1. Cancer Information Branch, Research Institute, National Cancer Center, Goyang, South Korea

    Yoon Jung Chang

  2. Quality of Cancer Care Branch, Research Institute and Hospital, National Cancer Center, Goyang, South Korea

    Young Ho Yun & Sang Min Park

  3. College of Nursing, Seoul National University, Seoul, South Korea

    So Woo Lee & Hyeoun-Ae Park

  4. College of Nursing, The Catholic University, Seoul, South Korea

    You-Ja Ro

  5. Department of Family Medicine, Seoul National University Hospital, 28 Yungun-dong, Jongro-gu, Seoul, South Korea

    Bong Yul Huh

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  1. Yoon Jung Chang
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  2. Young Ho Yun
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  3. Sang Min Park
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  4. So Woo Lee
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  5. Hyeoun-Ae Park
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  7. Bong Yul Huh
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Corresponding author

Correspondence to Bong Yul Huh.

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Chang, Y.J., Yun, Y.H., Park, S.M. et al. Nurses’ willingness to maximize opioid analgesia for severe cancer pain, and its predictor. Support Care Cancer 13, 743–751 (2005). https://doi.org/10.1007/s00520-005-0791-x

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  • DOI: https://doi.org/10.1007/s00520-005-0791-x

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