Abstract
Purpose
The purposes of this study were to evaluate the current situation of pain management outcomes, patients’ pain knowledge, and family caregivers’ pain knowledge in China and explore the impact of pain knowledge of patients and family caregivers on pain management outcomes.
Methods
A total of 410 patient-family caregiver dyads were assessed by Brief Pain Inventory (BPI), the Pain Knowledge subscales of Patient Pain Questionnaire (PPQ), and Family Pain Questionnaire (FPQ). The difference in pain management outcomes was analyzed using bivariate analysis first, and then variables with statistical significance in bivariate analysis were included in multivariable linear regression analysis.
Results
The average patient pain score in the last 24 h was 3.23 (SD = 2.16). The total average scores on pain knowledge of 410 patients and family caregivers were 3.60 ± 1.90 and 3.57 ± 1.76. Multivariable linear regression analysis showed taking strong opioids, patients’ perceived moderate health status, patients’ pain knowledge, and family caregivers’ pain knowledge were the main factors influencing the pain management outcomes.
Conclusion
Pain knowledge of patients and family caregivers were important indicators of pain management outcomes, indicating tailored cancer pain education program should be developed.
Similar content being viewed by others
Data availability
The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.
Code availability
SPSS version 20.0 (IBM Corp., New York, USA) was downloaded from Peking University Health Science Library.
References
National Comprehensive Cancer Network. NCCN Guidelines Version 1. 2019 Adult Cancer Pain. Available from: https://www.nccn.org/professionals/physiciangls/default.aspx#age . Accessed 2 Oct 2020
Van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van-Kleef M, Patijn J, (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 18(9):1437–14493
Johan Haumann EA, Joosten V, den Beuken-van Everdingen MH (2017) Pain prevalence in cancer patients: status quo or opportunities for improvement? Curr Opin Support Palliat Care 11:99–104
van den Beuken-van Everdingen MHJ, Hochstenbach LMJ, Joosten BEAJ, Tjan-Heijnen VCG, Janssen DJA (2016) Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. J Pain Relief 51(6):1070-1090.e9
Moja S, Apolone G (2008) Prevalence of undertreatment in cancer pain. A review of published literature. Annals Oncol 19(12):1985–1991
Lu YH, Gu YH, Yu WH (2018) Hospice and Palliative Care in China: development and challenges. Asia Pac J Oncol Nurs 5(1):26–32
Kwon JH (2014) Overcoming barriers in cancer pain management. J Clin Oncol 32(16):1727
Yang AD, Bai XX, Cheng ZY, Tan J, Du J (2017) Investigation and analysis of influential factors of pain condition in hospitalized cancer pain patients in Chengdu district. Chin J Ctrl Endem Dis 3(3):22–23
Liu YM, Shao ZH, Li W, Wang NY (2016) Factors influencing the analgesic effect of pain in advanced cancer patients with moderate or severe chronic pain. Chin Clin Oncol 21(3):251–256
Saifan A, Bashayreh I, Batiha AM, Aburuz M (2015) Patient and family caregiver related barriers to effective cancer pain control. Pain Manag Nurs 16(3):400–410
Sigridur G, Valgerdur S, Marianne K, Lukas R, Rainer S (2017) A multicenter study of attitudinal barriers to cancer pain management. Support Care Cancer 25(11):3595–3602
Barriers to Pain Management among Lithuanian Cancer Patients (2010) Pain Pract 10(2):145–157
Ferrell BR (2018) Family caregiving and cancer pain management. Anesth Analg 129(5):1408–1413
Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM, Firn JI, Paice JA, Peppercorn JM, Phillips T (2017) Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 35(1):96–114
Cohen MZ, Musgrave CF, Mcguire DB, Strumpf NE, Munsell MF, Mendoza TR, Gips M (2005) The cancer pain experience of Israeli adults 65 years and older: the influence of pain interference, symptom severity, and knowledge and attitudes on pain and pain control. Support Care Cancer 13(9):708–714
Singh H, Banipal RPS, Singh B (2017) Assessment of adequacy of pain management and analgesic use in patients with advanced cancer using the brief pain inventory and pain management index calculation. J Glob Oncol 3(3):235–241
Vuong S, DeAngelis C, Tsao M, Pulenzas N, Danjoux C (2016) Inadequate pain management in cancer patients attending an outpatient palliative radiotherapy clinic. Support Care Cancer 24(2):887–892
Lou FL, Shang SM (2018) Attitudes to pain management towards cancer patients and its influencing factors based on analysis of theoretical perspectives with “S- O- R” model, Heider balance theory and KAP model. Chin J Prac Nurs 34(13):1008–1015
Vallerand AH, Collins-Bohler D, Templin T, Hasenau SM (2007) Knowledge of and barriers to pain management in caregivers of cancer patients receiving homecare. Cancer Nurs 30(1):31–37
Yan Hu, Zhiwen W (2017) Nursing Research. People’s Medical Publishing House, Being
Cleeland CS (1989) Measurement of pain by subjective report. In: Chapman CR, Loeser JD (eds) Advances in pain research and therapy, vol 12. Raven, New York, pp 391–403
Hussein RG (2003) Cancer patients suffering pain unduly. J Adv Nurs 43:118
Xin SW, Mendoza TR, Gao SZ, Cleeland CS (1996) The Chinese version of the Brief Pain Inventory (BPI-C): its development and use in a study of cancer pain. Pain 67(2–3):407–416
Ferrell BR, Grant M, Borneman T, Juarez G, Veer AT (1999) Family caregiving in cancer pain management. J Palliat Med 2(2):185–195
Ferrell B. 25. Patient pain questionnaire. Available from: https://prc.coh.org/. Accessed 2 Oct 2020
Eccleston C, Mccracken LM, Jordan A, Sleed M (2007) Development and preliminary psychometric evaluation of the parent report version of the Bath Adolescent Pain Questionnaire (BAPQ-P): a multidimensional parent report instrument to assess the impact of chronic pain on adolescents. Pain 131(1–2):48–56
RW B, (1970) Back-translation for cross-cultural research. J Cross Cult Psychol Res 1(3):185–216
Chinese administrative districtives (2020). Available from: (2020). http://xzqh.org/html/show/cn/2020.html. Accessed 2 Jul 2021
Makhlouf SM, Pini S, Ahmed S, Bennett MI (2020) Managing pain in people with cancer-a systematic review of the attitudes and knowledge of professionals, patients, caregivers and public. J Cancer Educ 35(2):214–240
Yuhan Lu, Ma S, Guo M, Zhang Li, Wen L, Wang X (2004) The relationship of concerns about pain treatment between patients and their primary family caregivers. Modern Nursing 10(10):883–885
Adam R, Bond C, Murchie P (2015) Educational interventions for cancer pain. A systematic review of systematic reviews with nested narrative review of randomized controlled trials. Patient Educ Couns 98(3):269–282
Rau KM, Chen JS, Wu HB, Lin SF, Huang ML, Tai CJ, Hwang WL, Lu YC, Wang CC, Hsieh RK (2017) Cancer-related pain: a nationwide survey of patients’ treatment modification and satisfaction in Taiwan. Jpn J Clin Oncol 47(11):1060–1065
Prabhakar A, Smith TJ (2021) Total Pain #417. J Palliat Med 24(7):1100–1101
Ma XX, Lu YH, Yang H, Yu WH, Hou XT, Guo RX, Wang Y, Zhang YR (2020) Relationships between patient-related attitudinal barriers, analgesic adherence and pain relief in Chinese cancer inpatients. Support. Care Cancer 28(7):3145–3151
Elliott BA, Elliott TE, Murray DM, Braun BL, Johnson KM (1996) Patients and family members: the role of knowledge and attitudes in cancer pain. J Pain Symptom Manag 12(4):209–220
Acknowledgements
And we thank Yushuang He, Tingting Hu, Xuerong Liu, Xiaolei Yu, Fengxia Wang, and Weifeng Li for their help in the implementation of the project.
Funding
This work was supported by the Beijing Municipal Administration of Hospitals Incubating Program, coding PX2017052, and was supported by Yuhan Lu.
Author information
Authors and Affiliations
Contributions
Yuhan Lu, Xiaoxiao Ma, and Wenhua Yu designed the study.
Xiaoxiao Ma, Xin Li, and Dongqin Kang collected the clinical data.
Yuhan Lu, Xiaoxiao Ma, and Hong Yang contributed to the data analysis and data interpretation.
Xiaoxiao Ma wrote the manuscript.
Yuhan Lu approved the last version of the manuscript.
All the authors read and approved the final manuscript.
And we thank Yushuang He, Tingting Hu, Xuerong Liu, Xiaolei Yu, Fengxia Wang, and Weifeng Li for their help in the implementation of the project.
Corresponding author
Ethics declarations
Ethics approval
This study was approved by the Ethics Committee of Peking University Cancer Hospital.
Informed consent
The written informed consent was obtained.
Consent to participate
Research assistants explained the study purpose, procedures, and participants’ role in the study to all prospective participants before they started. Patients and family caregivers were informed that the autonomy to participate or withdraw in this study at any time was respected.
Consent for publication
N/A
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Ma, X., Yu, W., Lu, Y. et al. Pain knowledge of patients and family caregivers as predictors of pain management outcomes in cancer patients: a multicenter study in China. Support Care Cancer 30, 575–584 (2022). https://doi.org/10.1007/s00520-021-06457-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-021-06457-6