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Predictors of high score patient-reported barriers to controlling cancer pain: a preliminary report

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Abstract

Purpose

Pain is one of the most common and devastating symptoms in cancer patients, and misunderstandings on the patient’s part can cause major obstacles in pain management.

Method

We evaluated factors associated with patient’s high barrier score to managing cancer-associated pain by having 201 patients complete the Korean Barriers Questionnaire II, the Brief Pain Inventory—Korean, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and the Korean Beck Depression Inventory. The Pain Management Index (PMI) was also assessed.

Results

The patients were from nine oncology clinics in university hospitals and a veterans’ hospital in South Korea. The median pain score (0–10 scale) was 4, with a median percentage of pain improvement during the last 24 h of 70 %. A total of 150 patients (75 %) received strong opioids, and 177 (88 %) achieved adequate analgesia (positive PMI). Mean scores ± SD for the Barriers Questionnaire II ranged from 1.5 ± 1 to 2.8 ± 1.1, with the harmful effects subscale the highest. In the multiple regression model, depression was significantly associated with total barrier score to pain management (p < 0.0001). Pain reduction was significantly associated with the fatalism subscale.

Conclusions

Depression was associated with high barrier score in patients with cancer pain. Management of cancer pain should include screening for depression, and management of depression could reduce patient-reported barriers to pain management.

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Acknowledgments

We would like to express our appreciation to Dr. S. Gunnarsdottir for allowing us to translate the Barriers Questionnaire II into Korean and for assisting in the process of translation and back-translation.

Conflict of interest

Eduardo Bruera is supported in part by National Institutes of Health grant numbers RO1NRO10162-01A1, RO1CA122292-01, and RO1CA124481-01 and in part by the MD Anderson Cancer Center support grant # CA016672.

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Authors and Affiliations

  1. Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea

    Jung Hye Kwon, Hun Ho Song, Dae Young Zang, Ho Young Kim, Dae Ro Choi, Hyo Jung Kim, Jung Han Kim, Joo Young Jung, Geundoo Jang, Hyeong Su Kim & Ji Yun Won

  2. Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA

    Jung Hye Kwon & Eduardo Bruera

  3. Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea

    Sung Yong Oh

  4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Gary Chisholm

  5. Department of Internal Medicine, Eulji University Hospital, Daejeon, Republic of Korea

    Jung-Ae Lee

  6. Department of Medical Oncology and Hematology, Kyung Hee University School of Medicine, Seoul, Republic of Korea

    Jae Jin Lee

  7. Department of Hematology–Oncology, Dankook University School of Medicine, Cheonan, Republic of Korea

    Keon Woo Park

  8. Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea

    Seung-Hyun Nam

  9. Department of Internal Medicine, St. Mary’s Hospital, College of Medicine, Catholic University, Seoul, Republic of Korea

    Keehyun Lee

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  1. Jung Hye Kwon
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  2. Sung Yong Oh
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  14. Jung Han Kim
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  17. Hyeong Su Kim
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  18. Ji Yun Won
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  19. Eduardo Bruera
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Corresponding author

Correspondence to Eduardo Bruera.

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Kwon, J.H., Oh, S.Y., Chisholm, G. et al. Predictors of high score patient-reported barriers to controlling cancer pain: a preliminary report. Support Care Cancer 21, 1175–1183 (2013). https://doi.org/10.1007/s00520-012-1646-x

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  • DOI: https://doi.org/10.1007/s00520-012-1646-x

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