Relationships between patient-related attitudinal barriers, analgesic adherence and pain relief in Chinese cancer inpatients
- 14 Downloads
The purpose of this study was to evaluate patient-related attitudinal barriers and identify associated factors in Chinese cancer inpatients receiving opioids and to explore relationships between patient-related attitudinal barriers, analgesic adherence and pain relief.
A cross-sectional study was conducted. A total of 146 participants completed face-to-face surveys, including information about demographics, the Barriers Questionnaire-Chinese (BQ-C), analgesic adherence, average pain and breakthrough pain in the past 24 h. The Mann-Whitney U test and Kruskal-Wallis test were performed to test the differences in the attitudinal barrier scores between the adherence and nonadherence groups, the complete and incomplete pain relief groups and the groups based on demographics.
The majority of participants in this study were men (67.8%), over half of all participants were less than 60 years old, gastrointestinal cancer (47.3%) was the most common diagnosis and 59 (40.4%) acquired comprehensive pain education from the last discharge guidance procedure. The total BQ-C mean (SD) score was 1.61 ± 0.94. A total of 87 (59.6%) patients with cancer pain were completely relieved. Most of the patients (73.3%) completely took analgesics by orders. There was no significant difference in the total BQ-C score between the adherence group and the nonadherence group (P > 0.05), but the difference was significant between the complete pain relief group and the incomplete pain relief group (P < 0.05).
The findings of this study support unsatisfactory pain management and moderate analgesic adherence for Chinese inpatients. It is suggested that patient-related attitudinal barriers do not play an undermining role in pain management by negatively affecting patients’ analgesic adherence. Conversely, patients’ beliefs are more likely to be shaped by under treatment rather than as a cause.
KeywordsCancer pain patient-related barriers attitudes opioids adherence
YHL, XXM, HY and WHY designed the study.
XXM, HY, WHY, XTH, RXG, YW and YRZ collected the clinical data.
YHL and XXM contributed to the data analysis and data interpretation.
XXM wrote the manuscript.
YHL approved the last version of the manuscript.
All the authors read and approved the final manuscript.
This work was supported by Beijing Hospitals Authority (PX2017052).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.National Comprehensive Cancer Network. NCCN Guidelines Version 1.2019 Adult Cancer Pain. Available from: https://www.nccn.org/professionals/physiciangls/default.aspx#age.
- 7.Jung Hye K, Sung Yong O, Gary C, Jung-Ae L, Jae Jin L, Keon Woo P, Seung-Hyun N, Hun Ho S, Keehyun L, Dae Young Z (2013) Predictors of high score patient-reported barriers to controlling cancer pain: a preliminary report. Support Care Cancer 21(4):1175–1183. https://doi.org/10.1007/s00520-012-1646-x CrossRefGoogle Scholar
- 9.Shu-Yuan L, Kang-Pan C, Shiow-Luan T, Shu-Fang W, Yeu-Hui C, Tsae-Jyy W, Heng-Hsin T, Su-Fen C (2013) Relationship between belief about analgesics, analgesic adherence and pain experience in Taiwanese cancer outpatients. Asian Pac J Cancer Prevent Apjcp 14(2):713–716. https://doi.org/10.7314/APJCP.2013.14.2.713 CrossRefGoogle Scholar
- 10.Yeur-Hur L, Keefe FJ, Wei-Zen S, Lee-Yuan T, Ping-Ling C, Jeng-Fong C, Ling-Ling W (2002) Relationship between pain-specific beliefs and adherence to analgesic regimens in Taiwanese cancer patients: a preliminary study. J Pain Symptom Manag 24(4):415–423. https://doi.org/10.1016/S0885-3924(02)00509-2 CrossRefGoogle Scholar
- 13.Zeng D, Li K, Lin X, Mizuno M (2019) Attitudinal barriers to pain management and associated factors among cancer patients in mainland China: implications for cancer education. J Cancer Educ. https://doi.org/10.1007/s13187-018-1463-0
- 16.Du Pen SL, Du Pen AR, Polissar N, Hansberry J, Kraybill BM, Stillman M, Panke J, Everly R, Syrjala K (1999) Implementing guidelines for cancer pain management: results of a randomized controlled clinical trial. J Clin Oncol 17(1):361–370. https://doi.org/10.1200/jco.19126.96.36.1991 CrossRefPubMedGoogle Scholar
- 21.Ree D, Sellers DE, Spross JA, Jablonski ES, Hoyer DR, Solomon MZ (2005) Do patients' beliefs act as barriers to effective pain management behaviors and outcomes in patients with cancer-related or noncancer-related pain? Oncol Nurs Forum 32(2):363–374. https://doi.org/10.1188/05.ONF.363-374 CrossRefGoogle Scholar
- 23.Huang Y (2014) Clinical Epidemiology. Chaoyang, BeijingGoogle Scholar
- 24.Lu Y, Guan S, Ma S (2006) Effect evaluation behavior of attitude toward pain treatment for patients with cancer by health education. J Nurs Train 21(8):685–687Google Scholar
- 25.Yuhan L, Fan C, Yuhan L (2017) Cancer pain nursing. In: Palliative nursing: a practical guide for oncology nurses. Haidian, Beijing, p 41. https://doi.org/10.3969/j.issn.1002-6975.2006.08.006 CrossRefGoogle Scholar
- 26.Pain Treatment Quality Control and Improvement Center Cancer Pain Expert Group (2017) Cancer pain management standard in Beijing. Chin J Pain Med 23(12):881–889. https://doi.org/10.3969/j.issn.1006-9852.2017.12.001 CrossRefGoogle Scholar
- 27.Lou F, Shang S (2017) Attitudes towards pain management in hospitalized cancer patients and their influencing factors. Chin J Cancer Res 29(1):75–85. https://doi.org/10.21147/j.issn.1000-9604.2017.01.09 CrossRefPubMedPubMedCentralGoogle Scholar
- 28.Lu Y, Ma S (2005) The survey of cancer patients’ concerns about pain treatment. J Nurs Train 20(10):882–884Google Scholar
- 29.Chen L, Miaskowski C, Dodd M, Pantilat S (2008) Concepts within the Chinese culture that influence the cancer pain experience. Cancer Nurs 31(2):103–108. https://doi.org/10.1097/01.ncc.0000305702.07035.4d CrossRefPubMedGoogle Scholar
- 31.Huang Z, Zheng Y, Peng P, Xu D, Wang J (2009) Investigation into characteristics and treatment of cancer pain in Shanghai: a questionnaire survey in 2007. Cancer 29(12):992–996. https://doi.org/10.3781/j.issn.1000-7431.2009.10.016 CrossRefGoogle Scholar
- 32.Pang Y, Tang L, Song L (2013) A survey on malignant tumor pain patients and their family members. Chin J Pain Med 19(6):350–353. https://doi.org/10.3969/j.issn.1006-9852.2013.06.007 CrossRefGoogle Scholar
- 33.Cleary J, Radbruch L, Torode J, Cherny NI (2013) Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in Asia: a report from the Global Opioid Policy Initiative (GOPI). Ann Oncol 24(Supplement 11):24–32. https://doi.org/10.1093/annonc/mdt499 CrossRefGoogle Scholar
- 35.Meghani SH, Thompson AML, Chittams J, Bruner DW, Riegel B (2015) Adherence to analgesics for cancer pain: a comparative study of African Americans and Whites using an electronic monitoring device. J Pain 16(9):825–835. https://doi.org/10.1016/j.jpain.2015.05.009 CrossRefPubMedPubMedCentralGoogle Scholar