The Current Situation of Barriers to Pain Self-Management Among Cancer Patients Treated at the Oncology – Nuclear Medicine Center, Vinh Phuc General Hospital
Main Article Content
Abstract
Objective: To describe the current situation of barriers to pain self-management among cancer patients treated at the Oncology – Nuclear Medicine Center, Vinh Phuc General Hospital.
Materials and methods: A cross-sectional study was conducted on 116 cancer patients from January to June 2023. Data were collected using BQ-II, PSEQ, MMAS-8, PHQ-2, ECOG/WHO PS, and BPI-sfvn. SPSS 22.0 was applied for data analysis.
Results: The mean score of cognitive barriers was 2.22 ± 0.48 (moderate level), with the greatest concerns being drug tolerance (3.30 ± 0.97) and immune suppression (2.89 ± 1.26). Pain self-efficacy was low (24.97 ± 10.91/60). The mean medication adherence score was 7.29 ± 1.91/11, with 50% showing high adherence and 25% low adherence. About 35.3% of patients had suspected major depressive disorder, 43.1% had poor performance status, and the average pain level was moderate (3.64 ± 1.50), with the worst pain remaining high (5.14 ± 1.66).
Conclusions: Cancer patients still face multiple barriers to pain self-management, including concerns about analgesics, low self-efficacy, uneven adherence, depression, and poor performance status. Nurses play a crucial role in patient education, psychological support, and monitoring treatment adherence, in conjunction with multidisciplinary care, to enhance pain control and improve quality of life.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. International Agency for Research on Cancer (IARC). Global Cancer Observatory: Cancer Today. Lyon: IARC; 2020.
II. Vietnam Ministry of Health. Vietnam Cancer Statistics 2020. Hanoi: Ministry of Health; 2020.
III. Van den Beuken-van Everdingen, MHJ, de Rijke, JM, Kessels, AGH, 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):1437–1449.
IV. Breivik, H, Cherny, N, Collett, B, de Conno, F, Filbet, M, Foubert, N, et al (2009). Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol, 20(8):1420–1433.
V. World Health Organization (WHO). Cancer Pain Relief: A Guide to Opioid Availability. 2nd ed. Geneva: WHO; 1996.
VI. Caraceni ,A, Hanks, G, Kaasa, S, et al (2012). Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol, 13:e58–e68.
VII. Miaskowski, C, Penko, J, Herbst, L, et al (2004). Patient-related barriers to pain management in patients with cancer. Pain, 107:127–134.
VIII. De Wit, R, van Dam, F, Abu-Saad, H, et al (1997). Self-efficacy and pain management in patients with cancer. Eur J Pain,1:137–144.
IX. Nguyen, TT, Pham, TT, Tran, BX, et al (2019). Pain management in Vietnamese cancer patients: current status and challenges. J Pain Res, 12:2881–2890.
X. National Comprehensive Cancer Network (NCCN). Guidelines for Patients: Distress Management. Fort Washington: NCCN; 2020.
XI. Stearns, LJ, Boehmer, JP, Nicolaou, R, et al (2003). Adherence to opioid therapy for cancer pain: Patient perspectives. J Pain Symptom Manage, 25:140–147.
XII. Cleeland, CS, Gonin, R, Hatfield, AK, et al (1994). Pain and its treatment in outpatients with metastatic cancer. N Engl J Med, 330:592–596.
XIII. Ward, SE, Goldberg, N, Miller-McCauley, V, Mueller, C, Nolan, A, Pawlik-Plank, D, Robbins, A, Stormoen, D, Weissman, DE (1993). Patient-related barriers to management of cancer pain. Pain, 52(3):319–324.
XIV. Oldenmenger, WH, Sillevis Smitt, PA, van Dooren, S, Stoter, G, van der Rijt, CC (2009). A systematic review of barriers adequate cancer pain management and interventions to reduce them: a critical appraisal. European Journal of Cancer, 45(8):1370–1380.
XV. Nguyen, HTT, Tran , NTH, Pham NV (2020). Awareness and barriers to the use of analgesic medications among patients with cancer. Vietnam Journal of Medicine, 498(2):115–123.
XVI. Nicholas MK. The Pain Self-Efficacy Questionnaire (1989): Taking pain into account. European Journal of Pain, 13(2):153–163.
XVII. Ferreira-Valente , MA, Pais-Ribeiro, JL, Jensen, MP (2011). Associations between psychosocial factors and pain self-efficacy: a systematic review. Clinical Journal of Pain, 27(11):927–938.
XVIII. Nguyen TV (2021) . Pain self-management efficacy among cancer patients and associated factors. Vietnam Journal of Medicine, 502(1):145–152.
XIX. Morisky, DE, Ang ,A, Krousel-Wood, M, Ward, HJ (2018). Predictive validity of a medication adherence measure in an outpatient setting. Journal of Clinical Hypertension, 10(5):348–354.
XX. Wang, XM, Zhou, Q, Yang, XY, et al (2018). Opioid adherence and persistence in patients with cancer in China: a cross-sectional study. Support Care Cancer, 26(6):1965–1972.
XXI. Mitchell, AJ, Chan, M, Bhatti, et al (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncology. 2011;12(2):160–174.
XXII. Buccheri, G, Ferrign, D, Tamburini, M (1996). Karnofsky and ECOG performance status scoring in lung cancer: A prospective, longitudinal study of 536 patients from a single institution. European Journal of Cancer, 32A(7):1135–1141.
XXIII. Nguyen MT (2020). The current status of pain severity among cancer patients and associated factors. Vietnam Journal of Medicine. 2020;495(3):115–121.