Improvement of pain-related self-management for cancer patients through a modular transitional nursing intervention: A cluster-randomized multicenter trial

Abstract

Patients' self-management skills are affected by their knowledge, activities, and attitudes toward pain management. This trial aimed to test the Self Care Improvement through Oncology Nursing (SCION)-PAIN program, a multimodular structured intervention to reduce patients' barriers to self-management of cancer pain. Two hundred sixty-three patients with diagnosed malignancy, pain>3 days, and average pain > or = 3/10 participated in a cluster-randomized trial on 18 wards in 2 German university hospitals. Patients on the intervention wards received, in addition to standard pain treatment, the SCION-PAIN program consisting of 3 modules: pharmacologic, nonpharmacologic pain management, and discharge management. The intervention was conducted by specially trained cancer nurses and included components of patient education, skills training, and counseling. Starting with admission, patients received booster sessions every third day and one follow-up telephone counseling session within 2 to 3 days after discharge. Patients in the control group received standard care. Primary end point was the group difference in patient-related barriers to self-management of cancer pain (Barriers Questionnaire-BQ II) 7 days after discharge. The SCION-PAIN program resulted in a significant reduction of patient-related barriers to pain management 1 week after discharge from the hospital: mean difference on BQ II was -0.49 points (95% confidence interval -0.87 points to -0.12 points; P=0.02). Furthermore, patients showed improved adherence to pain medication; odds ratio 8.58 (95% confidence interval 1.66-44.40; P=0.02). A post hoc analysis indicated reduced average and worst pain intensity as well as improved quality of life. This trial reveals the positive impact of a nursing intervention to improve patients' self-management of cancer pain.

A systematic review of the effectiveness of patient-based educational interventions to improve cancer-related pain

“…The study population varied from 30 to 1256 patients at baseline. Twelve studies were conducted in the USA [18,[23][24][25][26][27][28][29][30][31][32][33], eight in Europe [20,21,[34][35][36][37][38][39], three in Asia [40][41][42], two in Australia [43,44] and one in Canada [45].…”

Impact of Pain and Evaluation of Education and Self-Care in Patients with Head and Neck Cancer

“…Earlier intervention studies on patients with cancer support our findings that SC had no significant impact on cancer pain [104,105,211] while other studies have shown that SC does reduce pain [212,213]. It is possible that hetero/homogeneity (participants and interventions) in the studies referred to above may have contributed to the different conclusions.…”

Interdisciplinary care programme to improve self-management for cancer patients undergoing stem cell transplantation: a prospective non-randomised intervention study

“…The previously developed S elf C are I ntervention in O ncology N ursing (Jahn et al . , , ) was adapted for patients undergoing H ematopoietic S tem C ell T ransplantation, (SCION‐HSCT) by the authors in cooperation with nurses of the University Hospital Halle Saale as conceptual framework for this study.…”