Investigation of Specifics of Self-Management towards Dealing with Cancer Pain among Adult Outpatients

Abstract

Purpose: This study aimed to identify specifics of self-management towards dealing with cancer pains among adult outpatients. Methods: Semi-structured interviews were conducted with 16 adult outpatients (9 males and 7 females) who suffered from cancer pain and the data obtained were analyzed using the qualitative synthesis method of KJ Ho. Results: An analysis of the results revealed these key findings for the following symbolic wording of the semi-structured interviews: Cooperative relationship with medical professionals; Problems originating from cancer pain; Self-regulation of analgesic medications based on the interactions with medical professionals; Self-regulation of the analgesic medications based on the physical perceptions of the effects; Self-regulation to maintain a balanced and calm mind, Fulfilling life by the pain alleviation and liberation from the restrictions imposed by the cancer; and Efforts to maintain their lives by themselves. Conclusion: Based on the cooperative relationship established with medical professionals, the patient carried out the self-regulation of cancer pain using analgesics, and self-regulation to maintain a balanced and calm mind. Nurses must therefore sufficiently educate patients regarding how to communicate successfully with medical professionals in order to improve cancer patients' pain management regarding both physical and mental aspects.

Evaluation of Appropriateness of A Nursing Intervention Program to Promote Pain Self-Management for Adult Outpatients with Cancer Pain

“…The reasons for the positive evaluation of the program may be because the components of the program, patient goals, and details of the interventions were extracted based on the conceptual analysis of self-management toward dealing with cancer pain;[ 5 ] and including the results of an empirical qualitative study of adult outpatients with cancer pain;[ 2 ] and because the methods of the interventions of the CPSM program were determined based on the results of a literature review of educational interventions. A further reason for the high score in the appropriateness and clinical applicability of the program would be that the program was modified by obtaining opinions based on the practical experience of pharmacists and oncology nurses.…”

“…Furthermore, it has been reported that outpatients reduce the doses of opioid analgesics due to worries about their tolerance and poisoning, and some patients suffer from drowsiness and constipation. [ 2 ] Considering these situations of outpatients in Japan, the use of the CPSM program would be clinically significant as it makes it easier for nurses to identify patients for intervention and to provide interventions that promote self-management of outpatients with cancer pain.…”

“…Yamanaka reported that self-management of cancer pain involves several factors, including the formation of a partnership with health-care professionals, ability to cope with physical and mental aspects depending on the patient social activities, and self-efficacy. [ 2 ] For this reason, it is difficult for health-care professionals alone to develop the independent attitude of patients with cancer pain toward self-management simply by providing advice and guidance on pain relief methods for patients with cancer pain. To resolve this, nurses are required to acquire advanced nursing skills, to intervene using these skills to promote cancer pain self-management (CPSM), as well as to have a basic knowledge and skills in cancer pain and pain treatment.…”

“…The conceptual framework of this study was developed based on the results of a conceptual analysis of self-management in dealing with cancer pain[ 5 ] and the results of a qualitative empirical study of 16 Japanese adult outpatients with cancer pain [ Figure 1 ]. [ 2 ] Adult patients with cancer pain are exposed to cancer pain-related problems, including experiencing obstacles in day-to-day life and social activities, as well as declines in motivation, due to the cancer pain, and difficulties in day-to-day life due to opioid-induced side effects. To cope with these issues based on a partnership with health-care professionals, patients become aware of cancer pain-related problems and make efforts to maintain their lives by themselves by self-regulation of analgesic medications based on self-monitoring of the pain, interaction with the health-care professionals, their own physical perceptions, and self-regulation of mental changes affected by the pain.…”

“…The components, patient goals, and details and methods of interventions of the CPSM program were determined based on the results of a literature review of educational interventions for patients with cancer pain,[ 6 ] the conceptual analysis of self-management toward dealing with cancer pain,[ 5 ] and a semi-structured interview survey with adult outpatients. [ 2 ]…”