Knowledge, Practices, and Perceived Barriers in Cancer Pain Management at Oncology Units: A Cross-Sectional Survey of Medical Staff in China

Abstract

Background Despite the great signs of progress in cancer pain management in China, the associated pain remains under-treated. Poor knowledge among the medical staff is an important factor contributing to the under-treatment of cancer pain. This study aimed to evaluate the knowledge, practices, and perceived barriers in cancer pain management among the medical staff at oncology units in China. Patients and Methods A cross-sectional survey was conducted with the medical staff (including physicians, nurses, and pharmacists) at oncology units in tertiary hospitals of China between December 2020 and January 2021. The questionnaire assessed the knowledge, practices, and perceived barriers in cancer pain management. Results A total of 1262 medical staff responded to the questionnaire; the response rate was 94.2%. Most participants had good knowledge of the three-step analgesic ladder of the World Health Organization (WHO) and the National Comprehensive Cancer Network (NCCN) guidelines for Adult Cancer Pain . Knowledge deficit was prominent in questions on opioid dose titration and rotation and adverse effects of opioids; the correct response rate was less than 40%. Training, work experience in oncology, and education level were significantly related to knowledge of cancer pain management (all P < 0.001). In clinical practice for cancer pain management, approximately 57.2% of medical staff were unfamiliar with opioid dose titration and rotation; only 14.4% treated cancer pain through multidisciplinary collaboration. Poor medication compliance, difficult individualized analgesia protocols, and insufficient multidisciplinary participation were the most frequently perceived barriers by the medical staff for pain management. Conclusion These findings suggested a further need for integrating recent guidelines to strengthen continued training (especially among juniors and those with low education levels) and patient education to improve the knowledge and clinical practices of cancer pain management among the medical staff in China. Multi-disciplinary management is required for the effective treatment of cancer pain.

Healthcare Professional Knowledge on Pain Definition and Management, Pre-test and Post-test Results of Short Courses

“…However, the level of awareness among healthcare workers was very high. Furthermore, respondents who had undergone training reported having more knowledge than those who hadn't (12). Our study showed that our participants had a higher awareness of the WHO analgesic ladder after the course (60.4% vs. 29.3%).…”

Nurses’ Knowledge, Perceived Barriers and Practices Regarding Cancer Pain Management: A Scoping Review

“…(2022) reported that approximately 85% of respondents claimed to have a comprehensive understanding of the three-step painkiller ladder recommended by the World Health Organization for cancer pain management. [ 11 ] In a separate study, Li et al . (2021) observed an average knowledge score of 21.56 among nurses, which surpassed the passing level.…”

“…(2022) found that over half of the medical staff were knowledgeable about guidelines for the treatment of cancer pain, and they reported conducting daily assessments of pain in cancer patients. [ 11 ]…”

“…[ 6 ] In addition, the lack of a multidisciplinary approach and individualised analgesia protocols further contribute to the barriers faced in pain management. [ 11 ]…”

“…[ 6 ] In addition, nurses’ understanding of cancer pain management was influenced by variables such as level of education, practice area, years of experience in oncology, profession and job title (Yu et al ., 2022). [ 11 ]…”