Physicians’ knowledge, perceived barriers, and practices regarding cancer pain management: a cross-sectional study from Palestine

Abstract

Background: Pain continues to be a prevalent yet undertreated problem among cancer patients. Achieving adequate control of cancer pain is influenced by physicians' knowledge and practices, which have been found to be inadequate by many studies. In this study, we aimed to examine knowledge and practices, as well as perceived barriers relating to the management of cancer pain among Palestinian physicians. Methods: This cross-sectional study took place at eight hospitals in the northern West Bank in Palestine. A questionnaire was developed and distributed to physicians who were responsible for the care of cancer patients. The questionnaire assessed knowledge, perceived barriers, assessment practices, pain documentation, and delaying processes relating to cancer pain management (CPM). Results: In total, we analysed 109 questionnaires. The mean age of the participants was 32.3 ± 7.0 years and 73.4% had less than 10 years of professional experience. After analysing the data, we found physicians' knowledge to be inadequate, with a mean knowledge score of 6.2 ± 1.9 out of 14. The barriers that were perceived by the highest percentages of physicians to affect CPM were inadequate pain assessment (89%), insufficient experience (79.8%), and insufficient knowledge (76.1%), all of which are staff-related. However, 65% reported assessing pain on every round and 70% asked about all items related to the nature of pain. Finally, obtaining opioids from the pharmacy was the most recognized delaying step in CPM. Conclusions: Despite reporting good practices, physicians showed substantial knowledge deficits regarding CPM. Besides, many barriers appear to impede effective CPM. Therefore, appropriate educational programmes and policy changes are recommended in order to improve professional performance as well as patient care.

Healthcare Providers’ Perceptions of the Cancer Pain Management Barriers at a Hospital in Zambia: A Qualitative Study

“…Based on the study's objective to explore and describe healthcare providers’ perceptions of the cancer pain management barriers at a hospital in Zambia, three themes emerged: patient-related barriers, healthcare provider-related barriers and institution-related barriers. The study's results reflect the multidimensional nature of barriers to cancer pain management, and these were also found in similar studies in a variety of other settings ( Ahmedzai et al, 2019 ; Goucke & Chaudakshetrin, 2018 ; Samara et al, 2018 ; Toba et al, 2019 ).…”

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“…The sample size was calculated to be 160 participants. This was increased to 176 participants to compensate for nonrespondents, where the average nonresponse rate was reported as 10% in a recent Palestinian study 19 . The sampling was done proportionally according to their respective populations (nurses and physicians') in each hospital.…”

The Symptom Burden and Quality of Life in Cancer Patients in the Gaza Strip, Palestine: A Cross-Sectional Study

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“…effective management [39]. Pain and its prevalence highlight the need for system-wide responses to improving the management of symptoms for patients with cancer, including both health professional and patient educational programmes such as public awareness of cancer signs/symptoms [40] and reducing misbeliefs about pain medications.…”