title: Pain and its treatment in hospitalized patients with metastatic cancer.
abstract: OBJECTIVE
  The aim of this prospective study was to assess the quality of pain management hospitalized cancer patients.
  
  
  METHODS
  In a quantitative and qualitative evaluation from six oncology centers in Italy, all consecutive cancer patients complaining of pain and hospitalized during the same 2 weeks were requested to fill in a McGill pain questionnaire (MPQ), a present pain intensity scale (PPI), and a hospital anxiety and depression acale (HADS), and to answer a questionnaire focused (QF) on the quality of medical and nursing care. The healthcare provider's antalgic prescriptions were assessed by an index of pain management (IPM).
  
  
  RESULTS
  Of 120 patients with pain admitted to oncology divisions (65 men and 52 women; mean age 57 years, range 21-79 years), 117 completed the questionnaires. The quantitative evaluation (PPI) showed a significant pain reduction between admission and discharge pain levels-from 2.65 to 1.50 ( p<0.001). While a significant reduction of anxiety (HADS) was also found-from 10.24 to 9.11 ( p<0.001)-depression did not improve (9.83 and 9.72). The most relevant information from qualitative evaluation (QF) was: in 37.6% of patients, pain level was higher overnight; 47% waited for spontaneous decrease of pain intensity before asking for nurse or physician intervention; 69% asked for nurse help when pain level was really high. The health care response to patients' pain was not completely satisfactory, since analgesic prescription was adequate in 56.52% but inadequate in 43.47%.
  
  
  CONCLUSIONS
  Pain control in hospitalized cancer patients is not completely satisfactory. The physician's attitude is to underestimate and undertreat pain, while nurses are not adequately trained for timely intervention despite published guidelines for pain management. The findings of this study support the concern of inadequate knowledge and inappropriate attitudes regarding pain management, even in cancer patients hospitalized in medical oncology divisions.
authors.affiliation: Medical Oncology, University Hospital of Parma, Parma, Italy. cascinu@yahoo.com
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
authors.forename: Paolo
authors.initials: P
authors.lastname: Giordani
authors.forename: Romina
authors.initials: R
authors.lastname: Agostinelli
authors.forename: Giampietro
authors.initials: G
authors.lastname: Gasparini
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
authors.forename: Giordano D
authors.initials: GD
authors.lastname: Beretta
authors.forename: Franca
authors.initials: F
authors.lastname: Pulita
authors.forename: Laura
authors.initials: L
authors.lastname: Iacorossi
authors.forename: Domenico
authors.initials: D
authors.lastname: Gattuso
authors.forename: Marzia
authors.initials: M
authors.lastname: Mare
authors.forename: Stefania
authors.initials: S
authors.lastname: Munaò
authors.forename: Roberto
authors.initials: R
authors.lastname: Labianca
authors.forename: Renata
authors.initials: R
authors.lastname: Todeschini
authors.forename: Roberta
authors.initials: R
authors.lastname: Camisa
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cellerino
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Catalano
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007297:Inpatients; D007558:Italy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000209:etiology / Q000451:nursing*; D059408:Pain Management; D010147:Pain Measurement; D011446:Prospective Studies; D011795:Surveys and Questionnaires