Oncologists' perceptions of cancer pain management in Spain: the real and the ideal.
OBJECTIVE
Studies in some countries suggest that cancer pain is often not adequately controlled, but little is known about the situation in Spain. The objective of this study was to identify medical oncologists' perceptions about pain management in their patients.


METHODS
Two-round Delphi survey of 24 medical oncologists from 22 large, geographically diverse hospitals in Spain. Physicians rated each of 150 statements on a Likert scale (1=strongly disagree; 5=strongly agree). The mean, standard deviation and frequency of replies in three agreement categories were calculated for each item. Statements allowing comparison of oncologists' perceptions of how pain is managed in routine clinical practice with how it should be managed were grouped together and analyzed.


RESULTS
The most notable discrepancies between the real and the ideal occurred in the failure to provide written information or to confirm that patients understand what they are told, the lack of comprehensive and systematic evaluation of pain, and the lack of use of non-pharmacological treatments (NPTs) for cancer pain.


CONCLUSIONS
Medical oncologists need to improve their communication skills, providing patients with both written and verbal information about their disease and the plan for pain management. Pain should be evaluated at each patient visit using validated scales, and greater attention should be paid to the possible use of NPTs.
Carulla Torrent
Joan
J
Medical Oncology Service, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.
Jara Sánchez
Carlos
C
Sanz Ortiz
Jaime
J
Batista López
Norberto
N
Camps Herrero
Carlos
C
Cassinello Espinosa
Javier
J
Lizón Giner
José
J
Montalar Salcedo
Joaqui N
JN
Fitch Warner
Kathryn
K
Gobbo Montoya
Milena
M
Díaz-Rubio García
Eduardo
E
D000328:Adult; D000700:Analgesics / Q000592:standards / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002985:Clinical Protocols / Q000592:standards; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006801:Humans; D008495:Medical Oncology / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010148:Intractable Pain / Q000209:etiology / Q000628:therapy*; D010353:Patient Education as Topic / Q000592:standards / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D013030:Spain; D011795:Surveys and Questionnaires
D000700:Analgesics