Randomized clinical trial of an intensive nursing-based pain education program for cancer outpatients suffering from pain.
BACKGROUND
The prevalence of pain in patients with cancer is still too high. Factors relating to ineffective pain treatment fall into three categories: the health care system, professional care providers, and patients. In patients, various barriers lead to noncompliance. Previous educational interventions have increased their knowledge of pain and decreased short-term pain levels. In this randomized controlled trial, the authors investigated how an intensive home-based education program given by nurses affected short-term and long-term pain levels.


METHODS
One hundred and twenty cancer patients were randomized to receive either the pain education program (PEP) or usual care. Pain, knowledge, quality of life, anxiety, and depression were measured at baseline and after 4 and 8 weeks. In the intervention group, effects on symptom levels were communicated to the treating physician.


RESULTS
The level of pain had decreased at 4 weeks, but not at 8 weeks. Significant decreases in pain only persisted in those patients with a high pain score at baseline. Knowledge of pain significantly increased in the intervention group. No correlation was found between increased pain knowledge and decreased pain levels.


CONCLUSIONS
The PEP given by nurses lowered pain intensity levels in cancer patients and increased their knowledge of pain. More attention should be paid to patient education and to communication between patients and health professionals regarding pain and pain management.
van der Peet
Evelien H
EH
Comprehensive Cancer Center Limburg, Maastricht, The Netherlands.
van den Beuken-van Everdingen
Marieke H J
MH
Patijn
Jacob
J
Schouten
Harry C
HC
van Kleef
Maarten
M
Courtens
Annemie M
AM
D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D003142:Communication; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D024802:Nurse's Role; D010045:Outpatients / Q000523:psychology; D010146:Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D011369:Professional-Patient Relations; D011788:Quality of Life; D013997:Time Factors