title: Mediating Effect of Family Caregivers' Hesitancy to Use Analgesics on Homecare Cancer Patients' Analgesic Adherence.
abstract: BACKGROUND
  Family caregivers play an increasingly critical role in cancer patients' symptom management as the number of cancer patients receiving home care grows. However, there is a lack of research measuring the impact of the family caregivers' hesitancy to use analgesics on analgesic adherence and the resulting influence on patient pain intensity.
  
  
  OBJECTIVE
  To examine whether family caregivers' hesitancy to use analgesics is a mediator that influences patient adherence and investigate how analgesic regimen adherence affects pain intensity.
  
  
  METHODS
  This study used a cross-sectional and descriptive design. One hundred seventy-six patient-family caregiver dyads (N = 352) were recruited from one local hospital in southern Taiwan. Instruments included the Short Version of the Barriers Questionnaire-Taiwan, the Morisky Medication Adherence Measure-Taiwan, the Brief Pain Inventory-Chinese, and demographic and illness questionnaires. A one-way analysis of variance and post hoc comparisons were performed to assess the influence of analgesic regimen adherence on pain intensity. Sobel tests were used to examine mediating effects.
  
  
  RESULTS
  Family caregivers' hesitancy to use analgesics was a significant mediator between patient barriers to use analgesics and patient analgesic regimen adherence (P < 0.0001). Patients with low and moderate adherence levels reported significantly higher levels of pain severity (F = 3.83, P < 0.05).
  
  
  CONCLUSIONS
  This study showed that family caregivers' hesitancy to use analgesics was a significant mediator associated with their hesitancy to use analgesics and the patients' analgesic adherence. It is important for health care providers to consider family caregivers' hesitancy to use analgesics when attempting to improve adherence to pain management regimens in clinical practice.
authors: Department of Nursing, Chang Gung University of Science and Technology, Chia-Yi Campus, Taiwan, Republic of China.
authors: Bih-O
authors: BO
authors: Lee
authors: School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China.
authors: Yi
authors: Y
authors: Liu
authors: Research Center for Nonlinear Analysis & Optimization, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China.
authors: Yi-Hsien
authors: YH
authors: Wang
authors: School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China.
authors: Hsin-Tien
authors: HT
authors: Hsu
authors: Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan, Republic of China.
authors: Chien-Liang
authors: CL
authors: Chen
authors: School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China. Electronic address: piling.chou@gmail.com.
authors: Pi-Ling
authors: PL
authors: Chou
authors: Institute of Human Resource Management, National Sun Yat-sen University, Kaohsiung, Taiwan, Republic of China.
authors: Wen-Chung
authors: WC
authors: Hsu
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006701:Home Nursing / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D059408:Pain Management / Q000523:psychology / Q000706:statistics & numerical data; D010147:Pain Measurement; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000700:Analgesics
keywords: Cancer pain; analgesics adherence; family caregivers; hesitancy to use analgesics; pain management