Randomized Clinical Trial to Evaluate a Cancer Pain Self-Management Intervention for Outpatients

Cancer pain self-management interventions in adults: scoping review

BACKGROUND

The predominant trend in cancer treatment now leans towards outpatient care, placing the responsibility of pain management largely on the patients themselves. Moreover, a significant portion of treatment for advanced cancer occurs in the home environment, so patient self-management becomes increasingly crucial for the effective treatment of cancer pain.

OBJECTIVES

To map self-management for pain in patients with cancer at all phases of the disease before examining the potential of pain self-care interventions for ill patients with cancer.

METHODS

A search was conducted on six electronic databases to locate studies published in English, from 2013 to 2023. We followed Arskey and O'Malley's Scoping Reviews guidelines.

RESULTS

This study thoroughly examined the provision of cancer pain self-management by healthcare professionals and identified four intervention types from 23 studies. Education emerged as the most prevalent form of self-management for cancer pain.

CONCLUSION

Guiding patients in managing their pain effectively, starting from their hospitalisation and extending to their discharge.

Exploring the Potential of Electronic Patient-Reported Outcome Measures to Inform and Assess Care in Sarcoma Centers: A Longitudinal Multicenter Pilot Study

BACKGROUND

Electronic patient-reported outcome measures (ePROMs) are useful tools to assess care needs of patients diagnosed with cancer and to monitor their symptoms along the illness trajectory. Studies regarding the application of ePROMs by advanced practice nurses (APNs) specialized in sarcoma care and the use of such electronic measures for care planning and assessing quality of care are lacking.

OBJECTIVE

To explore the potential of ePROMs in clinical practice for assessing the patient's quality of life, physical functionality, needs, and fear of progression, as well as distress and the quality of care in sarcoma centers.

METHODS

A multicenter longitudinal pilot study design was chosen. Three sarcoma centers with and without APN service located in Switzerland were included. The instruments EQ-5D-5L, Pearman Mayo Survey of Needs, the National Comprehensive Cancer Network Distress Thermometer, PA-F12, and Toronto Extremity Salvage Score were used as ePROMs. Data were analyzed descriptively.

RESULTS

Overall, 55 patients participated in the pilot study; 33 (60%) received an intervention by an APN, and 22 (40%) did not. Patients in sarcoma centers with APN service reported overall higher scores in quality of life and functional outcome. The number of needs and distress level were lower in sarcoma centers with APN service. No differences were found with respect to patients' fear of progression.

CONCLUSIONS

Most of the ePROMs proved to be reasonable in clinical practice. PA-F12 has shown low clinical relevance.

IMPLICATIONS FOR PRACTICE

Using ePROMs appears to be reasonable to obtain clinically relevant patient information and to evaluate the quality of care in sarcoma centers.

Experiences of cancer survivors with chemotherapy-induced peripheral neuropathy in the Netherlands: symptoms, daily limitations, involvement of healthcare professionals, and social support

PURPOSE

A significant proportion of cancer patients suffer from chemotherapy-induced peripheral neuropathy (CIPN). This descriptive study aimed to examine patients' experience of CIPN symptoms, daily limitations, involvement of healthcare professionals, and social support.

METHODS

Cross-sectional data have been collected in the Netherlands via a national online questionnaire comprising closed items only (February 2021).

RESULTS

Out of 3752 respondents, 1975 received chemotherapy only (i.e., without targeted therapy) and were therefore included. The majority (71.2%) reported symptoms in both hands and feet (e.g., tingling and loss of sensation or diminished sensation). Participants reported most limitations in household chores, social activities, hobbies, sports, walking, and sleeping and least in family/(taking care of) children, cycling, driving, self-care, eating and drinking, and sexuality and intimacy. Many patients indicated that their healthcare professionals informed them about the possibility of CIPN development before treatment (58.4%), and they paid attention to CIPN during and after treatment (53.1%). However, many patients (43%) reported a lack of information on what to do when CIPN develops. Few participants (22%) visited their general practitioner (GP) for CIPN. In general, patients' social environments sometimes to always showed empathy to patients.

CONCLUSIONS

Symptoms of CIPN are frequently reported and can result in various daily limitations. Support from professionals and peers is crucial in managing CIPN, which is sometimes lacking. Appropriate guidance and support should be provided to patients to decrease the impact of CIPN on daily life. Future research should investigate differences in chemotherapeutic agents and the resulting symptoms and consequences.

Empowering Cancer Patients with Self-Care and Pain Management Skills: A Quasi-Experimental Study

BACKGROUND

Cancer patients experience distress as a result of their health condition, which, in turn, contributes to the progression of the disease. Moreover, their daily activities, well-being, and health status are significantly impacted by pain and other symptoms. In this context, empowering these patients with self-care and pain management skills can greatly contribute to effective symptom control.

AIM

To develop and implement an educational approach focused on empowering family caregivers and patients with advanced cancer in effectively managing pain at home.

METHOD

An educational program, PECP/C-Pain Management, was developed to empower family caregivers and cancer patients to manage pain at home. A quasi-experimental study involving 52 participants with advanced cancer was conducted to test the program. Participants' skills, behaviors, and knowledge related to self-care and pain management were assessed before and after the intervention using an appropriate instrument, the Pain Management Knowledge and Behavior Scale.

RESULTS

Pain was reported as the primary symptom, and following the educational program, participants were able to monitor pain and other symptoms and effectively self-manage their treatment.

CONCLUSIONS

The findings suggest that the PECP/C-Pain Management intervention was effective in improving participants' knowledge and skills in managing pain, leading to better symptom control. In addition, the Pain Management Knowledge and Behavior Scale is a reliable tool for measuring the outcomes of this intervention.