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Testing the Implementation of a Pain Self-management Support Intervention for Oncology Patients in Clinical Practice

2017; Lippincott Williams & Wilkins; Volume: 41; Issue: 5 Linguagem: Inglês

10.1097/ncc.0000000000000502

1538-9804

Antje Koller, Jan Gaertner, Sabina De Geest, Monika Hasemann, Gerhild Becker,

Palliative Care and End-of-Life Issues

Background: In oncology, pain control is a persistent problem. Significant barriers to cancer pain management are patient related. Pain self-management support interventions have shown to reduce pain intensity and patient-related barriers. Comparative effectiveness research is a suitable approach to test whether effects are sustained in clinical practice. Objective: In this pilot randomized controlled trial, the implementation of the ANtiPain intervention into clinical practice was tested to assess the effects on pain intensity, function-related outcomes, self-efficacy, and patient-related barriers to pain management to prepare a larger effectiveness trial. Methods: Within 14 months, 39 adult oncology patients with pain scores of 3 or higher on a 10-point numeric rating scale were recruited in an academic comprehensive cancer center in Southern Germany. Patients in the control group (n = 19) received standard care. Patients in the intervention group (n = 20) received ANtiPain, a cancer pain self-management support intervention based on 3 key strategies: provision of information, skill building, and nurse coaching. An intervention session was performed in-hospital. After discharge, follow-up was provided via telephone calls. Data were collected at baseline and 1 and 6 weeks after discharge. Effect sizes were calculated for all outcomes. Results: Large effects were found for activity hindrance (Cohen d = 0.90), barriers ( d = 0.91), and self-efficacy ( d = 0.90). Small to moderate effects were found for average and worst pain (Cohen d = 0.17-0.45). Conclusions: Key findings of this study involved function-related outcomes and self-efficacy. Implications for Practice: Because these outcomes are particularly meaningful for patients, the integration of ANtiPain to routine clinical practice may be substantial. A larger study will be based on these findings.