Development of a cancer pain self-management resource to address patient, provider, and health system barriers to care

Article

Luckett, Tim, Davidson, Patricia M., Green, Anna, Marie, Natalie, Birch, Mary-Rose, Stubbs, John, Phillips, Jane, Agar, Meera, Boyle, Frances and Lovell, Melanie. 2019. "Development of a cancer pain self-management resource to address patient, provider, and health system barriers to care." Palliative and Supportive Care. 17 (4), pp. 472-478. https://doi.org/10.1017/S1478951518000792
Article Title

Development of a cancer pain self-management resource to address patient, provider, and health system barriers to care

ERA Journal ID40896
Article CategoryArticle
AuthorsLuckett, Tim (Author), Davidson, Patricia M. (Author), Green, Anna (Author), Marie, Natalie (Author), Birch, Mary-Rose (Author), Stubbs, John (Author), Phillips, Jane (Author), Agar, Meera (Author), Boyle, Frances (Author) and Lovell, Melanie (Author)
Journal TitlePalliative and Supportive Care
Journal Citation17 (4), pp. 472-478
Number of Pages8
Year2019
Place of PublicationUnited Kingdom
ISSN1478-9515
1478-9523
Digital Object Identifier (DOI)https://doi.org/10.1017/S1478951518000792
Web Address (URL)https://www.cambridge.org/core/journals/palliative-and-supportive-care/article/development-of-a-cancer-pain-selfmanagement-resource-to-address-patient-provider-and-health-system-barriers-to-care/1DAB4014E9CEBE7FBC279B5B31F0D917
Abstract

Objective: The majority of self-management interventions are designed with a narrow focus on patient skills and fail to consider their potential as 'catalysts' for improving care delivery. A project was undertaken to develop a patient self-management resource to support evidence-based, person-centered care for cancer pain and overcome barriers at the levels of the patient, provider, and health system. Method: The project used a mixed-method design with concurrent triangulation, including the following: a national online survey of current practice; two systematic reviews of cancer pain needs and education; a desktop review of online patient pain diaries and other related resources; consultation with stakeholders; and interviews with patients regarding acceptability and usefulness of a draft resource. Result: Findings suggested that an optimal self-management resource should encourage pain reporting, build patients' sense of control, and support communication with providers and coordination between services. Each of these characteristics was identified as important in overcoming established barriers to cancer pain care. A pain self-management resource was developed to include: (1) a template for setting specific, measureable, achievable, relevant and time-bound goals of care, as well as identifying potential obstacles and ways to overcome these; and (2) a pain management plan detailing exacerbating and alleviating factors, current strategies for management, and contacts for support. Significance of results: Self-management resources have the potential for addressing barriers not only at the patient level, but also at provider and health system levels. A cluster randomized controlled trial is under way to test effectiveness of the resource designed in this project in combination with pain screening, audit and feedback, and provider education. More research of this kind is needed to understand how interventions at different levels can be optimally combined to overcome barriers and improve care.

KeywordsCancer pain; Patient education; Self-efficacy; Self-management
ANZSRC Field of Research 2020420309. Health management
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Institution of OriginUniversity of Southern Queensland
Byline AffiliationsUniversity of Technology Sydney
HammondCare, Australia
CanSpeak, Australia
Mater Group, Australia
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Phillips, Jane, Heneka, Nicole and Shaw, Tim. 2013. "Exploring opiate errors in the specialist cancer and palliative care setting: perceptions of key stakeholders." COSA Annual Scientific Meeting 2013. Adelaide, Australia 12 - 14 Nov 2013 Australia.
Mapping cancer pain screening, assessment and reassessment practices within one Australian health district: results from a baseline chart audit
Phillips, Jane, Heneka, Nicole and Shaw, Tim. 2013. "Mapping cancer pain screening, assessment and reassessment practices within one Australian health district: results from a baseline chart audit." COSA Annual Scientific Meeting 2013. Adelaide, Australia 12 - 14 Nov 2013 Australia.
Impact of a Qstream Online Learning Module on Palliative Care Nurses’ Pain Assessment Competencies and Patients’ Reports of Pain: Results from a Quasi-Experimental Pilot Study
Phillips, Jane, Heneka, Nicole, Hickman, Louise, Lam, Lawrence and Shaw, Tim. 2013. "Impact of a Qstream Online Learning Module on Palliative Care Nurses’ Pain Assessment Competencies and Patients’ Reports of Pain: Results from a Quasi-Experimental Pilot Study." COSA Annual Scientific Meeting 2013. Adelaide, Australia 12 - 14 Nov 2013 Australia.