Assessment and Management of Adult Cancer Pain: A Systematic Review and Synthesis of Recent Qualitative Studies Aimed at Developing Insights for Managing Barriers and Optimizing Facilitators Within a Comprehensive Framework of Patient Care

Luckett, Tim and Davidson, Patricia M. and Green, Anna ORCID: https://orcid.org/0000-0002-7541-3665 and Boyle, Frances and Stubbs, John and Lovell, Melanie (2013) Assessment and Management of Adult Cancer Pain: A Systematic Review and Synthesis of Recent Qualitative Studies Aimed at Developing Insights for Managing Barriers and Optimizing Facilitators Within a Comprehensive Framework of Patient Care. Journal of Pain and Symptom Management, 46 (2). pp. 229-253. ISSN 0885-3924


Abstract

Context: Cancer pain is a common, burdensome problem, which is not well managed despite evidence-based guidelines. Objectives: To develop insights for managing barriers and optimizing facilitators to adult cancer pain assessment and management within a comprehensive framework of patient care. Methods: We undertook a systematic review and synthesis of qualitative studies. Medline, PsycINFO, Embase, AMED, CINAHL, and Sociological Abstracts were searched from May 20 to 26, 2011. To be included, the articles had to be published in a peer-reviewed journal since 2000; written in English; and report original qualitative studies on the perspectives of patients, their significant others, or health care providers. Article quality was rated using the checklist of Kitto et al. Thematic synthesis followed a three-stage approach using Evidence for Policy and Practice Information and Co-ordinating Centre-Reviewer 4 software: 1) free line-by-line coding of 'Results,' 2) organization into 'descriptive' themes, and 3) development of 'analytical' themes informative to our objective. At Stage 3, a conceptual framework was selected from the peer-reviewed literature according to prima facie 'fit' for descriptive themes. Results: Of 659 articles screened, 70 met the criteria, reporting 65 studies with 48 patient, 19 caregiver, and 21 health care provider samples. Authors rarely reported reflexivity or negative cases. Mead and Bower's model of patient-centered care accommodated 85% of the descriptive themes; 12% more related to the caregiver and service/system factors. Three themes could not be accommodated. Conclusion: Findings highlight the need to integrate patient/family education within improved communication, individualize care, use more nonpharmacological strategies, empower patients/families to self-manage pain, and reorganize multidisciplinary roles around patient-centered care and outcomes. These conclusions require validation via consensus and intervention trials.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Files associated with this item cannot be displayed due to copyright restrictions.
Faculty/School / Institute/Centre: No Faculty
Faculty/School / Institute/Centre: No Faculty
Date Deposited: 20 Jul 2022 01:18
Last Modified: 24 Nov 2022 23:35
Uncontrolled Keywords: Cancer; pain; qualitative research
Fields of Research (2020): 42 HEALTH SCIENCES > 4203 Health services and systems > 420316 Palliative care
Identification Number or DOI: https://doi.org/10.1016/j.jpainsymman.2012.07.021
URI: http://eprints.usq.edu.au/id/eprint/49591

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