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      Evaluation of patients’ needs to design and assess a patient education program in cancer pain

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          Abstract

          Purpose: Patient education constitutes a relevant strategy to improve pain management. In the field of therapeutic patient education (TPE), we aimed 1) to assess pain impact in cancer patients, 2) to identify patients’ educative needs in pain management, and 3) to refine research criteria for its future evaluation.

          Patients and methods: Pain intensity, relief and interference were assessed in 75 cancer patients with unbalanced background pain. Self-assessment questionnaire evaluated i) patients’ pain management and ii) their knowledge and needs in TPE.

          Results: Most patients experienced pain for more than 6 months and 41.6% reported adequate pain relief. Understanding pain and pain management were major patients’ preferences (>58%). Most patients declared they knew their pain treatments, but fewer than half of them were able to name them. However, education concerning pain treatment was considered as essential in <30% of patients. Almost all patients (97.1%) stated pain education as beneficial, with a preference for individualized sessions (41.2%). In addition, the assessment criteria for its future evaluation were refined.

          Conclusion: Targeted population mainly concerned patients with persistent pain. Only half of patients reported pain relief despite antalgics. Patient education was declared as beneficial for almost all participants.

          Practice implications: Tailoring a pain TPE on patients’ needs has the potential to help them to optimally manage their pain daily.

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          Most cited references 22

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          Patient participation: current knowledge and applicability to patient safety.

          Patient participation is increasingly recognized as a key component in the redesign of health care processes and is advocated as a means to improve patient safety. The concept has been successfully applied to various areas of patient care, such as decision making and the management of chronic diseases. We review the origins of patient participation, discuss the published evidence on its efficacy, and summarize the factors influencing its implementation. Patient-related factors, such as acceptance of the new patient role, lack of medical knowledge, lack of confidence, comorbidity, and various sociodemographic parameters, all affect willingness to participate in the health care process. Among health care workers, the acceptance and promotion of patient participation are influenced by other issues, including the desire to maintain control, lack of time, personal beliefs, type of illness, and training in patient-caregiver relationships. Social status, specialty, ethnic origin, and the stakes involved also influence patient and health care worker acceptance. The London Declaration, endorsed by the World Health Organization World Alliance for Patient Safety, calls for a greater role for patients to improve the safety of health care worldwide. Patient participation in hand hygiene promotion among staff to prevent health care-associated infection is discussed as an illustrative example. A conceptual model including key factors that influence participation and invite patients to contribute to error prevention is proposed. Further research is essential to establish key determinants for the success of patient participation in reducing medical errors and in improving patient safety.
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            Quality of cancer pain management: an update of a systematic review of undertreatment of patients with cancer.

            Pain is a frequent symptom in patients with cancer, with substantial impact. Despite the availability of opioids and updated guidelines from reliable leading societies, undertreatment is still frequent.
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              Overcoming barriers in cancer pain management.

               Jung Kwon (2014)
              Pain is a devastating symptom of cancer that affects the quality of life of patients, families, and caregivers. It is a multidimensional symptom that includes physical, psychosocial, emotional, and spiritual components. Despite the development of novel analgesics and updated pain guidelines, cancer pain remains undermanaged, and some patients with moderate to severe pain do not receive adequate pain treatment. Inadequate pain management can be attributed to barriers related to health care professionals, patients, and the health care system. Common professional-related barriers include poor pain assessment, lack of knowledge and skill, and the reluctance of physicians to prescribe opioids. Patient-related barriers include cognitive factors, affective factors, and adherence to analgesic regimens. System-related barriers such as limits on access to opioids and the availability of pain and palliative care specialists present additional challenges, particularly in resource-poor regions. Given the multidimensional nature of cancer pain and the multifaceted barriers involved, effective pain control mandates multidisciplinary interventions from interprofessional teams. Educational interventions for patients and health care professionals may improve the success of pain management.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                JPR
                jpainres
                Journal of Pain Research
                Dove
                1178-7090
                06 June 2019
                2019
                : 12
                : 1813-1823
                Affiliations
                [1 ] UMR 1086 Inserm ANTICIPE (Interdisciplinary Research Unit for Cancer Treatment and Prevention) and University of Normandy , Caen, France
                [2 ] Pain Assessment and Treatment Centre, Bayeux Hospital , Bayeux, France
                [3 ] Regional Pain Network for Lower Normandy , Bayeux, France
                [4 ] Clinical Research Unit, Centre François Baclesse , Caen, France
                [5 ] Pharmacie de la Croix d’Or , Paris, France
                [6 ] Pain and Palliative Care Unit, Lisieux Hospital , Lisieux, France
                [7 ] Pain Assessment and Treatment Consultation, Alençon-Mamers Intercommunal Hospital , Alençon, France
                [8 ] Pain and Palliative Care Unit, Centre François Baclesse , Caen, France
                [9 ] Pain and Palliative Care Unit, University Hospital , Caen, France
                [10 ] Pain Assessment and Treatment Centre, Avranches-Granville Hospital , Avranches, France
                Author notes
                Correspondence: V PrevostUMR 1086 Inserm ANTICIPE (Interdisciplinary Research Unit for Cancer Treatment and Prevention) and University of Normandy , Av. du Général Harris, 14076CAEN cedex 05, Caen, FranceTel +33 231 45 52 15Fax +33 231 45 86 30 Email virginie.prevost@ 123456unicaen.fr
                Article
                197920
                10.2147/JPR.S197920
                6560184
                © 2019 Prevost et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 2, Tables: 3, References: 32, Pages: 11
                Categories
                Original Research

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