Congress Abstracts 2003

38

EVALUATING THE RELATIONSHIP BETWEEN CANCER PAIN INTENSITY, SATISFACTION WITH PAIN RELIEF, AND ATTITUDINAL BARRIERS TO PAIN MANAGEMENT: ANOTHER LOOK. Mary Thomas, RN, MS, AOCN^®, Kathleen Fahey, RN, MS, and Marilyn Douglas, DNSc, RN, FAAN, VA Palo Alto Health Care System, Palo Alto, CA.

Despite increased focus on the problem, cancer pain (CP) remains a significant issue. Studies document that although some patients report high satisfaction with pain management, they also report high pain ratings (Dawson et al., 2002). The influence of attitudinal barriers to CP might be a factor in this paradox; research has documented that those with high CP have more attitudinal barriers (Ward et al., 1998). The purpose of this descriptive study was to further test the association between CP intensity ratings, satisfaction with, and attitudinal barriers to, CP management. Stress and coping theory provided the theoretical foundation of the study. Attitudinal barriers were measured by the Barriers Questionnaire (BQ); CP ratings were measured by the Brief Pain Inventory (both with established reliability and validity).
The sample of 151 non-hospitalized adults with pain due to cancer or its treatment was predominately male, middle-aged (M = 59.8 years, SD 12.2), and had a wide variety of cancer types. Patients rated their CP and satisfaction with pain relief using 0–10 numeric rating scales, their average CP over the previous week was rated at 4.7 (SD 2.1), worst pain was rated at 6.6 (SD 2.3), and least pain at 2.8 (SD 2.2). Pain management strategies provided an average relief of 59% (SD 30.1%); pain relief satisfaction ratings were similar (M = 6; SD 2.9). Current CP and lowest CP ratings were moderately correlated with % relief scores (r = -.40, -.312, respectively; p < .001). However, CP ratings were not well correlated with pain relief satisfaction. BQ subscale and total scores were low; they did not correlate with any of the CP, relief, or satisfaction ratings.
A subset of patients (n = 44) was interviewed. Qualitative data substantiated earlier findings that many barriers to CP management were based on communication and information issues, and on misunderstandings.
In contrast with previous studies, data from this study suggest that pain intensity, satisfaction with pain relief, or attitudinal barriers to CP management may not be well correlated. Further study is needed to understand these relationships. Efforts to enhance patients’ understanding and to improve communication with providers may help patients better manage their CP.