Abstract
BackgroundPain is one of cancer patients’ most frequent and distressing symptoms; however, analgesics’ side effects often increase symptom burden. Further, with the home rapidly becoming the primary cancer care setting, family caregivers (FCs) commonly play central roles in patients’ pain self-management, but with little or no preparation. One US-tested intervention, the PRO-SELF© Plus Pain Control Program (PCP), designed to support cancer outpatients and their FCs in pain self-management, is currently being tested in the Swiss multi-centre PEINCA study. The current PEINCA-FAM study is a sub-study of PEINCA. The aims of PEINCA-FAM are: a) to test the efficacy of the adapted German PRO-SELF © Plus PCP to reduce side effects of analgesics; b) to enhance patients’/FCs’ knowledge regarding cancer pain; and c) to explore FCs’ involvement in patients’ pain self-management.MethodsThis mixed methods project combines a multi-centre randomized controlled clinical trial with qualitative data collection techniques and includes 210 patients recruited from three oncology outpatient clinics. FCs involved in patients’ pain self-management are also invited to participate. After baseline evaluation, eligible participants are randomized to a 6-week intervention group and a control group. Both groups complete a daily pain and symptom diary. Intervention group patients/FCs receive the weekly psychoeducational PRO-SELF© Plus PCP interventions; control group patients receive usual care. After completing the six-week study procedures, a subsample of 7–10 patients/FCs per group and hospital (N = 42–60) will be interviewed regarding their pain management experiences. Data collection will take place from April 2016 until December 2018. An intent-to-treat analysis and generalized linear mixed models will be applied. Qualitative data will be analysed by using interpretive description. Quantitative and qualitative results will be combined within a mixed method matrix.DiscussionIn clinical practice, specially trained oncology nurses in outpatient clinics could apply the intervention to reduce side effects and to enhance patients’/FCs’ self-efficacy and pain management knowledge.Trial registrationThe PEINCA study is registered in the Clinical Trials.gov site (code: NCT02713919, 08 March 2016).
Highlights
DiscussionSpecially trained oncology nurses in outpatient clinics could apply the intervention to reduce side effects and to enhance patients’/Family caregivers (FCs)’ self-efficacy and pain management knowledge
Pain is one of cancer patients’ most frequent and distressing symptoms; analgesics’ side effects often increase symptom burden
Through our intervention to educate cancer patients and their Family caregivers (FCs), we aim to develop their knowledge regarding pain management, their self-efficacy regarding pain management, and their symptom self-management skills
Summary
This study is the first to evaluate the effects of a psychoeducational intervention to reduce analgesics’ side effects and to explore the involvement of FCs in pain management in a sample of Swiss cancer outpatients and their FCs. To achieve adequate pain and side effect self-management, cancer patients and their FCs require educational interventions Their self-management support should focus on enhancing patients’ and FCs’ pain management knowledge and self-efficacy, while improving their use of pain and side effect relief strategies [24, 59, 60]. This study’s results will contribute to the understanding of interventions designed to improve side effect self-management, knowledge and self-efficacy in cancer outpatients and their FCs. If efficacious, the proposed intervention could be implemented in clinical practice to reduce pain and analgesics’ side effects, while enhancing patients’ and their FCs’ pain management skills and knowledge
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