Self-efficacy For Pain Management Research Articles

Associations Between Cognitive Performance and Self-Efficacy for Pain Management in Older Adults With Chronic Pain

BackgroundSelf-efficacy for pain management is the key to successful pain management, yet little is known about the effect of cognitive performance on self-efficacy for pain management. This study aimed to examine to what extent cognitive performance is related to self-efficacy for pain management in older adults with chronic pain. MethodsThe analyses utilized data from the baseline assessment of the MOBILIZE Boston Study. Five neuropsychological tests—the Clock in the Box Test, Letter Fluency Test, Trail-making Test, Hopkins Verbal Learning Test, and WORLD Test—were performed to measure the cognitive performance domains of 458 participants, aged 70 years and reporting chronic pain and self-efficacy for pain management. We measured self-efficacy for pain management using the Chronic Pain Self-Efficacy Scale. Statistical analyses were done using multiple linear regression analysis. ResultsAfter adjusting for sociodemographic factors, general cognitive performance, executive function, as measured by the Clock in the Box Test, and attention, as measured by the Trail-Making Test Part A, were significantly associated with self-efficacy for pain management in older adults with chronic pain. However, after controlling for sociodemographic factors, chronic conditions, pain interference, and physical performance, the associations between cognitive performance measures and self-efficacy for pain management weakened. ConclusionGreater cognitive performance in attention and executive function might be associated with better self-efficacy for pain management. Future longitudinal research is required to investigate the long-term implications of cognitive performance changes on the progress of self-efficacy for pain management in community-dwelling older adults.

Measurement of Self-Efficacy in Pregnant Females with Low Back Pain

Background: Self-efficacy, the belief in one's ability to accomplish tasks, plays a crucial role in managing pain. Low back pain (LBP) is a common issue during pregnancy, significantly affecting daily life. This study aimed to assess the relationship between self-efficacy and pain severity in pregnant women with LBP.Objective: To measure self-efficacy and determine its association with pain severity in pregnant females suffering from LBP.Methods: A cross-sectional study was conducted from July to December 2023 at Akhtar Saeed Trust Hospital, Lahore. A total of 87 pregnant women with LBP were recruited using non-probability convenience sampling. Self-efficacy was measured using the General Self-Efficacy Scale, and pain severity was assessed using the Visual Analogue Scale. Data were analyzed using SPSS version 25, with descriptive statistics and chi-square tests used to explore associations.Results: The mean age of participants was 30.51 ± 3.72 years. Moderate pain was reported by 86.2% of participants, while 43.7% had high self-efficacy. A significant association was found between self-efficacy and pain severity (p = 0.028).Conclusion: Higher self-efficacy was significantly associated with lower pain severity in pregnant women with LBP, suggesting the importance of self-efficacy in pain management.

A Pilot Interprofessional Education Curriculum for Optimizing Mental Health in Chronic Pain Treatment and Understanding Interprofessional Practice.

With the urgent need for clinicians capable of responding to the opioid crisis, an interprofessional education (IPE) pilot curriculum was launched to assess trainee self-efficacy in managing chronic pain and mental health conditions, and attitudes toward interprofessional practice among resident physicians, family nurse practitioners (FNP), and physician assistant (PA) students. This study involved the implementation of a pilot curriculum consisting of five interactive IPE sessions. All invited trainees across two academic institutions were asked to complete the assessments. Self-efficacy in managing chronic pain and mental health was measured at baseline and following IPE training using a researcher-developed tool, while attitudes toward interprofessional practice were measured with the Attitudes Toward Health Care Teams scale. Resident physicians were compared to FNP/PA students to examine differences between groups and within groups over time. The final analysis involved 25 trainees who attended at least one IPE training session and completed pre-session and post-session surveys. The total pre-session survey and post-session survey response rate was 37.5% (n=36). Self-efficacy in chronic pain management improved among the resident physician (mean=3.85 ±0.40) and FNP/PA groups (mean=3.84±0.46) (p=0.05 and p=0.001), respectively. Self-efficacy in mental health management was not significantly improved among resident physicians (mean=3.41±0.49, p=0.48), but improved among FNP/PA students (mean=3.46±0.31, p<0.001). There was no difference in attitudes toward interprofessional practice. While IPE training did not result in attitudinal changes toward interprofessional practice, it shows potential for improving self-efficacy in managing chronic pain and mental health, particularly among FNP/PA trainees. This study was limited by a small sample size of trainees included in the finalanalysis.

Relationship between pain resilience and pain catastrophizing in older patients after total knee arthroplasty: Chain-mediating effects of cognitive emotion regulation and pain management self-efficacy

This study aimed to determine whether the relationship between pain resilience and pain catastrophizing in older patients after total knee arthroplasty (TKA) was mediated by cognitive emotion regulation strategies (CERS) and pain management self-efficacy (PMSE). Convenience cluster sampling was used in this cross-sectional study to recruit 382 older adults. The results revealed that pain catastrophizing was negatively correlated with pain resilience, adaptive CERS, and PMSE; however, it was positively correlated with maladaptive CERS (all p < 0.01). Mediation analysis revealed that both CERS (adaptive and maladaptive) and self-management independently and sequentially mediated the relationship between pain resilience and pain catastrophizing in older patients who underwent TKA. These findings demonstrate that CERS (adaptive and maladaptive) and PMSE play chain-mediating roles in the correlation between pain resilience and pain catastrophizing in older patients after TKA.

Health Care Discrimination Affects Patient Activation, Communication Self-Efficacy, and Pain for Black Americans

This study examines whether a key psychosocial factor—perceiving racial discrimination in health care—is associated with worse patient activation, communication self-efficacy, and physical health outcomes for Black veterans with chronic pain. Moreover, we explore the role of physician-patient working alliance as a moderator that may alleviate the potential consequences of perceiving racial discrimination. This work is a secondary analysis of baseline data from a clinical trial with 250 U.S. Black veterans with chronic musculoskeletal pain. Participants were recruited from primary care clinics at a Midwestern VA hospital between 2018 and 2021. Perceiving racial discrimination in health care was associated with lower patient activation, lower self-efficacy in communicating with one’s physician, higher pain intensity, and lower pain management self-efficacy (ps < .049) but was unrelated to reports of pain interference or use of pain coping strategies (ps > .157). Although the relationship between perceived discrimination and patient activation was moderated by working alliance (P = .014), having a stronger working alliance improved patient activation to varying degrees across levels of perceived discrimination (rather than buffering against negative outcomes when perceiving higher levels of discrimination). Moderation was not significant on any other measures. This study deepens our understanding of the broad range of health outcomes that are (not) associated with perceiving racial discrimination in health care. Contrary to prior theorizing, this work also indicates that having a strong working alliance does not attenuate the consequences of perceiving discrimination among Black individuals living with pain. These results highlight the need for system-level interventions to address perceptions of racial mistreatment in health care. PerspectiveThis work has important public health implications by identifying the broad range of outcomes associated with perceived discrimination in health care among Black Americans. Importantly, a strong physician-patient relationship did not buffer Black individuals from the consequences of perceiving discrimination. These findings inform intervention targets to mitigate racial health disparities.

Effect of Selected Yoga Interventions on Psycho-Physiological Function in IT Professionals with Chronic Back Pain - A Randomized Controlled Trial

Purpose: This study sought to explore the effects of specific yoga practices on psycho-physiological function in IT professionals suffering from CLBP. Material and Methods: IT professionals with CLBP (n=83) were randomly allocated to intervention group (n=41) in which they practiced yoga interventions for 12 weeks, while the control group (n=42) received standard care without any special intervention. Pain intensity, quality of life (QoL), chronic pain self-efficacy, and self-efficacy for managing chronic disease were evaluated before and after the 12-week intervention period using the brief pain inventory (BPI), rand 36-item health survey, chronic pain self-efficacy scale (CPSS), and 6-item stanford self-efficacy for managing chronic disease (SSMCD-6) scale. Yoga group participants (n=32) demonstrated significant improvements in pain intensity, QoL, chronic pain self-efficacy, and self-efficacy for managing chronic disease compared to the control group (n=34). Results: Specifically, the yoga group showed a mean reduction in intensity of pain from 6.8±1.2 to 4.2±1.0 (p&lt;0.001) on the BPI scale, an increment in QoL scores from 45.6±9.3 to 62.4±10.5 (p&lt;0.001), an enhancement in chronic pain self-efficacy from 60.2±8.5 to 78.5±6.7 (p&lt;0.001) on the CPSS, and another enhancement in self-efficacy for managing chronic disease from 25.4 ± 4.6 to 32.8 ± 5.2 (p &lt; 0.001) on the SSMCD-6 scale. Conclusion: Selected yoga interventions demonstrated favorable effects on psycho-physiological function in IT professionals with CLBP. Integrating these postures into management strategies for CLBP could offer promising outcomes in terms of pain reduction, enhanced quality of life, and improved self-efficacy for pain management. Further research is needed to validate these findings and explore long-term effects.

Nursing students' pain management self-efficacy and attitude towards patients with chronic pain: What can be done better in education? A cross-sectional study

AimThis study has been conducted to determine nursing students' pain management self-efficacy and attitudes towards patients with chronic pain. BackgroundPain is a significant phenomenon that often leads individuals to seek medical attention, influenced by various factors and commonly encountered by healthcare professionals. Adequate knowledge and positive attitudes among nurses play a crucial role in the thorough assessment and effective management of pain, resulting in favorable outcomes for hospitalized individuals. DesignThis study used a descriptive cross-sectional design. MethodsThe research was conducted with 322 undergraduate students who were continuing their education in the autumn semester of the 2023–2024 academic year at Aksaray University, Faculty of Health Sciences, Department of Nursing. Data have been collected by using Student Information Form, Pain Management Self-Efficacy Questionnaire (PMSEQ) and the Attitude of Healthcare Professionals towards Patients with Chronic Pain Scale. Mann-Whitney U, Kruskal-Wallis significance test and Spearman Correlation analysis have been used to evaluate the data. ResultsThe mean total score of the PMSEQ was 62.91 (SD 15.58) and the mean total score of the Attitude of Healthcare Professionals Towards Patients with Chronic Pain Scale was 3.94 (SD.52). Those students who willingly opted for the nursing profession, perceived themselves as proficient in managing chronic pain, administered care to patients experiencing pain during clinical placements, believed they received sufficient education in pain management throughout their studies and rated their overall health status as "very poor" demonstrated higher levels of self-efficacy in pain management (p<0.05). As a result of the analysis performed according to the mean scores of the Attitude of Healthcare Professionals Towards Chronic Pain Patients Scale and its sub-dimensions of the students participating in the study, a statistically significant difference has been found according to their gender, academic year and self-sufficiency in pain management (p<0.05). It has been determined that there is a weak positive correlation between the total mean scores of the participants' PMSEQ and the Attitude of Healthcare Professionals Towards Patients with Chronic Pain scale (r=.260; p<0.01). ConclusionsIn this study, as nursing students' self-confidence in pain management self-efficacy increased, their attitudes towards patients with pain also increased positively. In the nursing curriculum, there is a necessity for integrating pain management education and fostering awareness to adequately equip nursing students in addressing the pain requirements of patients.

Development and feasibility of a mindfulness-based dance/movement therapy intervention for chronic low back pain.

Responding to the need for innovative, multi-modal, non-pharmacological strategies in chronic low back pain (cLBP) care, this article presents the development and a mixed methods feasibility trial of a manualized Mindfulness-based Dance/Movement Therapy (M-DMT) program for cLBP. The 12-week program is designed as a group therapy, integrating mindfulness principles, creative/expressive dance and movement, and psychoeducational content focused on cLBP management. This holistic program seeks to cultivate nonjudgmental awareness of pain experiences, challenge maladaptive pain-related beliefs, enhance emotional well-being, foster social support, and promote effective coping strategies for the daily challenges associated with cLBP. The 12-week M-DMT intervention was administered to individuals with non-specific cLBP (N = 18, aged 51.7 ± 13.9 years, 72% female, 55% Black and 39% White). We assessed feasibility and acceptability through monitoring enrollment and retention rates, attendance, and adverse events. Moreover, we measured the intervention's credibility/expectancy, participants' perception of changes, and overall satisfaction. Additionally, we collected qualitative data, capturing participants' perspectives on the intervention's usefulness and perceived benefits. Specific benchmarks were established to gauge the successful feasibility and acceptability of the program. The adherence rate stood at 80%, with a perfect retention rate of 100%. The study successfully met the benchmarks for treatment acceptability and satisfaction criteria, with 61% of participants reporting "feeling better" or a "great deal better" after the intervention. No adverse events were observed. Participants found the intervention enjoyable and reported that it provided effective tools for cLBP and related symptoms. Notably, participants reported a decrease in fear-avoidance behaviors, increased motivation for physical activity, and a boost in self-efficacy for pain management. These encouraging findings establish a strong basis for considering the M-DMT intervention as a promising approach for cLBP management, warranting further investigation in larger-scale studies.

Evaluation of the relationship between intensive care nurses' pain management self-efficacy and perceptions of opioid drug administration

Evaluation of the relationship between intensive care nurses' pain management self-efficacy and perceptions of opioid drug administration

Mediating Effect of Self-Efficacy in Pain Management between Knowledge and Attitude of Pain toward Pain Management Practice among Nurses in Indonesia

Nurses' knowledge and attitudes significantly influence pain management practices. Higher levels of self-efficacy in pain management are associated with improved pain. This study explored the relationships between nurses’ knowledge and attitudes toward pain, self-efficacy in pain management, and actual pain management practices. This study employed a cross-sectional study which conducted at Sultan Agung Islamic Hospital, Indonesia, involving 249 nurses selected based on predefined criteria. Participants responded to an online survey encompassing demographic queries and standardized tools, namely the Knowledge and Attitude Survey Regarding Pain (KASRP-IDN), the Pain Management Self-Efficacy Questionnaire (PMSEQ-IDN), and the Nurse Behavior Questionnaire in Pain Management (NBQ-P). Mediation analysis was further conducted using the PROCESS add-on to discern the mediating effect of self-efficacy in pain management between knowledge and attitude of pain toward pain management practice among nurses. The study showed significant positive relationships among Knowledge and Attitude Survey Regarding Pain (KASRP), Pain Management Self-Efficacy (PMSE), and Pain Management Practice. However, the mediation analysis depicted that self-efficacy exerted a relatively modest mediating effect between KASRP and pain management practice (K2=0.17, CI= 0.05-0.27). The findings manifest the positive associations between knowledge-attitude regarding pain, self-efficacy in pain management, and pain management practices among nurses. In the future, in-service programs related to pain management should increase the nurses’ knowledge and attitude and enhance their confidence, resulting in actual practice in pain management. However, the mediation effect of self-efficacy is modest, indicating the plausible existence of other contributory variables or factors warranting further exploration and elucidation.

Online Learning to Improve Nurses’ Knowledge, Attitudes, and Self-Efficacy About Managing Postoperative Pain in Older Adults

BackgroundOlder adults undergoing total knee arthroplasty may develop chronic pain without effective postoperative pain management. Increasing nurses’ knowledge, changing their attitudes, and developing their pain management self-efficacy could improve the effectiveness of pain management. AimTo determine the effectiveness of an online learning program to help registered nurses to manage postoperative pain in older adults undergoing total knee arthroplasty. DesignA quasi-experimental pre-test–post-test design with intervention and control groups. MethodSix inpatient units were randomly selected at a large tertiary care medical center. Sixty nurses were evenly divided between intervention and control groups to participate in online learning about postoperative pain management in patients undergoing total knee arthroplasty. The content was based on Kolb's experiential learning theory. Data were collected on nurses’ knowledge and attitudes toward pain management and pain management self-efficacy at baseline and after completion. Data were analyzed using descriptive statistics, chi-square tests, paired t-tests, and independent t-tests. ResultsThe knowledge and attitudes about pain management and pain management self-efficacy toward older adults undergoing total knee arthroplasty of nurses in the intervention group significantly improved compared to the baseline and were also significantly higher than in the control group. ConclusionsAn online learning program improves nurses’ understanding and ability to manage pain in older adults undergoing total knee arthroplasty. This was therefore an effective learning method.

Chronic pain management in fibromyalgia: the INTEGRO (INTEGRated Psychotherapeutic InterventiOn) protocol and its application on two case studies.

To present an innovative integrated manualized psychotherapeutic intervention for fibromyalgia (FM) based on cognitive and behavioral therapy, acceptance and commitment therapy, and somatic experiential techniques (namely the INTEGRated Psychotherapeutic InterventiOn, INTEGRO) and illustrate its application on two case studies. INTEGRO is composed of 12 individual sessions. The main objectives of the intervention were psychoeducation of chronic pain mechanisms, understanding the role of cognitive and emotional variables in one's pain perception, teaching patient-tailored skills to increase pain awareness and its management, and learning how to live with pain experience. A 57-year-old woman (patient A) and a 26-year-old woman (patient B) with FM have been selected to describe their care pathways connected to the INTEGRO protocol. Data related to assessment variables and clinical processes have been reported, focusing on the mechanisms that contribute to the maintenance (i.e., avoidance or overcompensation) of chronic pain in FM, on the role of patients' naïf theories, and on the implications that all these aspects may have on the burden related to pain management. Both patients showed a reduction in FM burden and an increase in self-efficacy in pain management: patient A reported an improvement in emotional regulation ability; patient B showed a decrease in pain interference in work activities and on emotional dimension. Examining each phase of the clinical protocol through the lens of its clinical application, the paper provides insights into the relationship among crucial psychosocial mechanisms, pain perception, management in FM treatment, and how all these aspects have been dealt with during psychotherapeutic treatment.

Effect of educational booklet and role-playing on the mothers’ knowledge and self-efficacy in newborn pain management: A quasi-experimental study

AimThis study was conducted to determine and compare the effect of training using the educational booklet and role-playing on mothers’ knowledge and perception of self-efficacy in newborn pain management. BackgroundAccording to studies conducted in Iran, mothers lack knowledge about newborn pain management; as a result, their self-efficacy in this field is questioned. DesignThis is a quasi-experimental study in which 111 mothers of hospitalized infants were allocated into three groups' control,’ ‘role-playing,’ and ‘educational booklet.’ The data were collected using the non-parallel method. The group order to collect the data was determined through drawing. The control group received routine training, including general information about comforting the baby by the mother. In the second group, in addition to routine care, mothers were provided with an educational booklet on newborn pain management, and in the third group, in addition to routine care, mothers were trained educational content through role-playing during two 90-min sessions. Mothers' perception of self-efficacy was measured using a researcher-made questionnaire. Analysis of variance and post hoc tests were used to analyze the data. ResultsThe results showed a significant difference between mothers' knowledge in role-playing and educational booklet groups compared to the control group (P < 0.00). Moreover, there was a significant difference in mothers’ self-efficacy in the role-playing group compared to the control group and the educational booklet group (P < 0.00). ConclusionAccording to the findings of this study, educational booklets and role-playing can be used to enhance mothers' knowledge levels. However, practical methods such as role-playing are recommended to increase mothers’ self-efficacy levels.

Pain Management Education for Rural Hospice Family Caregivers: A Pilot Study With Embedded Implementation Evaluation.

Assessing and managing hospice patients' pain is a common source of anxiety among hospice family caregivers (HFCGs), especially caregivers in rural communities who face special challenges including distance, limited access, and concerns about opioid misuse. To pilot test Ready2Care, a pain management education intervention for rural HFCGs. We sought to determine whether there was a signal of benefit for clinically-relevant outcomes and to identify contextual factors pertinent to conducting a future randomized clinical trial of Ready2Care. We conducted a multi-method, single-arm study, enabling completion of paired t-tests comparing pre- and post-intervention measures of caregiver anxiety, pain management self-efficacy, barriers to pain management, and reports of patient pain intensity and corresponding patient and caregiver distress. We concurrently conducted an embedded implementation evaluation via calculation of descriptive statistics (recruitment and retention data) and directed content analysis of brief caregiver interviews. Twenty-seven (n = 27) HFCGs participated; 15 completed the study. Among completers, significant improvement was observed in patient pain intensity (average 1.4 points decrease on 0-10 scale) and in overall pain experience. No statistically significant changes were detected in caregiver anxiety, barriers to pain management, or pain management self-efficacy. Facilitators to successful conduct of a future clinical trial included high acceptability of Ready2Care, driven by its perceived clarity and relevance to caregivers' concerns. Barriers included lower-than-anticipated accrual and an attrition rate of nearly 44%. A multisite clinical trial of Ready2Care is warranted; however, its success may require more effective recruitment and retention strategies for rural caregiver participants.

Translation and validation of the Vietnamese version of the Pain Self-Efficacy Questionnaire in patients with cancer

Background: The Pain Self-Efficacy Questionnaire (PSEQ) measures self-efficacy for pain management in patients with chronic pain, including cancer pain. Although the questionnaire has been translated into many other languages, it has not yet been translated and tested in Vietnam. Objective: This study aimed to translate and validate the PSEQ into Vietnamese. Methods: The PSEQ was translated into Vietnamese using Brislin’s model. Next, the Vietnamese version of the questionnaire (Viet-PSEQ) was evaluated for content validity by six experts using the Item-Content Validity Index (I-CVI) and the Scale-Content Validity Index (S-CVI). The reliability of the questionnaire was examined with 30 patients with cancer, using test-retest reliability (Intra-Class Correlation - ICC) and internal consistency (Cronbach’s α). Results: The I-CVI values ranged from 0.5 to 0.88, and the S-CVI value was 0.93. The Cronbach's alpha was 0.91, and the ICC was 0.99 (95% CI: 0.949 – 0.997, p &lt;0.001). Conclusion: The Viet-PSEQ was found to be valid and reliable. Healthcare professionals can use this instrument to measure self-efficacy for pain management in patients with cancer in Vietnam.

Impairment in sleep health in young adults with chronic pain: a modifiable risk factor

BackgroundImpairments in sleep health are associated with the development or worsening of chronic pain. Further, chronic pain can cause sleep health disruption by impacting sleep onset, sleep maintenance, sleep quality, and causing daytime somnolence. However, the association between chronic pain and sleep disturbances in the young adult population is unclear.AimWe describe our initial experience in establishing and running a clinic for managing sleep health and chronic pain in young adults. We also describe the prevalence and the pattern of sleep disruption as well as its relationship with self-efficacy in pain management, depression, and quality of life in this cohort.MethodsAfter approval from the Institutional Review Ethics board, chart review and data extraction were conducted for patients who presented at the Young Adult Clinic (YAC) at Women’s College Hospital from March 1, 2018 to April 30, 2019.ResultsMedical charts of 55 patients were reviewed with the majority being females (71%). Chronic widespread pain was the most common pain syndrome diagnosed in our patients. Insomnia was the most common sleep-health related diagnosis in our patients. Patients with disorders of sleep were more likely to report lower self-efficacy for managing pain as compared to those with no sleep disorders (p = 0.023) but there was no significant difference between these two groups as regards risk for pain-related catastrophizing.ConclusionImpairments in sleep health may be an important modifiable risk factor for alleviating pain in young adults with chronic pain. Sleep disorders should be evaluated and addressed in this population.

Interventions for supporting self-management in people with musculoskeletal pain, including focus on varying levels of health literacy: A systematic overview of reviews

Background: Musculoskeletal (MSK) pain is a major cause of disability globally, affecting one in three adults. Self-management is a core recommendation for managing MSK pain; however, most self-management programmes require a high level of patient engagement, which may be partly influenced by health literacy levels. This overview aims to summarise current evidence on supported self-management and the influence of varying levels of health literacy in people with MSK pain. Methods: A systematic search was conducted for relevant systematic reviews in databases (Cochrane Library, Medline, EMBASE, CINAHLPlus, AMED, and PsycInfo). Data on study populations (including markers of health literacy), characteristics, and outcomes of supported self-management such as self-efficacy in pain management were extracted. Quality of systematic reviews was assessed using AMSTAR 2, and strength of evidence rated using a modified GRADE approach. Results: In total, 40 systematic reviews contributed evidence to this overview. Based on intervention components and mode of delivery, three main self-management intervention approaches were indicated: structured self-management education programmes (10 reviews), self-directed self-management (four reviews), and combined self-management activity and education programmes (26 reviews). MSK patients with low health literacy levels were found to have poorer outcomes with current self-management interventions. The strength of evidence for self-efficacy in pain management was assessed as low (across the three approaches). Only one review systematically extracted data on measures or markers of health literacy, highlighting an important gap in evidence. Conclusions: A comprehensive summary and critical assessment of current evidence on supported self-management and the influence of health literacy levels among patients with MSK pain was presented. There is a gap in evidence regarding potential mediators of the effects of supported self-management among people with musculoskeletal conditions and low levels of health literacy, thereby limiting the opportunity to positively influence outcomes.

Military Veterans’ Perspectives on Postoperative Opioid Use: A Secondary Analysis of Qualitative Data

PurposeThis qualitative analysis of interviews with surgical patients who received a brief perioperative psychological intervention, in conjunction with standard medical perioperative care, elucidates patient perspectives on the use of pain self-management skills in relation to postoperative analgesics. DesignThis study is a secondary analysis of qualitative data from a randomized controlled trial. MethodsParticipants (N = 21) were rural-dwelling United States Military Veterans from a mixed surgical sample who were randomized to receive a manual-based, telephone-based Perioperative Pain Self-management intervention consisting of a total of four pre- and postoperative contacts. Semi-structured qualitative interviews elicited participant feedback on the cognitive-behavioral intervention. Data was analyzed by two qualitative experts using MAXQDA software. Key word analyses focused on mention of analgesics in interviews. FindingsInterviews revealed a dominant theme of ambivalence towards postoperative use of opioids. An additional theme concerned the varied ways acquiring pain self-management skills impacted postoperative opioid (and non-opioid analgesic) consumption. Participants reported that employment of pain self-management strategies reduced reliance on pharmacology for pain relief, prolonged the time between doses, took the “edge off” pain, and increased pain management self-efficacy. ConclusionsPerioperative patient education may benefit from inclusion of teaching non-pharmacologic pain self-management skills and collaborative planning with patients regarding how to use these skills in conjunction with opioid and non-opioid analgesics. Perianesthesia nurses may be in a critical position to provide interdisciplinary postoperative patient education that may optimize postoperative pain management while minimizing risks associated with prolonged opioid use.

Determinants of quality of life among Omani family caregivers of adult patients with cancer pain.

The study aimed to explore the determinants of quality of life (QoL) among Omani family caregivers (FCGs) of adult patients with cancer pain. A descriptive cross-sectional design, measures of caregiver reaction, knowledge about cancer pain, self-efficacy for cancer pain and other symptom management, QoL, and patient functional status were used to collect data from 165 FCGs and patients. Descriptive, correlation, and regression analyses were performed. Most patients had intermittent (83%) and severe (50.9%) cancer pain. The FCGs had low QoL (58.44±17.95), and this mostly impacted support and positive adaptation (55.2%). Low QoL was associated with low self-rated health, low confidence in the ability to control the patient's pain, low self-efficacy, high perceived distress due to patient pain, and a high impact of caregiving on physical health. The level of caregiver distress due to the patient's pain (p<0.01), patient's functional status (p<0.01), and perceived impact of caregiving on health (p<0.05) were significant predictors of overall QoL. Omani FCGs of patients with cancer pain suffer a negative impact on their QoL, and this is related to the patient's level of pain and functional status, caregiver's health, and self-efficacy in cancer pain and symptom management. The FCGs' QoL may be enhanced by augmenting their skills and self-efficacy in cancer pain and symptom management and by health promotion programs.

Family Caregivers of Adult Cancer Patients in Oman: Predictors of Caregivers' Self-efficacy for Cancer Pain and Related Symptom Management at Home.

Family caregivers (FCGs) contribute significantly to the management of pain and other symptoms experienced by their family member with cancer and may not receive preparation to meet the changing patient needs. The aim of this study was to identify the predictors of FCG self-efficacy (SE) for pain and related symptom management of adult family members with cancer. Data were collected from 165 Omani FCGs. The questionnaire comprised the caregiver cancer pain and related symptom management SE scale, the Katz index, Caregiver Reaction Assessment, and Family Pain Questionnaire. Electronic medical records provided data on patients' cancer diagnosis, pain, and symptoms. Predictors of SE were examined using linear regression analysis. Most FCGs were female (58.2%) and children of the patient (53.9%). Most patients were on chemotherapy or palliative care (82.4%) and had at least stage 3 cancer (58.8%). Family caregivers reported average SE. The predictors of SE were as follows: patients' functional status (β = 40.90, P = .001), patients' pain intensity (β = -15.10, P = .036), FCGs' confidence in controlling the patients' pain (β = 28.80, P = .000), FCGs' self-rated health (β = -25.90, P = .038), and interaction of FCGs' knowledge level with patients' pain intensity (β = -1.31, P = .008), caregiving hours (β = -0.10, P = .025), and impact of caregiving on FCGs' physical health (β = 1.29, P = .031). Family caregivers' health status, knowledge, caregiving demands, patient functional status, and pain intensity have a significant effect on caregivers' symptom management. A deliberate model of care that includes supportive interventions to enhance the abilities of FCGs with symptom management is needed in Oman.