Testing the Implementation of a Pain Self-management Support Intervention for Oncology Patients in Clinical Practice: A Randomized Controlled Pilot Study (ANtiPain)
Testing the Implementation of a Pain Self-management Support Intervention for Oncology Patients in Clinical Practice: A Randomized Controlled Pilot Study (ANtiPain)
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DOI：
10.1097/ncc.0000000000000502
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发表时间：
2018-09-01
期刊：
影响因子：
2.6
通讯作者：
Becker, Gerhild
中科院分区：
文献类型：
--
作者：
Koller, Antje;Gaertner, Jan;Becker, Gerhild
背景：在肿瘤学中，疼痛控制是一个持续存在的问题。癌症疼痛管理的重大障碍与患者相关。疼痛自我管理支持干预已被证明可以降低疼痛强度和患者相关障碍。比较有效性研究是一种合适的方法来测试效果是否在临床实践中持续。目的：在这项试点随机对照试验中，将ANtiPain干预措施应用于临床实践，以评估其对疼痛强度、功能相关结局、自我效能和患者相关疼痛管理障碍的影响，为更大规模的有效性试验做准备。方法：在14个月内，在德国南部的一个学术性综合癌症中心招募了39名疼痛评分为3分或更高的成年肿瘤患者。对照组（n = 19）患者接受标准护理。干预组患者（n = 20）接受ANtiPain，这是一种基于3个关键策略的癌痛自我管理支持干预：提供信息、技能培养和护士指导。在医院进行了干预治疗。出院后，通过电话进行随访。在基线和出院后1周和6周收集数据。结果：发现活动障碍（科恩d = 0.90），障碍（d = 0.91），和自我效能（d = 0.90）的大的影响。平均和最严重的疼痛（科恩d = 0.17-0.45）。结论：这项研究的主要结果涉及功能相关的结果和自我efficacy.Implications for Practice：因为这些结果是特别有意义的患者，ANtiPain的整合到常规的临床实践可能是实质性的。一项更大的研究将基于这些发现。
Background: In oncology, pain control is a persistent problem. Significant barriers to cancer pain management are patient related. Pain self-management support interventions have shown to reduce pain intensity and patient-related barriers. Comparative effectiveness research is a suitable approach to test whether effects are sustained in clinical practice.Objective: In this pilot randomized controlled trial, the implementation of the ANtiPain intervention into clinical practice was tested to assess the effects on pain intensity, function-related outcomes, self-efficacy, and patient-related barriers to pain management to prepare a larger effectiveness trial.Methods: Within 14 months, 39 adult oncology patients with pain scores of 3 or higher on a 10-point numeric rating scale were recruited in an academic comprehensive cancer center in Southern Germany. Patients in the control group (n = 19) received standard care. Patients in the intervention group (n = 20) received ANtiPain, a cancer pain self-management support intervention based on 3 key strategies: provision of information, skill building, and nurse coaching. An intervention session was performed in-hospital. After discharge, follow-up was provided via telephone calls. Data were collected at baseline and 1 and 6 weeks after discharge. Effect sizes were calculated for all outcomes.Results: Large effects were found for activity hindrance (Cohen d = 0.90), barriers (d = 0.91), and self-efficacy (d = 0.90). Small to moderate effects were found for average and worst pain (Cohen d = 0.17-0.45).Conclusions: Key findings of this study involved function-related outcomes and self-efficacy.Implications for Practice: Because these outcomes are particularly meaningful for patients, the integration of ANtiPain to routine clinical practice may be substantial. A larger study will be based on these findings.