Pain coping, multidisciplinary care, and mHealth: Patients' views on managing advanced cancer pain.

IF 3.3 2区 医学 Q2 ONCOLOGY
Psycho‐Oncology Pub Date : 2024-02-01 DOI:10.1002/pon.6308
Sara M DeForge, Kyla Smith, Kris-Ann Anderson, Ashton R Baltazar, Meghan Beck, Andrea C Enzinger, James A Tulsky, Matthew Allsop, Robert R Edwards, Kristin L Schreiber, Desiree R Azizoddin
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引用次数: 0

Abstract

Objective: Pain is common among people with advanced cancer. While opioids provide significant relief, incorporating psycho-behavioral treatments may improve pain outcomes. We examined patients' experiences with pain self-management and how their self-management of chronic, cancer-related pain may be complemented by behavioral mobile health (mHealth) interventions.

Methods: We conducted semi-structured qualitative interviews with patients with advanced cancer and pain. Each participant reviewed content from our behavioral mHealth application for cancer pain management and early images of its interface. Participants reflected on their experiences self-managing cancer pain and on app content. Interviews were transcribed verbatim and analyzed using a combination of inductive and deductive thematic analysis.

Results: Patients (n = 28; 54% female; mean age = 53) across two geographic regions reported using psychological strategies (e.g., reframing negative thoughts, distraction, pain acceptance, social support) to manage chronic cancer-related pain. Patients shared their perspectives on the integration of psycho-behavioral pain treatments into their existing medical care and their experiences with opioid hesitancy. Patient recommendations for how mHealth interventions could best support them coalesced around two topics: 1.) convenience in accessing integrated pharmacological and psycho-behavioral pain education and communication tools and 2.) relevance of the specific content to their clinical situation.

Conclusions: Integrated pharmacological and psycho-behavioral pain treatments were important to participants. This underscores a need to coordinate complimentary approaches when developing cancer pain management interventions. Participant feedback suggests that an mHealth intervention that integrates pain treatments may have the capacity to increase advanced cancer patients' access to destigmatizing, accessible care while improving pain self-management.

疼痛应对、多学科护理和移动医疗:患者对晚期癌症疼痛管理的看法。
目的:疼痛是晚期癌症患者的常见病。虽然阿片类药物能明显缓解疼痛,但结合心理行为治疗可能会改善疼痛的治疗效果。我们研究了患者在疼痛自我管理方面的经验,以及如何通过行为移动医疗(mHealth)干预来补充他们对慢性癌症相关疼痛的自我管理:我们对晚期癌症疼痛患者进行了半结构化定性访谈。每位参与者都查看了我们的癌症疼痛管理行为移动医疗应用程序的内容及其界面的早期图像。参与者对他们自我管理癌痛的经验和应用程序内容进行了反思。访谈内容逐字记录,并采用归纳和演绎相结合的主题分析方法进行分析:两个地区的患者(n = 28;54% 为女性;平均年龄 = 53)报告说,他们使用心理策略(如重构消极想法、转移注意力、接受疼痛、社会支持)来管理与癌症相关的慢性疼痛。患者分享了他们对将疼痛心理行为治疗纳入现有医疗护理的看法,以及他们对阿片类药物犹豫不决的经历。患者就移动医疗干预如何为他们提供最佳支持提出的建议主要围绕两个主题:1)获取综合药物和心理行为疼痛教育和交流工具的便利性;2)具体内容与他们临床情况的相关性:结论:综合药物和心理行为疼痛治疗对参与者非常重要。结论:综合药物治疗和心理行为治疗对参与者来说非常重要,这强调了在制定癌症疼痛管理干预措施时协调互补方法的必要性。参与者的反馈表明,整合疼痛治疗的移动医疗干预措施可能有能力增加晚期癌症患者获得去污名化、可获得的护理的机会,同时改善疼痛的自我管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Psycho‐Oncology
Psycho‐Oncology 医学-心理学
CiteScore
6.30
自引率
8.30%
发文量
220
审稿时长
3-8 weeks
期刊介绍: Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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