Patient empowerment in cancer pain management: an integrative review

Leppink, I.J.C. (2013) Patient empowerment in cancer pain management: an integrative review.

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Abstract:Background: Pain in patients with cancer is underestimated in prevalence and severity, although more than half of the patients with cancer experience pain. Whereas empowerment has been highlighted as central to success in nonmalignant pain management, empowerment has not been well studied in cancer pain management. The lack of an overview of the existing literature hampers the comparison of results across different studies and implementation of the research findings in everyday cancer pain practice. Aim: To provide an overview of the literature and give recommendations on patient empowerment in cancer pain management. The questions guiding this review are a) What does patient empowerment in cancer pain management comprise? b) How is the concept of patient empowerment operationalized in literature on cancer pain management? c) To what extent are empowerment-based interventions effective in improving cancer pain management? Study design and methods: An integrative review was conducted to develop understanding of empowerment and empowerment related concepts within pain management for patients with cancer. This method includes both empirical and theoretical publications. Databases PubMed, CINAHL and PsycINFO were searched for relevant publications from 1990 to April 2012. Two researchers independently reviewed each citation for inclusion and data on patient empowerment in cancer pain management were extracted and categorized for analysis. Results: The final selection resulted in 26 papers eligible for review. None of the publications gave an exact definition of patient empowerment in cancer pain management. Various empowerment-related concepts were mentioned in literature. All concepts considered relevant were categorized as ‘self-efficacy’ or ‘patient participation’. Self-efficacy was more extensively studied than patient participation in cancer pain management. Interventions that comprised education seemed most successful in improving pain management and coping skills training may have additional effects. An intervention in which the main informal caregiver was involved in education and training also showed additional positive effects on patient self-efficacy and pain measures. No additional effects were found for coaching or interventions comprising education that was customized to the individual patient. However, more research in this area of healthcare is necessary to substantiate the findings. Conclusion: Patient empowerment comprises the combination of active patient participation in and self-efficacy for cancer pain management. Education and training in pain management skills may improve patient empowerment. Since cancer patients experience specific barriers to pain management, it seems important that an educational intervention addresses all common barriers to cancer pain management and encourages patients’ active participation in their pain management. Future research should develop educational and skills-training interventions to increase active participation of cancer pain patients to self-manage their cancer pain.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
Link to this item:http://purl.utwente.nl/essays/63527
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