Abstract
The current study evaluated the oncology nurse’s knowledge, attitude, related factors of cancer-related pain management (CPM), and clinical recommendations for improving knowledge and attitude. In this systematic review, international databases (PubMed, EMBASE, Web of science (WOS), Science Direct, and Scopus) were searched for relevant studies published in English language from March 30, 2000 to March 30, 2018. The quality of the studies was evaluated using the Hoy instrument. Out of 888 initial studies, 12 studies performed on 3574 participants were included in the final stage of the review. Based on the results, most studies indicated that nurses had a poor (n = 4) or moderate (n = 4) knowledge of CPM. The lowest and the highest knowledge levels were 28.5% and 75%, respectively. According to most studies, nurses had a fair (average) (n = 4) or negative (n = 3) attitude toward CPM. The important factors related to the nurses’ knowledge of CPM included previous pain-related education programs (n = 7) and having work experience with cancer patients (n = 4). The most important barrier was the deficit in staff’s knowledge of pain (n = 2). The important clinical recommendations for improving nurses’ levels of knowledge included the implementation of educational programs (n = 9), training programs (n = 3) on CPM and including CPM topics in nursing curricula (n = 5). This systematic review showed that most nurses had poor knowledge of CPM and a fair attitude toward CPM, indicating the importance of considering the barriers to knowledge, strengthening the positive relevant factors, and using clinical recommendations based on clinical guidelines such as including CPM topics in nursing curricula and implementing educational programs on CPM to improve the knowledge, attitude, and skills of oncology nurses. The results of the present study could be used by policymakers to provide care for cancer patients and manage their pain.
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References
Bouya S, Rafiemanesh H, Balouchi A, Taheri S, Badakhsh M, Didehvar M (2018) Health-related quality of life of Iranian breast cancer patients: a meta-analysis and systematic review. Breast Cancer Res Treat 1–8
Ham O-K, Chee W, Im E-O (2017) The influence of social structure on cancer pain and quality of life. West J Nurs Res 39(12):1547–1566
Zylla D, Larson A, Chuy G, Illig L, Peck A, Van Peursem S, Fulbright JW, Pawloski PA, Richter S, Mettner J (2017) Establishment of personalized pain goals in oncology patients to improve care and decrease costs. J Oncol Pract 13(3):e266–e272
Haumann J, Joosten EBA, van den Beuken-van MHJ (2017) Pain prevalence in cancer patients: status quo or opportunities for improvement? Curr Opin Support Palliat Care 11(2):99–104
van den Beuken-van MHJ, Hochstenbach LMJ, Joosten EAJ, Tjan-Heijnen VCG, Janssen DJA (2016) Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. J Pain Symptom Manage 51(6):1070–1090. e1079
Oldenmenger WH, Geerling JI, Mostovaya I, Vissers KCP, de Graeff A, Reyners AKL, van der Linden YM (2018) A systematic review of the effectiveness of patient-based educational interventions to improve cancer-related pain. Cancer Treat Rev 63:96–103
Bouya S, Balouchi A, Ahmadidarehsima S, Badakhsh M (2018) Knowledge and source of information about early detection techniques of breast Cancer among women in Iran: a systematic review. J Cancer Prev 23(1):51–60
Alnajar MK, Darawad MW, Alshahwan SS, Samarkandi OA (2017) Knowledge and attitudes toward cancer pain management among nurses at oncology units. J Cancer Educ 1–8
Purkayastha A, Sarin A, Sharma N, Singh S, Bisht N (2018) Knowledge, attitude and practice of paramedical staff and nursing assistants towards Cancer Pain Management in a Tertiary Cancer Care Centre. Clin Oncol 3:1439
Jun M-H, Gong S-H, Lee S-H, Kim Y-H, Choi J-S, Park K-S (2006) Knowledge and attitude toward cancer pain management: clinical nurses versus doctors. J Korean Acad Soc Nursi Educ 12(1):115–123
Kim HJ, Park IS, Kang KJ (2012) Knowledge and awareness of nurses and doctors regarding cancer pain management in a tertiary hospital. Asian Oncol Nurs 12(2):147–155
Kim M-h, Park HG, Park EC, Park K (2011) Attitude and knowledge of physicians about cancer pain management: young doctors of South Korea in their early career. Jpn J Clin Oncol 41(6):783–791
Moher D, Liberati A, Tetzlaff J, Altman DG, Prisma Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097
McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C (2016) PRESS peer review of electronic search strategies: 2015 guideline statement. J Clin Epidemiol 75:40–46
Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, Baker P, Smith E, Buchbinder R (2012) Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol 65(9):934–939
Darawad M, Alnajar MK, Abdalrahim MS, El-Aqoul AM (2017) Cancer pain Management at Oncology Units: comparing knowledge, attitudes and perceived barriers between physicians and nurses. J Cancer Educ 1–9. doi:https://doi.org/10.1007/s13187-017-1314-4
Alqahtani M, Jones LK (2015) Quantitative study of oncology nurses' knowledge and attitudes towards pain management in Saudi Arabian hospitals. Eur J Oncol Nurs 19(1):44–49. https://doi.org/10.1016/j.ejon.2014.07.013
Bernardi M, Catania G, Lambert A, Tridello G, Luzzani M (2007) Knowledge and attitudes about cancer pain management: a national survey of Italian oncology nurses. Eur J Oncol Nurs 11(3):272–279. https://doi.org/10.1016/j.ejon.2006.09.003
Ferreira FS, Santos J, Meira KC (2016) Knowledge of resident nurses on the management of cancer pain: a crosssectional study. Online Braz J Nurs 15(4):694–703
Jho HJ, Kim Y, Kong KA, Kim DH, Choi JY, Nam EJ, Choi JY, Koh S, Hwang KO, Baek SK, Park EJ (2014) Knowledge, practices, and perceived barriers regarding cancer pain management among physicians and nurses in Korea: a nationwide multicenter survey. PLoS One 9(8):e105900. https://doi.org/10.1371/journal.pone.0105900
Lai YH, Chen ML, Tsai LY, Lo LH, Wei LL, Hong MY, Hsiu LN, Hsiao-Sheen ST, Chen SC, Kao CC, Huang TW, Chang SC, Chen L, Guo SL (2003) Are nurses prepared to manage cancer pain? A national survey of nurses' knowledge about pain control in Taiwan. J Pain Symptom Manag 26(5):1016–1025. https://doi.org/10.1016/S0885-3924(03)00330-0
Shahriary S, Shiryazdi SM, Shiryazdi SA, Arjomandi A, Haghighi F, Vakili FM, Mostafaie N (2015) Oncology nurses knowledge and attitudes regarding Cancer pain management. Asian Pac J Cancer Prev 16(17):7501–7506
Utne I, Smastuen MC, Nyblin U (2018) Pain knowledge and attitudes among nurses in Cancer Care in Norway. J Cancer Educ. https://doi.org/10.1007/s13187-018-1355-3
Xue Y, Schulman-Green D, Czaplinski C, Harris D, McCorkle R (2007) Pain attitudes and knowledge among RNs, pharmacists, and physicians on an inpatient oncology service. Clin J Oncol Nurs 11(5):687–695
Yildirim YK, Cicek F, Uyar M (2008) Knowledge and attitudes of Turkish oncology nurses about cancer pain management. Pain Manag Nurs 9(1):17–25. https://doi.org/10.1016/j.pmn.2007.09.002
Enskär K, Ljusegren G, Berglund G, Eaton N, Harding R, Mokoena J, Chauke M, Moleki M (2007) Attitudes to and knowledge about pain and pain management, of nurses working with children with cancer: a comparative study between UK, South Africa and Sweden. J Res Nurs 12(5):501–515. https://doi.org/10.1177/1744987107080455
Zhang Q, Yu C, Feng S, Yao W, Shi H, Zhao Y, Wang Y (2015) Physicians' practice, attitudes toward, and knowledge of Cancer pain Management in China. Pain Med (United States) 16(11):2195–2203. https://doi.org/10.1111/pme.12819
Peker L, Celebi N, Canbay Ö, Sahin A, Cakir B, Uzun S, Aypar U (2008) Doctors' opinions, knowledge and attitudes towards cancer pain management in a university hospital. Agri 20(2):20–30
Lou F, Shang S (2017) Attitudes towards pain management in hospitalized cancer patients and their influencing factors. Chin J Cancer Res 29(1):75–85
Lin C-C (2000) Barriers to the analgesic management of cancer pain: a comparison of attitudes of Taiwanese patients and their family caregivers. Pain 88(1):7–14
Hochberg U, Perez J, Borod M (2018) New frontier: cancer pain management clinical fellowship. Support Care Cancer 1–5
Kwon JH (2014) Overcoming barriers in cancer pain management. J Clin Oncol 32(16):1727–1733
Mann E, Carr E (2018) Pain management. Foundation Studies for Caring: Using Student-Centred Learning 259
Manchikanti L, Kaye AM, Knezevic NN, McAnally H, Slavin K, Trescot AM, Hirsch J (2017) Responsible, safe, and effective prescription of opioids for chronic non-cancer pain: American Society of Interventional Pain Physicians (ASIPP) guidelines. Pain Physician 20(2S):S3–S92
Syrjala KL, Jensen MP, Elena Mendoza M, Yi JC, Fisher HM, Keefe FJ (2014) Psychological and behavioral approaches to cancer pain management. J Clin Oncol 32(16):1703–1711
Xu X, Luckett T, Wang AY, Lovell M, Phillips JL (2018) Cancer pain management needs and perspectives of patients from Chinese backgrounds: a systematic review of the Chinese and English literature. Palliat Support Care 1–15
Alqahtani M, Jones LK (2015) Quantitative study of oncology nurses' knowledge and attitudes towards pain management in Saudi Arabian hospitals. Eur J Oncol Nurs 19(1):44–49
Elumelu TN, Adenipekun AA, Eriba LO, Akinlade BI (2014) Knowledge of cancer pain management among nurses in a Nigerian tertiary health institution. J Nurs Educ Pract 4(4):74
Samarkandi OA (2018) Knowledge and attitudes of nurses toward pain management. Saudi J Anaesth 12(2):220
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Bouya, S., Balouchi, A., Maleknejad, A. et al. Cancer Pain Management Among Oncology Nurses: Knowledge, Attitude, Related Factors, and Clinical Recommendations: a Systematic Review. J Canc Educ 34, 839–846 (2019). https://doi.org/10.1007/s13187-018-1433-6
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DOI: https://doi.org/10.1007/s13187-018-1433-6