Pain knowledge of patients and family caregivers as predictors of pain management outcomes in cancer patients: a multicenter study in China.

PURPOSE: The purposes of this study were to evaluate the current situation of pain management outcomes, patients' pain knowledge, and family caregivers' pain knowledge in China and explore the impact of pain knowledge of patients and family caregivers on pain management outcomes. METHODS: A total of 410 patient-family caregiver dyads were assessed by Brief Pain Inventory (BPI), the Pain Knowledge subscales of Patient Pain Questionnaire (PPQ), and Family Pain Questionnaire (FPQ). The difference in pain management outcomes was analyzed using bivariate analysis first, and then variables with statistical significance in bivariate analysis were included in multivariable linear regression analysis. RESULTS: The average patient pain score in the last 24 h was 3.23 (SD = 2.16). The total average scores on pain knowledge of 410 patients and family caregivers were 3.60 ± 1.90 and 3.57 ± 1.76. Multivariable linear regression analysis showed taking strong opioids, patients' perceived moderate health status, patients' pain knowledge, and family caregivers' pain knowledge were the main factors influencing the pain management outcomes. CONCLUSION: Pain knowledge of patients and family caregivers were important indicators of pain management outcomes, indicating tailored cancer pain education program should be developed.

Structural Equation Model of Factors Related to Death Anxiety for Chinese Patients with Cancer.

This study aimed to develop a model that specifies the predictive effects of factors on death anxiety among Chinese patients with cancer using structural equation modeling. Using convenience sampling, data were collected from 353 cancer patients. Self-administered questionnaires included Social Support Rating Scale, Rosenberg Self-Esteem Scale, Connor Davidson Resilience Scale, Templer's Death Anxiety Scale, and socio-demographic factors. The results showed that social support, self-esteem, and resilience significantly impacted death anxiety. The final model fitted the data acceptably (χ2 = 37.319, df =31, p = 0.201). Social support mediated death anxiety through self-esteem and resilience. Resilience mediated the buffer effect of self-esteem on death anxiety as an intermediary factor. Findings suggest the need for further studies to explore effective interventions to provide social support and improve self-esteem and resilience among patients with cancer to alleviate death anxiety.

Congruence of cancer pain experience between patients and family caregivers and associated factors: a multicenter cross-sectional study in China.

PURPOSE: The purposes of this study were to determine whether there were differences in the cancer pain experience between patients and family caregivers (FCGs) and to explore the associated factors that influence cancer pain experience congruence. METHODS: A multicenter cross-sectional study was conducted. A total of 410 patient-family caregiver dyads completed face-to-face surveys, including information about basic characteristics, the Patient Pain Questionnaire (PPQ), and the Family Pain Questionnaire (FPQ). The difference in cancer pain experience between patients and family caregivers was analyzed using a paired t test. Indicators for the congruence of cancer pain experience were analyzed using the chi-square test and two independent-sample t tests for bivariate analysis and multivariate binary logistic regression analysis. RESULTS: Of the patients, 57.1% were men, and 60.7% perceived moderate performance status. The majority of the family caregivers was female (54.9%). The mean (SD) score on the pain experience subscale was 4.82 (1.66) for 410 patients and 5.02 (1.66) for 410 family caregivers. The difference was significant (P < 0.01). Additionally, 87 (21.2%) dyads were in the congruent group, and 323 (78.8%) dyads were in the incongruent group. Patients' self-perceived moderate performance status (OR = 2.983, P < 0.01) and family caregivers' pain knowledge (OR = 1.171, P < 0.05) were the main factors influencing the congruence of cancer pain experience. CONCLUSION: The findings of this study indicate that family caregivers reported significantly worse cancer pain experiences than patients. Family caregivers' pain knowledge was a primary influencing factor. It is suggested that educational interventions aimed at teaching family caregivers and patients how to communicate their pain experience and improving the knowledge of family members regarding pain and its management may help in aligning their perceptions and thereby contribute to better quality of life and pain management outcomes.

Effectiveness of palliative care simulation in newly hired oncology nurses' training.

Objective: The aim of the study was to evaluate the effectiveness of palliative care simulations with standardized patients in improving the knowledge, skill performance, and critical thinking of newly hired oncology nurses. Methods: By convenience sampling, 59 newly hired oncology nurses in 2019 were enrolled as control group and 50 in 2020 as simulation group at a grade-A tertiary cancer hospital. Simulation group accepted theory (3 sessions) and simulation teaching includes three representative scenarios (6 sessions) in palliative care: pain management, special scenario communication, and turn over. Control group accepted traditional theory and skill teaching (9 sessions). Then both groups underwent four weeks clinical practice. The knowledge score was assessed by knowledge questionnaires, skill performance by standardized clinical evaluations, and critical thinking by the California Critical Thinking Disposition Inventory in both groups before and after intervention. The satisfaction of two groups was assessed by the learning satisfaction scale. Analysis of variance was conducted among the two groups by SPSS20.0. A difference was considered significant when P â€‹< â€‹0.05. Results: After intervention, the simulation group was significantly greater in knowledge of pain management (t â€‹= â€‹-7.560, P â€‹< â€‹0.001), and knowledge of special scenario communication (Z â€‹= â€‹5.031, P â€‹< â€‹0.001), as well as the skill score of turnover (Z â€‹= â€‹2.808, P â€‹= â€‹0.005) than the control group. The critical-thinking score was also significantly greater in the simulation group (Z â€‹= â€‹6.229, P â€‹< â€‹0.001). The simulation group had higher satisfaction (Z â€‹= â€‹5.144，P â€‹< â€‹0.001). Conclusions: Palliative care simulation with standardized patients can improve newly hired oncology nurses' knowledge, skill performance, and critical thinking and satisfaction of teaching. It would be an effective strategy to train newly hired oncology nurses.

Validation of the Constipation Risk Assessment Scale (CRAS) in Chinese cancer patients.

PURPOSE: The Constipation Risk Assessment Scale (CRAS) is a valid tool for predicting the risk of developing constipation. This study aimed to translate the CRAS into Chinese and evaluate its psychometric properties in Chinese cancer patients. METHOD: The CRAS was translated into Chinese following standard forward- and back-translation procedures. Scale and item indices were calculated for content validity (S-CVI; I-CVI). In total, 175 cancer patients were assessed with the CRAS on the first day of antitumour treatment, of whom 145 were submitted to the predictive validity test, and their defecation pattern, stool consistency, and ease of defecation were assessed for one week. A receiver operating characteristic (ROC) curve was used to describe the prediction accuracy of CRAS-C for constipation. Reliability was evaluated by means of an interrater reliability test using the intraclass correlation coefficient (ICC) in 30 patients. RESULTS: The S-CVI was 0.99, and for each item, the I-CVI was 0.80-1.00. The area under the curve of CRAS-C was 0.722 (95% CI, 0.631-0.812). A CRAS-C score ≥11 indicated a high constipation risk, and a score <11 indicated a low constipation risk. The sensitivity and specificity were 0.887 (95% CI, 0.763-0.953) and 0.500 (95% CI, 0.376-0.624), respectively, and the positive predictive value and negative predictive value were 0.588 (95% CI, 0.472-0.695) and 0.846 (95% CI, 0.688-0.936), respectively. The ICC between the two raters for the total CRAS-C score was 0.963, and the ICC in the four subscales was 0.843-0.955. CONCLUSIONS: The CRAS-C demonstrated favourable content validity, predictive validity and interrater reliability. It can be used in the identification of subjects at risk of constipation and the development of constipation prevention programmes in Chinese cancer patients.

Correlates of Physical Activity in Colorectal Cancer Patients Based on Health Promotion Model.

BACKGROUND: Increasing attention is being given to physical activity in colorectal cancer patients. Some studies have explored a few correlates of physical activity separately. A contemporary study based on the Health Promotion Model may systematically broaden the understanding of physical activity in colorectal cancer patients. OBJECTIVE: To understand the status of physical activity in Chinese colorectal cancer patients and to explore the correlated factors. METHODS: A total of 168 adults with colorectal cancer were recruited at 3 tertiary hospitals in China. Participant data were collected on demographics, physical activity, biological factors, anxiety and depression, benefits/barriers to physical activity, self-efficacy, and social support. SAS 8.2 was used for statistical analysis, including descriptive analysis, correlation analysis, single factor analysis, and multiple stepwise regression analysis. RESULTS: Only 25.60% of colorectal cancer survivors reached the requirements of the Colorectal Cancer Survivorship Care Guidelines. Employment states, number of complications, fatigue, body image, depression, perception of benefits/barriers, and self-efficacy were closely correlated with physical activity in Chinese colorectal cancer patients. CONCLUSIONS: The physical activity status of patients with colorectal cancer is not optimal. The correlated factors that nurses can take measures to improve are fatigue, body image, depression, perception of benefits/barriers, and self-efficacy, which may improve physical activity in colorectal cancer patients in China. Additional research is needed to determine if improving factors correlated with physical activity will assist with directly increasing physical activity. IMPLICATIONS FOR PRACTICE: Nurses should evaluate physical activity of colorectal cancer patients timely and play an active role in health promotion programs to improve colorectal cancer patients' physical activity.