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探討越南癌症病人疼痛控制的病人相關障礙因子
Other Title
Patient-related barriers to cancer pain management in North Vietnam
Type
thesis
Date Issued
2017-06-26
Author(s)
阮 银 江
Advisor
林佳靜
Subjects
系所名稱：護理學系碩士暨碩士在職專班
Description
學位別：碩士
語文別：英文
指導教授：林佳靜
口試委員：郭淑瑜;邱曉彥
中文關鍵字：病人相關障礙因子;癌症疼痛;疼痛處置
英文關鍵字：patient-related barriers;cancer pain;pain management
語文別：英文
指導教授：林佳靜
口試委員：郭淑瑜;邱曉彥
中文關鍵字：病人相關障礙因子;癌症疼痛;疼痛處置
英文關鍵字：patient-related barriers;cancer pain;pain management
Abstract
ABSTRACT
Title of Thesis: Patient-related barriers to cancer pain management in North Vietnam
Institution: School of Nursing, Taipei Medical University Author: Nguyen Ngan Giang
Thesis Advisor: Professor, Chia-Chin Lin
Holding concerns and misconceptions about analgesics using are common among patients with cancer. Those may lead patients to be reluctant to report pain and/or receive the appropriate analgesics and serve as barriers to pain management. The Barriers Questionnaire-II is a tool used to evaluate attitudinal barriers to optimal pain management worldwide. The purpose of this study was to explore the attitudinal barriers of cancer patient to effective cancer pain relief in North Vietnam. For this, a descriptive and cross-sectional study was conducted during August and September in 2016. Two hundred and thirty-two patients with cancer were recruited from Palliative Care and Pain Relief Department of Vietnam National Cancer Institute. Participants completed the Vietnamese Barrier Questionnaire-II form (VBQ-II), the Vietnamese Brief Pain Inventory and a demographic questionnaire. Internal consistency (⍺) for the total VBQ-II scale was 0.83 for the pilot study and was 0.87 for the main study. The total VBQ-II mean score (SD) was 3.26 (0.53), and for four subscale mean scores were Fatalism 2.26 (0.85); Harmful 3.22 (0.69); Physiological effects 3.27 (0.66); Communication 3.20 (0.83). Male was found to get stronger fatalism barrier than female [2.33 (0.87); 2.10 (0.81), respectively] but female got stronger physiological barrier than male [3.41 (0.67); 3.20 (0.65), respectively]. Patients who were higher education were found to get more concerns about harmful effects of using analgesics [3.37 (0.76); 3.18 (0.75), respectively]. Among patients reported having cancer-related pain on
II
the day they completed the questionnaires, who were inadequately medicated for pain had significantly higher score on the total VBQ-II mean than who were adequately medicated [the mean were 3.34 (0.57) and 3.16 (0.50) respectively]. Those patients who reported hesitancy to use pain medication had significantly higher score on the total VBQ-II mean than who did not hesitate [3.12 (0.6); 3.35 (0.46), respectively] and on several sub-scales. Those patients who reported hesitancy to report pain had significantly higher score on the total VBQ-II mean [3.18 (0.54); 3.35 (0.50), respectively] and the communication subscale [3.07 (0.80); 3.35 (0.84), respectively] than who did not hesitate. There was no significant association between barrier score and pain intensity and pain interference; and no significant association was found between participants’ characteristics and barrier scores and pain management variables.
This study provides baseline information about the patient-related barriers to effective cancer pain control at the Vietnam National Cancer Institute. The VBQ-II was demonstrated as a reliable and fairly valid measure of these barriers to cancer pain management.
Key words: patient-related barriers, cancer pain, pain management
Title of Thesis: Patient-related barriers to cancer pain management in North Vietnam
Institution: School of Nursing, Taipei Medical University Author: Nguyen Ngan Giang
Thesis Advisor: Professor, Chia-Chin Lin
Holding concerns and misconceptions about analgesics using are common among patients with cancer. Those may lead patients to be reluctant to report pain and/or receive the appropriate analgesics and serve as barriers to pain management. The Barriers Questionnaire-II is a tool used to evaluate attitudinal barriers to optimal pain management worldwide. The purpose of this study was to explore the attitudinal barriers of cancer patient to effective cancer pain relief in North Vietnam. For this, a descriptive and cross-sectional study was conducted during August and September in 2016. Two hundred and thirty-two patients with cancer were recruited from Palliative Care and Pain Relief Department of Vietnam National Cancer Institute. Participants completed the Vietnamese Barrier Questionnaire-II form (VBQ-II), the Vietnamese Brief Pain Inventory and a demographic questionnaire. Internal consistency (⍺) for the total VBQ-II scale was 0.83 for the pilot study and was 0.87 for the main study. The total VBQ-II mean score (SD) was 3.26 (0.53), and for four subscale mean scores were Fatalism 2.26 (0.85); Harmful 3.22 (0.69); Physiological effects 3.27 (0.66); Communication 3.20 (0.83). Male was found to get stronger fatalism barrier than female [2.33 (0.87); 2.10 (0.81), respectively] but female got stronger physiological barrier than male [3.41 (0.67); 3.20 (0.65), respectively]. Patients who were higher education were found to get more concerns about harmful effects of using analgesics [3.37 (0.76); 3.18 (0.75), respectively]. Among patients reported having cancer-related pain on
II
the day they completed the questionnaires, who were inadequately medicated for pain had significantly higher score on the total VBQ-II mean than who were adequately medicated [the mean were 3.34 (0.57) and 3.16 (0.50) respectively]. Those patients who reported hesitancy to use pain medication had significantly higher score on the total VBQ-II mean than who did not hesitate [3.12 (0.6); 3.35 (0.46), respectively] and on several sub-scales. Those patients who reported hesitancy to report pain had significantly higher score on the total VBQ-II mean [3.18 (0.54); 3.35 (0.50), respectively] and the communication subscale [3.07 (0.80); 3.35 (0.84), respectively] than who did not hesitate. There was no significant association between barrier score and pain intensity and pain interference; and no significant association was found between participants’ characteristics and barrier scores and pain management variables.
This study provides baseline information about the patient-related barriers to effective cancer pain control at the Vietnam National Cancer Institute. The VBQ-II was demonstrated as a reliable and fairly valid measure of these barriers to cancer pain management.
Key words: patient-related barriers, cancer pain, pain management