Impact of an Educational Program on Pain Management in Patients With Cancer Living at Home

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Abstract
To assess the effect of an educational homecare program on pain relief in patients with advanced cancer. Quasi-experimental (pretest post-test, nonequivalent group). Four community-based primary care centers providing social and healthcare services in the Quebec City region of Canada. 80 homecare patients with advanced cancer who were free of cognitive impairment, who presented with pain or were taking analgesics to relieve pain, and who had a life expectancy of six weeks or longer. The educational intervention included information regarding pain assessment and monitoring using a daily pain diary and the provision of specific recommendations in case of loss of pain control. Pain intensity data were collected prior to the intervention, and reassessments were made two and four weeks later. Data on beliefs were collected at baseline and two weeks. All data were collected by personal interviews. Patients beliefs about the use of opioids; average and maximum pain intensities. Patients beliefs regarding the use of opioids were modified successfully following the educational intervention. Average pain was unaffected in the control group and was reduced significantly in patients who received the educational program. The reduction remained after controlling for patients initial beliefs. Maximum pain decreased significantly over time in both the experimental and control groups. An educational intervention can be effective in improving the monitoring and relief of pain in patients with cancer living at home. Homecare nurses can be trained to effectively administer the educational program during their regular homecare visits.