Lee, Y.J., Hyun, M.K., Jung, Y.J., Kang, M.J., Keam, B., & Go, S.J. (2014). Effectiveness of education interventions for the management of cancer pain: A systematic review. Asian Pacific Journal of Cancer Prevention, 15, 4787–4793.

DOI Link

Purpose

STUDY PURPOSE: To evaluate evidence of the effectiveness of education interventions in pain management

TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: MEDLINE, EMBASE, Cochrane Library, KISS, KMBASE, and KoreaMed
 
KEYWORDS: MeSH headings and keywords for neoplasems, analgesics, various specific opioids, health education, and pain management
 
INCLUSION CRITERIA: English or Korean language; peer-reviewed publication; trials investigating educational interventions for pain; included both randomized, controlled trials and nonrandomized studies

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 3,324
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies (ACROBAT-NRSI) and the Cochrane tool for randomized studies

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 27 with ten randomized, controlled trials included in the meta-analysis
  • TOTAL PATIENTS INCLUDED IN REVIEW = 2,380
  • SAMPLE RANGE ACROSS STUDIES: 30–1,256 patients
  • KEY SAMPLE CHARACTERISTICS: Not provided

Results

The most frequent educational used tool was a booklet. A few studies involved the discussion of self-control and relaxation, but most of the content was description of pain management and misconceptions regarding the use of opioids. An analysis of seven randomized, controlled trials' (using the Brief Pain Inventory) effects on severe pain showed an SMD –0.34 (CI = 95%, –0.55, –0.13, p = 0.001). The SMD of average pain was –0.73 (CI = 95%, –0.64, –0.15, p = 0.002). The effects on pain in studies using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire showed no significant effect.

Conclusions

This analysis suggests that educational interventions have a positive effect on pain control.

Limitations

  • High heterogeneity in the analysis
  • Diverse educational interventions
  • The analysis included a few studies that also incorporated more psychoeducational types of interventions; however, these were included with simple educational booklet use in the meta-analysis.
  • Most of the studies had an undetermined risk of bias.

Nursing Implications

The findings of this meta-analysis need to be viewed with some caution given the heterogeneity found in the analysis, the risk of bias determined. and the lack of differentiation between the education provided via booklets or other materials and the psychoeducational interventions that also included counseling, discussion, and relaxation techniques. However, it is clear that patients who need pain management also need education for self-management. Yet it is not clear if simple education alone is sufficient to facilitate effective patient self-management with analgesics.

Legacy ID

5198