The Usefulness of a Daily Pain Management Diary for Outpatients With Cancer-Related Pain

Karen Schumacher

Setsuko Koresawa

Claudia M. West

Marylin Dodd

Steven M. Paul

Debu Tripathy

Peter Koo

Christine Miaskowski

ONF 2002, 29(9), 1304-1313. DOI: 10.1188/02.ONF.1304-1313

Purpose/Objectives: To describe the usefulness of daily pain management diaries to outpatients with cancer who participated in a randomized clinical trial of the PRO-SELF© Pain Control Program.

Design: Randomized clinical trial in which a daily pain management diary was used for data collection in the control group and for data collection and nurse coaching regarding the pain management program in the intervention group.

Setting: Seven outpatient oncology settings.

Sample: 155 patients with pain from bone metastases and 90 family caregivers.

Methods: Content and statistical analysis of audiotaped answers to a semistructured questionnaire.

Main Research Variables: Patients' and family caregivers' perceptions of the usefulness of a daily pain management diary; specific ways in which the diary was used.

Findings: Patients in both the intervention (75%) and control groups (73%) found the diary useful. The diary was used to heighten awareness of pain, guide pain management behavior, enhance a sense of control, and facilitate communication. Family caregivers in both groups also reported that the diary was useful.

Conclusions: The completion of a daily pain management diary is useful to patients and family caregivers and may function as an intervention for self-care.

Implications for Nursing: Research-based evidence supports the importance of using a daily pain management diary in clinical practice.

Jump to a section

    References

    Allard, P., Maunsell, E., Labbé, J., & Dorval, M. (2001). Educational interventions to improve cancer pain control: A systematic review. Journal of Palliative Medicine, 4, 191-203.

    Avery, C.H., March, J., & Brook, R.H. (1980). An assessment of the adequacy of self-care by adult asthmatics. Journal of Community Health, 5, 167-180.

    Ayres, J.G., Campbell, L.M., & Follows, R.M.A. (1996). A controlled assessment of an asthma self-management plan involving a budesonide dose regimen. OPTIONS research group. European Respiratory Journal, 9, 886-892.

    Blake, F., Salkovskis, P., Gath, D., Day, A., & Garrod, A. (1998). Cognitive therapy for premenstrual syndrome: A controlled trial. Journal of Psychosomatic Research, 45, 307-318.

    Burman, M.E. (1995). Health diaries in nursing research and practice. Image: Journal of Nursing Scholarship, 27, 147-152.

    Burrows, M., Dibble, S., & Miaskowski, C. (1998). Differences in outcomes among patients experiencing different types of cancer-related pain. Oncology Nursing Forum, 25, 735-741.

    Clarke, W.L., Cox, D.J., Gonder-Frederick, L.A., Julian, D., Schlundt, D., & Polonsky, W. (1995). Reduced awareness of hypoglycemia in adults with IDDM. Diabetes Care, 18, 517-522.

    Cruise, E.C., Broderick, J., Porter, L., Kaell, A., & Stone, A.A. (1996). Reactive effects of diary self-assessment in chronic pain patients. Pain, 67, 253-258.

    de Wit, R., van Dam, F., Hanneman, M., Zandbelt, L., van Buuren, A., van der Heijden, K., et al. (1999). Evaluation of the use of a pain diary in chronic cancer pain patients at home. Pain, 79, 89-99.

    de Wit, R., van Dam, F., Zandbelt, L., van Buuren, A., van der Heijden, K., Leenhousts, G., et al. (1997). A pain education program for chronic cancer pain patients: Follow-up results from a randomized controlled trial. Pain, 73, 55-69.

    Dodd, M.J. (1984). Measuring informational intervention for chemotherapy knowledge and self-care behavior. Research in Nursing and Health, 7, 43-50.

    Dodd, M.J. (1988). Efficacy of proactive information on self-care in chemotherapy patients. Patient Education and Counseling, 11, 215-225.

    Du Pen, S.L., Du Pen, A.R., Polissar, N., Hansberry, J., Kraybill, B.M., Stillman, M., et al. (1999). Implementing guidelines for cancer pain management: Results of a randomized controlled clinical trial. Journal of Clinical Oncology, 17, 361-370.

    Fawzy, A., Vashi, V., Chung, M., Dias, N., & Gaffney, M. (1999). Clinical correlation of maximal urinary flow rate and plasma doxazosin concentrations in the treatment of benign prostatic hyperplasia. Multicenter Study Group. Urology, 53, 329-335.

    Ferrell, B.R., Ferrell, B.A., Ahn, C., & Tran, K. (1994). Pain management for elderly patients with cancer at home. Cancer, 74(Suppl. 7), 2139-2146.

    Ferrell, B.R., Ferrell, B.A., Rhiner, M., & Grant, M. (1991). Family factors influencing cancer pain management. Postgraduate Medical Journal, 67(Suppl. 2), S64-S69.

    Follick, M.J., Ahern, D.K., & Laser-Wolston, N. (1984). Evaluation of a daily activity diary for chronic pain patients. Pain, 19, 373-382.

    Freer, C.B. (1980). Self care: A health diary study. Medical Care, 18, 853-861.

    Geddes, D.M., Dones, L., Hill, E., Law, K., Harper, P.G., Spiro, S.G., et al. (1990). Quality of life during chemotherapy for small cell lung cancer: Assessment and use of a daily diary card in a randomized trial. European Journal of Cancer, 26, 4484-4492.

    Glover, J., Dibble, S.L., Dodd, M.J., & Miaskowski, C. (1995). Mood states of oncology outpatients: Does pain make a difference? Journal of Pain and Symptom Management, 10, 120-128.

    Grant, M.M., & Rivera, L.M. (1995). Pain education for nurses, patients, and families. In D.B. McGuire, C.H. Yarbro, & B.R. Ferrell (Eds.), Cancer pain management (2nd ed., pp. 289-319). Boston: Jones and Bartlett.

    Helman, C.G. (1994). Culture, health and illness. Oxford: Butterworth-Hinemann.

    Hickey, T., Akiyama, H., & Rakowski, W. (1991). Daily illness characteristics and health care decisions of older people. Journal of Applied Gerontology, 10, 169-184.

    Honkoop, P.C., Sorbi, M.J., Godaert, G.L., & Spierings, E.L. (1999). Highdensity assessment of the IHS classification criteria for migraine without aura: A prospective study. Cephalgia, 19, 201-206.

    Jacox, A., Carr, D.B., Payne, R., et al. (1994). Management of cancer pain: Clinical practice guideline, number9 (AHCPR Publication No. 94-0593). Rockville, MD: Agency for Health Care Policy and Research, U.S. Department of Health and Human Services, Public Health Service.

    Jamison, R., & Brown, G.K. (1991). Validation of hourly pain intensity profiles with chronic pain patients. Pain, 45, 123-128.

    Janson-Bjerklie, S., & Shnell, S. (1988). Effect of peak flow information on patterns of self-care in adult asthma. Heart and Lung, 17, 543-549.

    Jensen, M.P., Karoly, P., & Braver, S. (1986). The measurement of clinical pain intensity: A comparison of six methods. Pain, 27, 117-126.

    Juarez, G., Ferrell, B., & Borneman, T. (1998). Influence of culture on cancer pain management in Hispanic patients. Cancer Practice, 6, 262-269.

    Karnofsky, D. (1977). Performance scale. In G.T. Kennealley & M.S. Mitchell (Eds.), Factors that influence the therapeutic response in cancer. New York: Plenum Press.

    Lefebvre, J.C., Keefe, F.J., Affleck, G., Raezer, L.B., Starr, K., Caldwell, D.S., et al. (1999). The relationship of arthritis self-efficacy to daily pain, daily mood, and daily pain coping in rheumatoid arthritis patients. Pain, 80, 425-435.

    Lewis, B., Lewis, D., & Cumming, G. (1995). Frequent measurement of chronic pain: An electronic diary and empirical findings. Pain, 60, 341-347.

    Maunsell, E., Allard, P., Dorval, M., & Labbé, J. (2000). A brief pain diary for ambulatory patients with advanced cancer: Acceptability and validity. Cancer, 88, 2387-2397.

    McCaffery, M. (1999). Pain: Clinical manual (2nd ed.). St. Louis, MO: Mosby.

    McGuire, D.B. (1995). The multiple dimensions of cancer pain: A framework for assessment and management. In D.B. McGuire, C.H. Yarbro, & B.R. Ferrell (Eds.), Cancer pain management (2nd ed., pp. 1-17). Boston: Jones and Bartlett.

    McGuire, D.B., Yarbro, C.H., & Ferrell, B.R. (Eds.). (1995). Cancer pain management (2nd ed.). Boston: Jones and Bartlett.

    Miaskowski, C., & Dibble, S.L. (1995). The problem of pain in outpatients with breast cancer. Oncology Nursing Forum, 22, 791-797.

    Miaskowski, C., Dodd, M.J., West, C., Schumacher, K., Paul, S.M., Tripathy, D., et al. (2001). A randomized clinical trial of the effectiveness of the PRO-SELF© Pain Control Program in improving cancer pain management. Manuscript submitted for publication.

    Miaskowski, C., Zimmer, E.F., Barrett, K.M., Dibble, S.L., & Wallhagen, M. (1997). Differences in patients' and family caregivers' perceptions of the pain experience influence patient and caregiver outcomes. Pain, 72, 217-226.

    Milanowski, J., Qualtrough, J., & Perrin, V.L. (1999). Inhaled beclomethasone (BDP) with non-CFC propellant (HFA 134a) is equivalent to BDP-CFC for the treatment of asthma. Respiratory Medicine, 93, 245-251.

    Mitchell, E.S., Woods, N.F., & Lentz, M.J. (1994). Differentiation of women with three perimenstrual symptom patterns. Nursing Research, 43, 25-30.

    Moscato, G., Dellabianca, A., Perfetti, L., Bramè, B., Galdi, E., Niniano, R., et al. (1999). Occupational asthma: A longitudinal study on the clinical and socioeconomic outcome after diagnosis. Chest, 115, 249-256.

    Musci, E.C., & Dodd, M.J. (1990). Predicting self-care with patients and family members' affective states and family functioning. Oncology Nursing Forum, 17, 394-400.

    Nail, L.M., Jones, L.S., Greene, D., Schipper, D.L., & Jensen, R. (1991). Use and perceived efficacy of self-care activities in patients receiving chemotherapy. Oncology Nursing Forum, 18, 883-887.

    Nathan, R.A., Minkwitz, M.C., & Bonuccelli, C.M. (1999). Two first-line therapies in the treatment of mild asthma: Use of peak flow variability as a predictor of effectiveness. Annals of Allergy, Asthma, and Immunology, 82, 497-503.

    Oleske, D.M., Heinze, S., & Otte, D.M. (1990). The diary as a means of understanding the quality of life of persons with cancer receiving home nursing care. Cancer Nursing, 13, 158-166.

    Polit, D., & Hungler, B. (1978). Nursing research: Principles and methods. Philadelphia: Lippincott.

    Porter, D., Leviton, A., Slack, W.V., & Graham, J.R. (1981). A headache chronicle: The daily recording of headaches and their correlates. Journal of Chronic Disease, 34, 481-486.

    Richardson, A. (1994). The health diary: An examination of its use as a data collection method. Journal of Advanced Nursing, 19, 782-791.

    Richardson, A., Ream, E., & Wilson-Barnett, J. (1998). Fatigue in patients receiving chemotherapy: Patterns of change. Cancer Nursing, 21, 17-30.

    Ross, M.M., Rideout, E.M., & Carson, M.M. (1994). The use of the diary as a data collection technique. Western Journal of Nursing Research, 16, 4414-4425.

    Schumacher, K.L., Koresawa, S., West, C., Hawkins, C., Johnson, C., Wis, E., et al. (2002). Putting cancer pain management regimens into practice at home. Journal of Pain and Symptom Management, 23, 369-382.

    Schwartz, A.L. (2000). Daily fatigue patterns and effect of exercise in women with breast cancer. Cancer Practice, 8, 16-24.

    Silvers, D., Kipnes, M., Broadstone, V., Patterson, D., Quigley, E.M.M., McCallum, R., et al. (1998). Domperidone in the management of symptoms of diabetic gastroparesis: Efficacy, tolerability, and quality-of-life outcomes in a multicenter controlled trial. DOM-USA-5 study group. Clinical Therapeutics, 20, 438-453.

    Spross, J.A., & Burke, M.W. (1995). Nonpharmacological management of cancer pain. In D.B. McGuire, C.H. Yarbro, & B.R. Ferrell (Eds.), Cancer pain management (2nd ed., pp. 159-205). Boston: Jones and Bartlett.

    Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. (1998). Number 10. The management of chronic pain in patients with breast cancer. Canadian Medical Association Journal, 158(Suppl. 3), S71-S81.

    Stewart, W.F., Lipton, R.B., Simon, D., Liberman, J., & Von Korff, M. (1999). Validity of an illness severity measure for headache in a population sample of migraine sufferers. Pain, 79, 291-301.

    Stoller, E.P., & Forster, L.E. (1992). Patterns of illness behavior among rural elderly: Preliminary results of a health diary study. Journal of Rural Health, 8, 13-26.

    Sveinsdóttir, H. (1998). Prospective assessment of menstrual and premenstrual experiences of Icelandic women. Health Care for Women International, 19, 71-82.

    Thys-Jacobs, S., Alvir, J.J., & Fratarcangelo, P. (1995). Comparative analysis of three PMS assessment instruments--The identification of premenstrual syndrome with core symptoms. Psychopharmacology Bulletin, 31, 389-396.

    Verbrugge, L.M. (1980). Health diaries. Medical Care, 18, 73-95.

    West, C.M., Dodd, M.J., Paul, S.M., Schumacher, K., Tripathy, D., Koo, P., et al. (in press). The PRO-SELF® pain control program: An effective approach for cancer pain management. Oncology Nursing Forum.

    Woods, N.F. (1985). Self-care practices among young adult married women. Research in Nursing and Health, 8, 227-233.

    Yeager, K., Miaskowski, C., Dibble, S.L., & Wallhagen, M. (1995). Differences in pain knowledge and perceptions of the pain experience between outpatients with cancer and their family caregivers. Oncology Nursing Forum, 22, 1235-1241.