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A qualitative study of patient and provider perspectives on using web-based pain coping skills training to treat persistent cancer pain

Published online by Cambridge University Press:  07 March 2017

Christine Rini ,
Maihan B. Vu ,
Hannah Lerner ,
Catherine Bloom ,
Jessica Carda-Auten ,
William A. Wood ,
Ethan M. Basch ,
Peter M. Voorhees ,
Katherine E. Reeder-Hayes  and
Francis J. Keefe
Christine Rini*
Affiliation:
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
Maihan B. Vu
Affiliation:
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina
Hannah Lerner
Affiliation:
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
Catherine Bloom
Affiliation:
Duke Clinical Research Institute, Durham, North Carolina
Jessica Carda-Auten
Affiliation:
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
William A. Wood
Affiliation:
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
Ethan M. Basch
Affiliation:
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
Peter M. Voorhees
Affiliation:
Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina
Katherine E. Reeder-Hayes
Affiliation:
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
Francis J. Keefe
Affiliation:
Duke University Medical Center, Durham, North Carolina
*
Address correspondence and reprint requests to: Christine Rini, who is now at the John Theurer Cancer Center, Hackensack University Medical Center, 40 Prospect Avenue, Jurist Research Building, Room 302, Hackensack, New Jersey, 07601. E-mail: christine.rini@hackensackmeridian.org.
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Abstract

Objective:

Persistent pain is common and inadequately treated in cancer patients. Behavioral pain interventions are a recommended part of multimodal pain treatments, but they are underused in clinical care due to barriers such as a lack of the resources needed to deliver them in person and difficulties coordinating their use with clinical care. Pain coping skills training (PCST) is an evidence-based behavioral pain intervention traditionally delivered in person. Delivering this training via the web would increase access to it by addressing barriers that currently limit its use. We conducted a patient pilot study of an 8-week web-based PCST program to determine the acceptability of this approach to patients and the program features needed to meet their needs. Focus groups with healthcare providers identified strategies for coordinating the use of web-based PCST in clinical care.

Method:

Participants included 7 adults with bone pain due to multiple myeloma or metastasized breast or prostate cancer and 12 healthcare providers (4 physicians and 8 advanced practice providers) who treat cancer-related bone pain. Patients completed web-based PCST at home and then took part in an in-depth qualitative interview. Providers attended focus groups led by a trained moderator. Qualitative analyses identified themes in the patient and provider data.

Results:

Patients reported strongly favorable responses to web-based PCST and described emotional and physical benefits. They offered suggestions for adapting the approach to better fit their needs and to overcome barriers to completion. Focus groups indicated a need to familiarize healthcare providers with PCST and to address concerns about overburdening patients. Providers would recommend the program to patients they felt could benefit. They suggested applying a broad definition of cancer pain and having various types of providers help coordinate program its use with clinical care.

Significance of results:

Web-based PCST was acceptable to patients and providers. Our findings suggest that patients could benefit from this approach, especially if patient and provider barriers are addressed.

Keywords

Cancer painPain coping skills trainingeHealthCognitive behavioral interventionPain management
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Issue 2 , April 2018 , pp. 155 - 169
Copyright
Copyright © Cambridge University Press 2017 

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