Factors associate with opioid-taking self-efficacy among cancer patient with pain

• Main Authors: Ding, She-Anne, 丁熙安
• Other Authors: Liang, Shu-Yuan
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/69888624128032183435

碩士 === 國立臺北護理健康大學 === 護理研究所 === 101 === Abstract Pain is one of the most common cancer symptoms, and the most dreadful experience for cancer patients. Most cancer pain arises from treatment and in the later stage of the illness. Opioids are important medications for pain management, especially for relieving moderate or severe cancer-related pain. However, there are 38% to 85% of patients suffering from different levels of cancer pain in Taiwan. Available evidence of chronic non-cancer pain suggests that self-efficacy is able to maintain or modify health behaviors, but few researches have employed self-efficacy theory to cancer pain management. Cancer pain has adverse impacts on patients’ emotional state and quality of life. It is rational to apply the concept of self-efficacy to delineate the levels of cancer pain severity, pain interference, pain relief, emotional state, and quality of life. Therefore, this present study intended to explore cancer patients’ opioid-taking self-efficacy, and to understand the relationship between the levels of cancer pain severity, emotional state, quality of life, and opioid-taking self-efficacy among cancer patients. Using convenience sampling, this research recruited 109 patients with cancer pain from a teaching hospital in Taipei. Data were collected by means of the following instruments: Opioid-Taking Self-Efficacy-Cancer (OTSES-CA), the Chinese version of Brief Pain Inventory (BPI-C), Hospital Anxiety and Depression Scale (HADS), and European Organization for Research & Treatment of Cancer Quality of Life Group Questionnaire , version 3.0 (EORTC QLQ-C30, (version 3.0)). The data were analyzed by descriptive statistics including mean, standard deviation, frequency, percentage, and inferential statistics including t-test, analysis of variance of ANOVA, Pearson’s correlation, and stepwise regression. Results showed that patients in this current study had moderate opioid-taking self-efficacy (M=7.56, SD=0.17 ). Married participants had higher levels of opioid-taking self-efficacy in “tailoring medication regimens” subscale, compared with unmarried patients (t= -2.51, p< .05). Those without adverse reactions when taking opioids had higher scores on the total scale of OTSES-CA (t=2.19, p< .05) and “managing treatment-related concerns” subscale (t=2.31, p< .05), compared with their counterparts. Patients in the present study had mild level of anxiety (M= 7.38, SD= 4.29) and moderate level of depression (M= 10.50, SD= 3.95). Opioid-taking self-efficacy had partial negative relationship with both anxiety and depression. In other words, the higher scores on the total scale of OTSES-CA (r=-.29, p< .01), and the subscales of “communicating about pain and analgesic-taking” (r=-.37, p< .001), “acquiring help” (r=-.22, p< .05), and “managing treatment-related concerns” (r=-.32, p< .001), the lower scores of patients’ level of anxiety ; the higher scores on “communicating about pain and analgesic-taking” subscale, the lower scores of patients’ level of depression (r=-.27, p< .01). Opioid-taking self-efficacy and quality of life were partially positive correlated, in that the higher scores on “communicating about pain and analgesic-taking” subscale, the higher scores on the global health status/quality of life scale of EORTC QLQ-C30(r= .19, p< .05). The higher scores on the total scale of OTSES-CA(r= .30, p< .01), and the subscales of “communicating about pain and analgesic-taking”(r= .33, p< .001), “acquiring help”(r= .20, p< .05), and “managing treatment-related concerns” (r=.31, p< .001), the higher scores on the functional scale of EORTC QLQ-C30. However, the higher scores on the total scale of OTSES-CA (r= -.22, p< .05), and the subscales of “communicating about pain and analgesic-taking”(r=-.30, p< .01) and “managing treatment-related concerns” (r=-.22, p< .05), the lower scores on the symptom scale of EORTC QLQ-C30. The relationship between opioid-taking self-efficacy and perception of cancer pain was positive but not statistically significant. Encountering patients receiving opioids to managing cancer pain, health care providers should pay more attention to those who are not married and those with side effects of opioids. Provided that opioid-taking self-efficacy is related to patients’ emotional state and quality of life, health professionals should provide comprehensive information relevant to opioids and dealing with side effects of opioids. While teaching a patient to use opioids for cancer pain, health workers can encourage him/her by introducing an experienced peer or sharing his/her past experience to increase the patient’s opioid-taking self-efficacy; therefore, a better emotional state and quality of life could thus be achieved.