Pain course cuts stress in terminal cancer patients and partners

Involving both patients with end-stage cancer and their caregivers in a pain management program has benefits for both, results of a pilot study suggest.

In the March issue of the Journal of Pain and Symptom Management, Dr. Francis J. Keefe, of Duke University in Durham, North Carolina, and his associates note that they conducted a partner-guided pain management training protocol that included educational information about cancer pain and training in cognitive and behavioral pain coping skills. The program involved three hour-long sessions administered by nurse educators. Included were 28 patient-partner pairs randomly assigned to the pain management program and 28 assigned to usual care. Patients had advanced cancer diagnoses and a life expectancy of less than 6 months.After adjustment for pre-treatment pain, patients’ responses on the 10-point Brief Pain Inventory scale showed a pattern of less pain in the intervention group. This amounted to 4.60 for the week’s usual pain versus 5.19 in the control group. Corresponding scores for week’s worst pain were 6.46 and 6.93. However, the results did not reach statistical significance.Partners who participated in the pain management program reported significantly higher levels of self-efficacy in helping the patient control pain (25% higher) and other symptoms (19% higher). There was also a trend toward lower levels of caregiver strain.The authors suggest that more training sessions earlier in the patients’ illness could have even more impact and conclude that “partner-guided pain management training may have potential in buffering the stressful impact of caregiving at the end of life.”(Source: J Pain Symptom Manage 2005;29:263-272: Reuters Health: Oncolink: May 2005.)