Treatment of pain in pediatric oncology: a Swedish nationwide survey
Child; Female; infant; Male; Pain Measurement; Education; Questionnaires; Sweden; Combined Modality Therapy; Education; Preschool; Non-U.S. Gov't; infant; Newborn; Human; Nursing; Support; Adolescence; Neoplasms/complications; continuing; Medical; Drug Administration Routes; Physician's Practice Patterns; Antineoplastic Agents/adverse effects; continuing; Hospital Departments; Morphine/adverse effects; Pain/etiology/therapy; Radiotherapy/adverse effects
Pain treatment is a crucial aspect in the care of children with cancer and there are many studies demonstrating inefficient pain treatment. In this study, questionnaires dealing with pain treatment of children with malignant diseases were sent to all (47) pediatric departments in Sweden. The aims of this nationwide survey were to evaluate the extent and causes of pain, the use of methods for pain evaluation (e.g. analysis of type of pain and monitoring of pain intensity), principles of pain management, side effects of pain treatment and the educational needs of physicians and nurses regarding these issues. The response rate was 100%. Answers from physicians and nurses reveal that pain is a common symptom during different periods of cancer treatment. Pain due to treatment and procedures is a greater problem than pain due to the malignant disease itself. Instruments for the measurement of pain intensity and analysis of the type of pain are still rarely used. Most physicians (63%) follow the analgesic 'ladder' principle recommended by World Health Organization (WHO). According to a majority of physicians and nurses (72%), pain could be treated more effectively than it is presently, and 64% state that they need more time for the management of pain. Both physicians and nurses state that they need additional education in different areas of pain evaluation and pain treatment. Swedish treatment practices for the management of pediatric cancer pain roughly follow the published guidelines, but many improvements are still necessary.
1996
Ljungman G; Kreuger A; Gordh T; Berg T; Sorensen S; Rawal N
Pain
1996
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/s0304-3959(96)03193-4" target="_blank" rel="noreferrer">10.1016/s0304-3959(96)03193-4</a>
Trading treatment toxicity for survival in locally advanced non-small cell lung cancer
Female; Humans; Male; Aged; Middle Aged; Patient Satisfaction; Non-U.S. Gov't; Research Support; Carcinoma; Radiotherapy/adverse effects; Antineoplastic Combined Chemotherapy Protocols/adverse effects; Combined Modality Therapy/psychology; Lung Neoplasms/mortality/pathology/psychology/therapy; Non-Small-Cell Lung/mortality/pathology/psychology/therapy; Prostatic Neoplasms/mortality/pathology/psychology/therapy; Radiotherapy Dosage
PURPOSE: To determine how patients weigh potential survival benefits against the potential toxicity of different treatment strategies for locally advanced non-small cell lung cancer (NSCLC). Specifically, we were interested in what improvement in survival probability patients would want to have before accepting more toxic therapy. PATIENTS AND METHODS: Fifty-six outpatients who had experienced lung cancer (n = 22) or prostate cancer (n = 34), and 20 clinic nurses and radiation therapy technologists participated. A treatment trade-off interview was conducted with each participant that compared low-dose versus high-dose radiotherapy and high-dose radiotherapy versus combination chemo-radiotherapy. Preferences for treatments were assessed by systematically increasing the hypothetical survival advantage of the more toxic treatment until the person reached his or her threshold for choosing the more toxic treatment. RESULTS: A wide range of thresholds was observed for both groups. The distributions of survival advantage thresholds for lung cancer and prostate cancer patients were not significantly different but were generally lower thresholds than those declared by staff. If the 3-year survival advantage was 10%, 60% of patients and 15% of staff would consider combination therapy over high-dose radiotherapy. Within patients, apparent willingness to consider more toxic treatments was not significantly related to age, sex, education, or preferred role in decision making. The treatment trade-off method had good test-retest reliability. CONCLUSION: There is great interindividual variability in willingness to accept aggressive treatments for locally advanced NSCLC. When choosing NSCLC treatment, each patient should be provided with comprehensive information about the options so that he or she may express his or her preferences should he or she wish to participate in the decision.
1997
Brundage MD; Davidson JR; Mackillop WJ
Journal Of Clinical Oncology
1997
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1200/jco.1997.15.1.330" target="_blank" rel="noreferrer">10.1200/jco.1997.15.1.330</a>