DOI QR코드

DOI QR Code

Attitudes of Medical Students Regarding Cancer Pain Management: Comparison Between Pre- and Post-Lecture Test Findings

  • Nimmaanrat, Sasikaan (Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University) ;
  • Oofuvong, Maliwan (Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University)
  • Published : 2015.12.03

Abstract

Background: Medical practitioners' attitudes have a significant impact on quality of care for cancer pain patients. This study was conducted to determine if being given a lecture concerning cancer pain and its management could improve the attitudes of medical students. Materials and Methods: A comparative study was conducted in 126 fifth-year medical students. Each student completed a pretest consisting of 3 questions about attitudes toward the optimal use of analgesics and 5 questions about attitudes toward prescribing opioids. Then they were given a 1.5-hour lecture, immediately following which they completed a post-test with the same questions. Results: Analysis with either comparison between groups or by matching, the post-test showed significantly more positive attitudes (p<0.05) of the medical students in all 3 questions about optimal use of analgesics and 4 out of 5 questions about prescription of opioids. The post-test results showed significantly more negative attitudes concerning the most appropriate stage for patients with severe pain to receive maximal doses of analgesics. Conclusions: Conservative attitudes, especially concerns about addiction, have been associated with a reluctance in many physicians to prescribe opioids. This study found that cancer pain education can help to improve medical student attitudes. However, fear of addiction and tolerance was still evident so emphasis of this particular issue during a lecture is essential. Providing appropriate information by means of a lecture can improve the attitudes of medical students regarding cancer pain management. However, more information should be given to lessen fear of addiction and tolerance.

Keywords

References

  1. Akiyama M, Takebayashi T, Morita T, et al (2012). Knowledge, beliefs, and concerns about opioids, palliative care, and homecare of advanced cancer patients: a nationwide survey in Japan. Support Care Cancer, 20, 923-31. https://doi.org/10.1007/s00520-011-1161-5
  2. Alvarez YE, Sanchez CAR, Martinez FC, et al (2010). Professional survey on knowledge and clinical patterns of pain management in Spanish medical oncology. Clin Transl Oncol, 12, 819-24. https://doi.org/10.1007/s12094-010-0603-8
  3. Bennett MI, Flemming K, Closs SJ (2011). Education in cancer pain management. Curr Opin Support Palliat Care, 5, 20-4. https://doi.org/10.1097/SPC.0b013e328342c607
  4. Breuer B, Fleishman SB, Cruciani RA, et al (2011). Medical oncologists' attitudes and practice in cancer pain management: a national survey. J Clin Oncol, 29, 4769-75. https://doi.org/10.1200/JCO.2011.35.0561
  5. Fairchild A (2010). Under-treatment of cancer pain. Curr Opin Support Palliat Care, 4, 11-5. https://doi.org/10.1097/SPC.0b013e328336289c
  6. Gustafsson M, Borglin G (2013). Can a theory-based educational intervention change nurses' knowledge and attitudes concerning cancer pain management? A quasi-experimental design. BMC Health Serv Res, 13, 328. https://doi.org/10.1186/1472-6963-13-328
  7. Jacobsen R, Liubarskiene Z, Moldrup C, et al (2009). Barriers to cancer pain management: a review of empirical research. Medicina, 45, 427-33.
  8. Kaki AM (2011). Medical students' knowledge and attitude toward cancer pain management in Saudi Arabia. Saudi Med J, 32, 628-32.
  9. Kim M, Park HG, Park EC, et al (2011). Attitude and knowledge of physicians about cancer pain management: young doctors of South Korea in their early career. Jpn J Clin Oncol, 41, 783-91. https://doi.org/10.1093/jjco/hyr043
  10. Lasch K, Greenhill A, Wilkes G, et al (2002). Why study pain? A qualitative analysis of medical and nursing faculty and students' knowledge of and attitudes to cancer pain management. J Palliat Med, 5, 57-71. https://doi.org/10.1089/10966210252785024
  11. Liao Z, Hao J, Guo Y, et al (2013). Assessment of cancer pain management knowledge in Southwest China: a survey of 259 physicians from small city and county hospitals. J Palliat Med, 16, 692-5. https://doi.org/10.1089/jpm.2012.0418
  12. Machira G, Kariuki H, Martindale L (2013). Impact of an educational pain management programme on nurses' pain knowledge and attitudes in Kenya. Int J Palliat Nurs, 19, 341-6. https://doi.org/10.12968/ijpn.2013.19.7.341
  13. Murinson BB, Nenortas E, Mayer RS, et al (2011). A new program in pain medicine for medical students: integrating core curriculum knowledge with emotional and reflective development. Pain Med, 12, 186-95. https://doi.org/10.1111/j.1526-4637.2010.01050.x
  14. Niemi-Murola L, Nieminen JT, Kalso E, et al (2007). Medical undergraduate students' belief attitudes toward pain - how do they mature? Eur J Pain, 11, 100-6.
  15. Nimmaanrat S, Phungrassami T, Prechawai C (2008). Medical Students' Knowledge and Attitudes toward Cancer Pain and Its Management. Songkla Med J, 26, 423-9.
  16. Nimmaanrat S, Prechawai C (2009). Interns' Knowledge and Attitudes regarding Cancer Pain and Cancer Pain Management. Songkla Med J, 27, 491-501.
  17. Nimmaanrat S, Prechawai C, Phungrassami T (2010). Cancer Pain and Its Management: A Survey on Interns' Knowledge, Attitudes and Barriers. Palliat Care Res Treat, 4, 11-7.
  18. Pelayo-Alvarez M, Perez-Hoyos S, Agra-Varela Y (2013). Clinical effectiveness of online training in palliative care of primary care physicians. J Palliat Med, 16, 1-9.
  19. Rustoen T, Valeberg BT, Kolstad E, et al (2012). The Pro-$Self^{(C)}$ pain control program improves patients' knowledge of cancer pain management. J Pain Symptom Manage, 44, 321-30. https://doi.org/10.1016/j.jpainsymman.2011.09.015
  20. Sloan PA, Plymale MA, Johnson M, et al (2001). Cancer pain management skills among medical students: the development of a cancer pain objective structured clinical examination. J Pain Symptom Manage, 21, 298-306. https://doi.org/10.1016/S0885-3924(00)00278-5
  21. Weinstein SM, Laux LF, Thornby JI, et al (2000). Medical students' attitudes toward pain and the use of opioid analgesics: implications for changing medical school curriculum. South Med J, 93, 472-8. https://doi.org/10.1097/00007611-200093050-00006
  22. Xhixha A, Rama R, Radbruch L (2013). Reducing the barriers to pain management in Albania: results from an educational seminar with family doctors. J Palliat Med, 16, 758-61. https://doi.org/10.1089/jpm.2012.0514
  23. Yanjun S, Changli W, Ling W, et al (2010). A survey on physician knowledge and attitudes towards clinical use of morphine for cancer pain treatment in China. Support Care Cancer, 18, 1455-60. https://doi.org/10.1007/s00520-009-0768-2