Question

A Randomized, Clinical Trial of Education
or Motivational-Interviewing–Based Coaching Compared to Usual Care to Improve Cancer Pain Management

Mary Laudon Thomas, RN, MS, AOCN®, Janette E. Elliott, RN-BC, MS, AOCN®, Stephen M. Rao, Ph.D., Kathleen F. Fahey, RN, MS, CNS, Steven M. Paul, Ph.D., and Christine Miaskowski, RN, Ph.D., FAAN

Despite important advances in its management, cancer pain remains a significant clinical problem (Apolone et al., 2009; McGuire, 2004; van den Beuken-van Everdingen et al., 2007). In a meta-analysis, cancer pain was found in 64% of patients with metastatic disease, 59% of patients receiving antineoplastic therapy, and 33% of patients who had received curative cancer treatment (van den Beuken- van Everdingen et al., 2007). Cancer pain also has a negative effect on patients’ functional status (Ferreira et al., 2008; Holen, Lydersen, Klepstad, Loge, & Kassa, 2008; Vallerand, Templin, Sasenau, & Riley-Doucet, 2007) and is associated with psychological distress (Cohen et al., 2003; Vallerand, Hasenau, Templin, & Collins-Bohler, 2005). The effect of cancer pain on an individual’s quality of life (QOL) can be significant and extend beyond disturbances in mood and physical function (Burckhardt & Jones, 2005; Dahl, 2004; Fortner et al., 2003).

Review of the Literature

Please give the conclusion, implications, and recommendation for the article above

Answer 1

Recommendation:
pain was assessed with brief pain inventory with self-report instrument to assess the quality of pain, severity and interference calculated with scores..All this recommendation gave negative outcomes with pain control.Educational intervention gave positive outcome in decreasing cancer pain..Coaching interventions helpful in clinical practice ,it decrease their pain,vitality,mental health,general health..It Implemented with brief ongoing sessions to reinforce the coaching intervention.. Intervention and its effect demand cancer pain..Motivational interview with pressing issues facing the patient during coaching telephone calls is the standardized instrument..
Implication:
Motivational interviewing based on the Transtheoretical model and its principles involve addressing issues from the patient perspective and making individual to change a particular behavior consider changing a attitude can result in improving their cancer pain management..Advanced practice Nurse(APNs) provide comprehensive assessments of symptoms and problem faced by cancer patient by using Motivational interviewing ,APN can develop plan of care to decrease the symptoms..
conclusions:
Coaching intervention with various type of controls make sure the specific effect of the intervention can provide control factors like time,attention,motivation,expectation and experience..Cancer pain managed address from integrated biopsycho- social approach like pharmacologic, cognitive, behavioral, motivational, educations to achieve this study successful for cancer pain management..