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1 Exploring learning processes associated with a cancer pain self-management intervention in patients and family caregivers: A mixed methods study
بررسی فرآیندهای یادگیری مرتبط با مداخله خود مدیریت سرطان در بیماران و مراقبت های خانوادگی: مطالعه یک روش ترکیبی -2021
Aim: Explore learning processes associated with a psychoeducational pain selfmanagement intervention. Background: Self-management of cancer pain is challenging for patients and their family caregivers (FCs). While psychoeducational interventions can support them to handle these tasks, it remains unclear how learning pro- cesses are hampered or facilitated. Methods: A convergent parallel mixed methods design with qualitative data collection embedded in a randomized controlled trial (RCT) was used. Outpatients with cancer and FCs were recruited from three Swiss university hospitals. The six-week intervention consisted of education, skills building, and nurse coaching. Quantitative data on pain management knowledge and self-efficacy were analyzed using multilevel models. Patients and FCs were interviewed post-RCT regarding their learning experiences. Qualitative data analysis was guided by interpretive description. Finally, quantitative and qualitative data were integrated using case level comparisons and a meta-matrix. Results: Twenty-one patients and seven FCs completed this study. The group-by-time effect showed increases in knowledge (p = 0.035) and self-efficacy (p = 0.007). Patients and FCs learning through experience was sup- ported by an intervention nurse, who was perceived as competent and trustworthy. After the study, most intervention group participants felt more confident to implement pain self-management. Finally, data integration showed that declining health hampered some patients pain self-management. Conclusions: Competent and trustworthy nurses can support patients and FCs pain self-management by providing individualized interventions. Using a diary, jointly reflecting on the documented experiences, and addressing knowledge deficits and misconceptions through the use of academic detailing can facilitate patients and FCs learning of critical skills.
keywords: سرطان | مدیریت درد | آموزش بیمار | روش های ترکیبی تحقیق | خودکار کارآمدی | Cancer | Pain management | Patient education | Mixed methods research | Self-efficacy
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