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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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