Patients' and Nurses' Barriers Regarding Cancer Pain Management: Strategies to Overcome

Background: Cancer pain affects millions of patients world-wide, according to the Egyptian National Cancer Institute, the prevalence of cancer-related pain is varied between 20% to 50% of patients. Barriers to effective pain control are related to the healthcare system, healthcare providers, and patients, although pain considered as the 5th vital sign, it is still has serious deficits in managing cancer pain related barriers overcoming barriers to effective cancer pain management calls for increased attention and strong efforts.  Aim: The aim of this study was to: (1) identify patients' and nurses' barriers to cancer pain management and (2) develop and implement nursing strategies to overcome patients' and nurses' barriers to cancer pain management. Methodology: A quazi experimental design was utilized for conducting the study. A convenience sample of 100 adult cancer patients and 20 nurses working at nuclear medicine unit at kasr Al-Ani Educational Hospital. Data were collected through six tools; (1) A Self-Administered Questionnaire Format for Nurses, (2) An Observational Checklist Format, (3) A Self-Administered Questionnaire Format for Patients, (4) Numeric pain rating scale (NPRC) Cleland, Childs & Whitman (2007), (5) Patients' Barriers Questionnaire and (6) Patient educational interventions. Results: Patients' and nurses' barriers regarding cancer pain management improved after implementing nursing strategies. Conclusion: Implementation of nursing strategies was associated with reducing the patients' and nurses' barriers related to cancer pain management. Recommendations: Ongoing training and educational opportunities for both patients and nurse should be available to ensure implementation of nursing strategies to overcome barriers related to cancer pain management. Keywords: Patients' and Nurses' Barriers, Cancer Pain Management, Strategie

Effectiveness of Aromatherapy in Early Palliative Care for Oncology Patients: Blind Controlled Study

Background: Palliative care is the active holistic treatment of people of all ages who have serious health-related suffering as a result of severe illness, and especially of those who are close to the end of life. Palliative care is provided to cancer patients who experience serious suffering that cannot be relieved without professional intervention and that compromises physical, social, spiritual, and emotional functioning. A straightforward, low-risk, and affordable palliative care approach may be provided through aromatherapy, a type of complementary and alternative medicine. The study objective is to assess the comparative effectiveness of massage, aromatherapy massage, and massage combined with aromatherapy inhalation on cancer patients receiving palliative care. Methods: A total of 100 participants who were divided into four groups at random. The first group, designated as the control group, received standard hospital nursing care, the second group received massage only (using the odorless almond carrier oil), the third group received massage with lavender oil, and the fourth group received combined (inhalation and massage) aromatherapy. The Rotterdam Symptom Checklist (RSCL), given two weeks after aromatherapy, was used to examine participants’ perspectives of care. Results: On the RSCL, combined aromatherapy performed best. In terms of reported physical symptoms, psychological symptoms, and activities, there were statistically significant differences between the scores of the control group and each of the experimental groups. Nonetheless, the total quality of life score showed no significant difference between the control group and the massage only group (t = 0.529, p = 0.60). Conclusions: When paired with aromatherapy inhalation, massage has a positive effect on physical, psychological symptoms, activities, and overall quality of life for cancer patients receiving early palliative care. Nurses and other healthcare providers are recommended to support programs that provide message therapy to reduce reported bodily symptoms, psychological problems, and limited activities among cancer patients.Funding Statement This study was supported via funding from Prince Sattam Bin Abdulaziz University project number (PSAU/2023/R/1444)

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially