Latter Sue, Hopkinson Jane B, Richardson Alison, Hughes Jane A, Lowson Elizabeth, Edwards Deborah
Faculty of Health Sciences, University of Southampton, Southampton, UK.
School of Healthcare Sciences, Cardiff University, Cardiff, Wales, UK.
BMJ Support Palliat Care. 2016 Sep;6(3):263-75. doi: 10.1136/bmjspcare-2015-000958. Epub 2016 May 5.
Family carers play a significant role in managing pain and associated medicines for people with advanced cancer. Research indicates that carers often feel inadequately prepared for the tasks involved, which may impact on carers' and patients' emotional state as well as the achievement of optimal pain control. However, little is known about effective methods of supporting family carers with cancer pain medicines.
To systematically identify and review studies of interventions to help carers manage medicines for pain in advanced cancer. To identify implications for practice and research.
A systematic literature search of databases (MEDLINE, CINAHL, PsycINFO and AMED) was carried out to identify studies of pain medication management interventions that involved family carers of patients with advanced cancer, and reported specific outcomes for family carers. Patient pain outcomes were also sought. Studies were quality appraised; key aspects of study design, interventions and outcomes were compared and a narrative synthesis of findings developed.
8 studies were included; all had significant methodological limitations. The majority reported improvements in family carer knowledge and/or self-efficacy for managing pain medicines; no effect on patient pain outcomes; and no adverse effects. It was not possible to discern any association between particular intervention characteristics and family carer outcomes.
Current evidence is limited, but overall suggests face-to-face educational interventions supported by written and/or other resources have potential to improve carers' knowledge and self-efficacy for pain management. Further research is needed to identify how best to help family carers manage pain medicines for patients with advanced cancer.
家庭照顾者在晚期癌症患者的疼痛及相关药物管理中发挥着重要作用。研究表明，照顾者往往觉得对所涉及的任务准备不足，这可能会影响照顾者和患者的情绪状态以及最佳疼痛控制的实现。然而，对于支持家庭照顾者管理癌症疼痛药物的有效方法知之甚少。
系统识别和综述旨在帮助照顾者管理晚期癌症疼痛药物的干预措施研究。确定对实践和研究的启示。
对数据库（MEDLINE、CINAHL、PsycINFO和AME D）进行系统文献检索，以识别涉及晚期癌症患者家庭照顾者的疼痛药物管理干预措施研究，并报告家庭照顾者的具体结果。同时也查找患者的疼痛结果。对研究进行质量评估；比较研究设计、干预措施和结果的关键方面，并对研究结果进行叙述性综合分析。
纳入8项研究；所有研究都有明显的方法学局限性。大多数研究报告称，家庭照顾者在管理疼痛药物方面的知识和/或自我效能有所提高；对患者疼痛结果无影响；且无不良反应。无法辨别特定干预特征与家庭照顾者结果之间的任何关联。
目前的证据有限，但总体表明，以书面和/或其他资源为支持的面对面教育干预措施有可能提高照顾者在疼痛管理方面的知识和自我效能。需要进一步研究以确定如何最好地帮助家庭照顾者管理晚期癌症患者的疼痛药物。
