Academic Unit of Palliative Care, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK.
J Cancer Educ. 2023 Jun;38(3):789-797. doi: 10.1007/s13187-022-02185-5. Epub 2022 Jun 2.
Cancer pain presents in approximately 66% of patients in advanced stages. Although several guidelines and pharmacological options are available for cancer pain management (CPM), assessment and treatment of cancer pain remain inadequate globally, particularly in developing countries. Lack of knowledge and negative attitudes towards CPM among healthcare professionals (HCPs) are important barriers to CPM. This survey aimed to evaluate nurses' and physicians' knowledge, attitudes, and potential barriers regarding CPM in Libya. This cross-sectional survey involved a convenience sample of 152 oncology nurses and physicians working in six oncology settings in Libya. The response rate was 76%. The Barriers Questionnaire II (BQ-II) was used for data collection (higher scores signify greater attitudinal barriers and poorer knowledge). Data analysis was carried out using Statistical Package for Social Sciences (SPSS), version 26 software. An independent t-test (unadjusted estimate) indicated that Libyan nurses showed higher mean barrier scores (mean = 3.8, SD = 0.7) to CPM than physicians (mean = 2.9, SD = 0.8), p < 0.001. The six most common differences in attitudinal barriers between nurses and physicians were "opioid side effects," "poor tolerance," "strong patient endures pain," "distract the physician," "drug addiction," and "opioids impair immune function," p < 0.001. Multiple regression results (adjusted estimate) indicated that nurses had more barrier scores to CPM than physicians (B = - 0.530, p < 0.05), and participants with higher educational levels were associated with lower barrier scores to CPM (B = - 0.641, p < 0.05). Our results suggest that Libyan oncology HCPs hold perceived barriers, lack of knowledge, and negative attitudes towards CPM. Professional education and training in CPM, addressing phobia and myths on opioid usage, and the benefits and complications of using opioids are likely to result in reduced barriers to CPM in Libya.
癌症疼痛在晚期患者中约有 66%出现。尽管有几种指南和药物选择可用于癌症疼痛管理（CPM），但全球范围内癌症疼痛的评估和治疗仍然不足，特别是在发展中国家。医护人员（HCPs）对 CPM 的知识匮乏和负面态度是 CPM 的重要障碍。本调查旨在评估利比亚护士和医生在 CPM 方面的知识、态度和潜在障碍。这项横断面调查涉及利比亚六家肿瘤学环境中工作的 152 名肿瘤护士和医生的便利样本。回复率为 76%。使用障碍问卷 II（BQ-II）进行数据收集（较高的分数表示态度障碍更大，知识水平更低）。数据分析使用社会科学统计软件包（SPSS）版本 26 软件进行。独立 t 检验（未调整的估计值）表明，利比亚护士对 CPM 的平均障碍评分（均值=3.8，标准差=0.7）高于医生（均值=2.9，标准差=0.8），p<0.001。护士和医生在态度障碍方面的六个最常见差异是“阿片类药物的副作用”、“耐受性差”、“患者忍受疼痛能力强”、“分散医生注意力”、“药物成瘾”和“阿片类药物损害免疫功能”，p<0.001。多元回归结果（调整后的估计值）表明，护士对 CPM 的障碍评分高于医生（B=-0.530，p<0.05），且受教育程度较高的参与者对 CPM 的障碍评分较低（B=-0.641，p<0.05）。我们的结果表明，利比亚肿瘤学 HCPs 对 CPM 存在感知障碍、缺乏知识和负面态度。CPM 的专业教育和培训、解决对阿片类药物使用的恐惧和误解，以及使用阿片类药物的益处和并发症，可能会降低利比亚 CPM 的障碍。
