Mulonda Jennipher Kombe, Havenga Yolanda, de Villiers Martjie
Adelaide Tambo School of Nursing Science, Tshwane University of Technology, Pretoria, South Africa.
SAGE Open Nurs. 2023 Sep 3;9:23779608231197008. doi: 10.1177/23779608231197008. eCollection 2023 Jan-Dec.
Cancer incidence and mortality are increasing worldwide, and pain is the most common symptom patients experience. Despite developments in cancer pain management and guidelines, the pain often remains undertreated. Effective pain management ultimately involves overcoming several complex institutional, patient, and healthcare provider-related barriers.
The objective of the study was to explore and describe healthcare providers' perceptions of the cancer pain management barriers at a hospital in Zambia.
A descriptive qualitative study was conducted. Data were collected from 10 purposively sampled medical doctors and registered nurses using prepiloted semistructured individual interviews. Interviews were audio recorded and transcribed verbatim. Thematic analysis was done, and trustworthiness was enhanced based on the criteria described by Lincoln and Guba. Ethical principles, as outlined in the Declaration of Helsinki, were adhered to.
Three themes emerged, namely patient-related barriers (biographic characteristics, patient knowledge and perceptions), healthcare provider-related barriers (knowledge and perceptions and language barriers), and institution-related barriers (resource limitations and lack of standards and guidelines). Healthcare providers' views that cultural beliefs about cancer being caused by witchcraft and the use of traditional medicine and services are barriers to cancer pain management were unique to this study.
Cancer pain management requires a total pain management approach that addresses the barriers to pain management strategies from a patient, healthcare provider, and institutional perspective. The knowledge deficit among patients and healthcare providers is a barrier to cancer pain management and one of the most common challenges reported in the literature. This study further points toward a need to develop culturally competent healthcare providers.
全球癌症发病率和死亡率都在上升，疼痛是患者最常经历的症状。尽管癌症疼痛管理和指南有所发展，但疼痛往往仍未得到充分治疗。有效的疼痛管理最终需要克服几个复杂的机构、患者及医疗服务提供者相关的障碍。
本研究的目的是探索和描述赞比亚一家医院的医疗服务提供者对癌症疼痛管理障碍的看法。
进行了一项描述性定性研究。通过预先设计的半结构化个人访谈，从10名有目的抽样的医生和注册护士那里收集数据。访谈进行了录音并逐字转录。进行了主题分析，并根据林肯和古巴描述的标准增强了可信度。遵循了《赫尔辛基宣言》中概述的伦理原则。
出现了三个主题，即患者相关障碍（个人特征、患者知识和认知）、医疗服务提供者相关障碍（知识和认知以及语言障碍）以及机构相关障碍（资源限制以及缺乏标准和指南）。医疗服务提供者认为关于癌症由巫术引起以及使用传统药物和服务的文化信仰是癌症疼痛管理的障碍，这是本研究独有的观点。
癌症疼痛管理需要一种全面的疼痛管理方法，从患者、医疗服务提供者和机构的角度解决疼痛管理策略的障碍。患者和医疗服务提供者之间的知识差距是癌症疼痛管理的障碍，也是文献中报道的最常见挑战之一。本研究进一步表明需要培养具备文化能力的医疗服务提供者。
