Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-22T15:18:42.092Z Has data issue: false hasContentIssue false
  • English
  • Français

Cancer pain management needs and perspectives of patients from Chinese backgrounds: a systematic review of the Chinese and English literature

Published online by Cambridge University Press:  17 January 2018

Xiangfeng Xu Open the ORCID record for Xiangfeng Xu [Opens in a new window] ,
Tim Luckett ,
Alex Yueping Wang ,
Melanie Lovell  and
Jane L. Phillips
Xiangfeng Xu*
Affiliation:
Faculty of Health, University of Technology, Sydney, NSW, Australia
Tim Luckett
Affiliation:
Faculty of Health, University of Technology, Sydney, NSW, Australia
Alex Yueping Wang
Affiliation:
Faculty of Health, University of Technology, Sydney, NSW, Australia
Melanie Lovell
Affiliation:
Greenwich Palliative and Supportive Care Services, Greenwich, NSW, Australia
Jane L. Phillips
Affiliation:
Faculty of Health, University of Technology, Sydney, NSW, Australia
*
Author for correspondence: Xiangfeng Xu, Faculty of Health, University of Technology Sydney, Bldg. 10, Level 3, 235 Jones St (PO Box 123), Ultimo, NSW 2007, Australia. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

More than half of all cancer patients experience unrelieved pain. Culture can significantly affect patients’ cancer pain-related beliefs and behaviors. Little is known about cultural impact on Chinese cancer patients’ pain management. The objective of this review was to describe pain management experiences of cancer patients from Chinese backgrounds and to identify barriers affecting their pain management.

Method

A systematic review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they reported pain management experiences of adult cancer patients from Chinese backgrounds. Five databases were searched for peer-reviewed articles published in English or Chinese journals between1990 and 2015. The quality of included studies was assessed using Joanna Briggs Institution's appraisal tools.

Results

Of 3,904 identified records, 23 articles met criteria and provided primary data from 6,110 patients. Suboptimal analgesic use, delays in receiving treatment, reluctance to report pain, and/or poor adherence to prescribed analgesics contributed to the patients’ inadequate pain control. Patient-related barriers included fatalism, desire to be good, low pain control belief, pain endurance beliefs, and negative effect beliefs. Patients and family shared barriers about fear of addiction and concerns on analgesic side effects and disease progression. Health professional–related barriers were poor communication, ineffective management of pain, and analgesic side effects. Healthcare system–related barriers included limited access to analgesics and/or after hour pain services and lack of health insurance.

Significance of results

Chinese cancer patients’ misconceptions regarding pain and analgesics may present as the main barriers to optimal pain relief. Findings of this review may inform health interventions to improve cancer pain management outcomes for patients from Chinese backgrounds. Future studies on patients’ nonpharmacology intervention-related experiences are required to inform multidisciplinary and biopsychosocial approaches for culturally appropriate pain management.

Keywords

Cancer painChinesecultural influencepain management
Type
Review Article
Information
Palliative & Supportive Care , Volume 16 , Issue 6 , December 2018 , pp. 785 - 799
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Al-Atiyyat, NMH (2009) Cultural diversity and cancer pain. Journal of Hospice and Palliative Nursing 11(3), 154–166.Google Scholar
Arai, L, Britten, N, Popay, J, et al. (2007) Testing methodological developments in the conduct of narrative synthesis: a demonstration review of research on the implementation of smoke alarm interventions. Evidence & Policy 3(3), 361–383.Google Scholar
Australian Bureau of Statistics (2012) Reflecting a nation: stories from the 2011 census. Cultural Diversity in Australia. Available from http://www.abs.gov.au/ausstats/[email protected]/Lookup/2071.0main+features902012-2013.Google Scholar
Brant, JM (2014) Pain. In Cancer symptom management, 4th ed. Yarbro, CH, Wujcik, D, and Gobel, BH (eds.), pp. 69–91. Sudbury, MA: Jones and Bartlett Publishers.Google Scholar
Butow, PN, Sze, M, Dugal-Beri, , et al. (2010) From inside the bubble: migrants’ perceptions of communication with the cancer team. Support Care in Cancer 19(2), 281–290.Google Scholar
Chen, LM, Miaskowski, C, Dodd, M, and Pantilat, S (2008) Concepts within the Chinese culture that influence the cancer pain experience. Cancer Nursing 31(2), 103–108. doi:10.1097/01.NCC.0000305702.07035.4d.Google Scholar
Chen, ZY, Mai, WX, Wang, ZH, et al. (2007) Influence of social psychological environmental factors on pain behaviors of cancer patients. Journal of Clinical Rehabilitative Tissue Engineering Research 11 (47), 9521–9526.Google Scholar
Chung, JW, Wong, TK, and Yang, JC (2000) The lens model: assessment of cancer pain in a Chinese context. Cancer Nursing 23(6), 454–461.Google Scholar
Dayer-Berenson, L (2014a) Asians/Pacific Islanders. In Cultural competencies for nurses: impact on health and illness, 2nd ed. Dayer-Berenson, L (ed.), pp. 237–257). Burlington, MA: Jones & Bartlett Learning.Google Scholar
Dayer-Berenson, L (2014b) Overview of cultural foundations, cultural competency and transcultural nursing/health care. In Cultural competencies for nurses: impact on health and illness, 2nd ed. Dayer-Berenson, L (ed.), pp. 1–6. Burlington, MA: Jones & Bartlett Learning.Google Scholar
Deng, D, Fu, L, Zhao, YX, et al. (2012). The relationship between cancer pain and quality of life in patients newly admitted to Wuhan Hospice Center of China. American Journal of Hospice & Palliative Medicine 29(1), 53–59.Google Scholar
Dhingra, L, Lam, K, Homel, P, et al. (2011) Pain in underserved community-dwelling Chinese American cancer patients: demographic and medical correlates. The Oncologist 16(4), 523–533.Google Scholar
Dy, SM, Asch, SM, Naeim, A, et al. (2008) Evidence-based standards for cancer pain management. Journal of Clinical Oncology 26(23), 3879–3885.Google Scholar
Edrington, J, Miaskowski, C, Dodd, M, et al. (2007) A review of the literature on the pain experience of Chinese patients with cancer. Cancer Nursing 30(5), 335–346.Google Scholar
Federation of Ethnic Communities’ Councils of Australia (2010) Cancer and culturally and linguistically diverse communities. Available from http://www.fecca.org.au/images/stories/pdfs/cancer_cald_communities_report2010.pdf.Google Scholar
Flemming, K (2010) The use of morphine to treat cancer-related pain: a synthesis of quantitative and qualitative research. Journal of Pain Symptom Management 39(1), 139–154.Google Scholar
Hu, Q, Qiu, H, Mei, N, et al. (2010) Survey of cancer pain and its treatment. Journal of Prevention and Treatment Cancer 37(12), 280–283.Google Scholar
Huang, ZZ, Zh, Y, Peng, P, et al. (2009) Characteristic and treatment of cancer pain in Shanghai: results of survey in 2007. Tumor 29(10), 992–996.Google Scholar
Im, EO, Liu, Y, Kim, YH, and Chee, W (2008) Asian American cancer patients’ pain experience. Cancer Nursing 31(3), E17–E23.Google Scholar
Jacobsen, R, Møldrup, C, Christrup, L, and Sjøgren, P (2009) Patient-related barriers to cancer pain management: a systematic exploratory review. Scandinavian Journal of Caring Sciences 23(1), 190–208.Google Scholar
Lai, YH, Guo, SL, Keefe, FJ, et al. (2004) Effects of brief pain education on hospitalized cancer patients with moderate to severe pain. Support Care Cancer 12(9), 645–652.Google Scholar
Lai, YH, Keefe, FJ, Sun, WZ, et al. (2002) Relationship between pain-specific beliefs and adherence to analgesic regimens in Taiwanese cancer patients: a preliminary study. Journal of Pain and Symptom Management 24(4), 415–423.Google Scholar
Lasch, KE (2000) Culture, pain, and culturally sensitive pain care. Pain Management Nursing 1(3), 16–22.Google Scholar
Lasch, KE, Wilkes, G, Montuori, LM, et al. (2000) Using focus group methods to develop multicultural cancer pain education materials. Pain Management Nursing 1(4), 129–138.Google Scholar
Li, YX, Yu, JQ, Tang, L, et al. (2013) Cancer pain management at home: voice from an underdeveloped region of China. Cancer Nursing 36(4), 326–334.Google Scholar
Liang, S-Y, Li, C-C, Wu, S-F, et al. (2011) The prevalence and impact of pain among Taiwanese oncology outpatients. Pain Management Nursing 12(4), 197–205.Google Scholar
Liang, SY, Chen, KP, Tsay, SL, et al. (2013a) Relationship between belief about analgesics, analgesic adherence and pain experience in Taiwanese cancer outpatients. Asian Pacific Journal of Cancer Prevention 14(2), 713–716.Google Scholar
Liang, SY, Tung, HH, Wu, SF, et al. (2013b) Concerns about pain and prescribed opioids in Taiwanese oncology outpatients. Pain Management Nursing 14(4), 336–342.Google Scholar
Liang, SY, Wu, SF, Chao, TC, et al. (2015) The impact of pain on the quality of life of Taiwanese oncology patients. Pain Management Nursing 16(2), 128–136.Google Scholar
Liang, SY, Yates, P, Edwards, H, and Tsay, SL (2008a) Factors influencing opioid-taking self-efficacy and analgesic adherence in Taiwanese outpatients with cancer. Psychooncology 17(11), 1100–1107.Google Scholar
Liang, SY, Yates, P, Edwards, H, and Tsay, SL (2008b) Opioid-taking tasks and behaviours in Taiwanese outpatients with cancer. Journal of Clinical Nursing 17(15), 2079–2088.Google Scholar
Liang, SY, Yates, P, Edwards, H, and Tsay, SL (2012). Opioid-taking self-efficacy amongst Taiwanese outpatients with cancer. Support Care Cancer 20(2), 199–206.Google Scholar
Liberati, A, Altman, D, Tetzlaff, J, et al. (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. Annals of Internal Medicine 151(4), W-65–W-94.Google Scholar
Lin, CC (2000) Barriers to the analgesic management of cancer pain: a comparison of attitudes of Taiwanese patients and their family caregivers. Pain 88(1), 7–14.Google Scholar
Lin, CC (2001) Congruity of cancer pain perceptions between Taiwanese patients and family caregivers: relationship to patients’ concerns about reporting pain and using analgesics. Journal of Pain and Symptom Management 21(1), 18–26.Google Scholar
Lin, CC and Ward, SE (1995) Patient-related barriers to cancer pain management in Taiwan. Cancer Nursing 18(1), 16–22.Google Scholar
Lin, CP, Hsu, CH, Fu, WM, et al. (2016) Key opioid prescription concerns in cancer patients: a nationwide study. Acta Anaesthesiologica Taiwanica 54(2), 51–56.Google Scholar
Lin, XY, Yang, Q, Lai, JH, et al. (2013) Exploring factors associated with adherence of cancer patients to pain treatment. Chinese Journal of Pain Medicine 19(6), 373–375.Google Scholar
Liu, Y, Zhang, P-Y, Na, J, et al. (2013) Prevalence, intensity, and prognostic significance of common symptoms in terminally Ill cancer patients. Journal of Palliative Medicine 16(7), 752–757.Google Scholar
Lu, YH, Guan, S, and Ma, SL (2006) Effects of educational program on pain control for cancer patients. Chinese Journal of Pain Medicine 12(5), 280–283.Google Scholar
Luckett, T, Davidson, PM, Green, A, et al. (2013) Assessment and management of adult cancer pain: a systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care. Journal of Pain and Symptom Management 46(2), 229–253.Google Scholar
Oldenmenger, WH, Sillevis Smitt, PAE, Van Dooren, S, et al. (2009) A systematic review on barriers hindering adequate cancer pain management and interventions to reduce them: a critical appraisal. European Journal of Cancer 45(8), 1370–1380.Google Scholar
Open Minds (2005) The White Paper on opioids and pain: a pan-European challenge. Available from http://www.pae-eu.eu/wp-content/uploads/2013/12/Opioids-and-pain-a-Pan-European-Challenge.pdfGoogle Scholar
Paice, JA, Bell, RF, Kalso, EA, and Soyannwo, OA (2010) Cancer pain: from molecules to suffering. Seattle, WA: IASP Press.Google Scholar
Pang, Y, Tang, LL, and Song, LL (2013). A survey on pain management of cancer patient and their family. Chinese Journal of Pain Medicine 19(6), 350–353.Google Scholar
Peng, WL, Wu, GJ, Sun, WZ, et al. (2006) Multidisciplinary management of cancer pain: a longitudinal retrospective study on a cohort of end-stage cancer patients. Journal of Pain Symptom Management 32(5), 444–452.Google Scholar
Popay, J, Roberts, H, Sowden, A, et al. (2006) Guidance on the conduct of narrative synthesis in systematic reviews: a product from the ESRC Methods Programme. Lancaster, UK: University of Lancaster.Google Scholar
Ruseel, PB and Tandon, A (2011) Cancer pain. In Perspectives on cancer care. Fawcett, JTN & Mcqueen, A (eds.), pp. 122–158. Oxford, UK: Blackwell Publishing Ltd.Google Scholar
Ruzicka, D (2001) Pain management. In Oncology nursing secrets: questions and answer about caring for patients with cancer, 2nd ed. Gates, RA and Fink, RM (eds.), pp. 391–415. Philadelphia, PA: Hanley & Belfus, Inc.Google Scholar
Smith, TJ and Saiki, CB (2015) Cancer pain management. Mayo Clinic Proceedings 90(10), 1428–1439.Google Scholar
Song, L, Wu, CR, Liu, H, et al. (2014) An investigation about cancer pain of inpatients in department of oncology in west China hospital. Chinese Journal of Pain Medicine 20(9), 630–634.Google Scholar
Tang, ST (2010) Diffusion effects of an inpatient hospice unit on improving the parent hospital's pain management of terminally ill cancer patients not receiving hospice care in Taiwan. Cancer Nursing 33(3), 221–227.Google Scholar
Tang, ST, Tang, WR, Liu, TW, et al. (2010) What really matters in pain management for terminally ill cancer patients in Taiwan. Journal of Palliative Care 26(3), 151–158.Google Scholar
The Joanna Briggs Institute (2014a) JBI new level of evidence. Available from http://joannabriggs.org/assets/docs/approach/JBI-Levels-of-evidence_2014.pdfGoogle Scholar
The Joanna Briggs Institute (2014b) The Joanna Briggs Institute Reviewer's Manual 2014 Edition. Available from http://joannabriggs.org/assets/docs/sumari/ReviewersManual-2014.pdf.Google Scholar
The Joanna Briggs Institute (2015) JBI systematic review protocol template. Available from http://joannabriggs.org/assets/docs/jbc/operations/prot-sr-bpis-tech-templates/JBI-SR-Protocol-Template.docx.Google Scholar
Tjuin, T, See, CL, Chien, LH, et al. (2007). Patient-related barriers to effective use of self-administered opioids in cancer pain management. Singapore Nursing Journal 34(2), 23–32.Google Scholar
Tse, MM, Wong, AC, Ng, HN, et al. (2012) The effect of a pain management program on patients with cancer pain. Cancer Nursing 35(6), 438–446.Google Scholar
Van Den Beuken-Van Everdingen, MHJ, De Rijke, JM, Kessels, AG, et al. (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Annuals of Oncology 18(9), 1437–1449.Google Scholar
Van Den Beuken-Van Everdingen, MHJ, Hochstenbach, LMJ, Joosten, EAJ, et al. (2016) Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. Journal of Pain and Symptom Management 51(6), 1070–1090.Google Scholar
Wills, BS and Wootton, YS (1999) Concerns and misconceptions about pain among Hong Kong Chinese patients with cancer. Cancer Nursing 22(6), 408–413.Google Scholar
World Health Organization (2015) WHO's cancer pain ladder for adults. Available from http://www.who.int/cancer/palliative/painladder/en/.Google Scholar
Xia, JY (2015) Adherence of elderly cancer patients to oral analgesics. Chinese Journal of Gerontics 5(35), 2804–2805.Google Scholar
Yarbro, CH, Wujcik, D, and Gobel, BH (2011) Cancer nursing: principles and practice (7 ed.). Sudbury, MA: Jones and Bartlett Publishers.Google Scholar
Yates, PM, Edwards, HE, Nash, RE, et al. (2002) Barriers to effective cancer pain management: a survey of hospitalized cancer patients in Australia. Journal of Pain and Symptom Management 23(5), 393–405.Google Scholar
Yin, A, Bai, X and Liu, Y (2007) The effect of social support on hospitalizing behavior of tumor patient. Medicine and Society 20(8), 42–44.Google Scholar
Supplementary material: File

Xu et al. supplementary material

Xu et al. supplementary material 1

Download Xu et al. supplementary material(File)
File 39 KB