nach oben

Supportive Care in Cancer

Erschienen in:

01.11.2010 | Original Article

A survey on physician knowledge and attitudes towards clinical use of morphine for cancer pain treatment in China

verfasst von: Su Yanjun, Wang Changli, Weng Ling, Jennifer Catherine Ai-lian Woo, Kwauk Sabrina, Liu Chang, Zhang Lei

Erschienen in: Supportive Care in Cancer | Ausgabe 11/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

The WHO’s three-step guideline for cancer pain management has been introduced in China; however, there remain large differences in the standards of cancer pain management between China and other developed countries. This survey was carried out to determine the degree of physician knowledge on morphine use and the factors that impede morphine use in clinical practice in China.

Methods

A self-reported questionnaire was designed and administered to randomly selected physicians in four tertiary hospitals in the cities of Changchun and Changsha in China. Statistical analyses were conducted using SPSS statistical software.

Results

Two hundred and one clinical physicians participated in the survey. Physicians who reported having received training in cancer pain management and drug use demonstrated a significantly higher mean score of basic knowledge compared to physicians who reported not having received training (9.31 ± 2.88:8.23 ± 2.70, u = 2.74, p < 0.001). The top three cited impediments to widespread clinical use of morphine for cancer pain were: (1) lack of professional knowledge and training; (2) fear of opioid addiction; and (3) physicians’ personal preferences to select other drugs.

Conclusions

Medical staffs lack the basic knowledge and harbor misconceptions about the clinical use of morphine for cancer pain treatment. Creating training opportunities for medical staffs is necessary to increase their awareness and knowledge of effective cancer pain management.

Nur mit Berechtigung zugänglich

World Health Organization (2003) Global cancer rates could increase by 50% to 15 million by 2020. http://www.who.int/mediacentre/news/releases/2003/pr27/en/

Goldberg GR, Morrison RS (2007) Pain management in hospitalized cancer patients: a systematic review. J Clin Oncol 25:1792–1801CrossRefPubMed

Jeon YS, Kim HK, Cleeland CS, Wang XS (2007) Clinicians’ practice and attitudes toward cancer pain management in Korea. Support Care Cancer 15:463–469CrossRefPubMed

Mercadante S, Lodi F, Sapio M, Calliqara M, Serretta R (1995) Long-term ketamine subcutaneous continuous infusion in neuropathic cancer pain. J Pain Symptom Manage 10:564–568CrossRefPubMed

Hagen NA, Wasylenko E (1999) Methadone: outpatient titration and monitoring strategies in cancer pain. J Pain Symptom Manage 18:369–375CrossRefPubMed

Hunt R, Fazekas B, Thorne D, Brooksbank M (1999) A comparison of subcutaneous morphine and fentanyl in hospicecancer patients. J Pain Symptom Manage 18:111–119CrossRefPubMed

World Health Organization (1986) Cancer pain relief. World Health Organization, Geneva

World Health Organization (2000) Achieving balance in national opioids control policy. Guidelines for assessment. http://whqlibdoc.who.int/hq/2000/WHO_EDM_QSM_2000.4.pdf

Sun Y, Luo AL et al (2004) The text book of the clinical application and regulation management of narcotic drugs. Ministry of Health Press, Beijing

10.

Sun WZ, Hou WY, Li JH (1996) Republic of China: status of cancer pain and palliative care. J Pain Symptom Manage 12:127–129CrossRefPubMed

11.

Wang WS, Li TD, Yu SY, Gu WP, Xu GW (2002) China: status of pain and palliative care. J Pain Symptom Manage 24:177–179CrossRefPubMed

12.

Liu ZM, Zhou WH, Lian Z et al (1999) A survey of attitudes, knowledge and clinical practice on cancer pain care in Chinese health professionals. Chinese Journal of Pain Medicine 5:1–7

13.

Elliott TE, Murray DM, Elliott BA, Braun B, Oken MM, Johnson KM, Post-White J, Lichtblau L (1995) Physician knowledge and attitudes about cancer pain management: a survey from the Minnesota Cancer Pain Project. J Pain Symptom Manage 10:494–504CrossRefPubMed

14.

Sapir R, Pharm B, Sci MM et al (1999) Cancer pain: knowledge and attitudes of physicians in Israel. J Pain Symptom Manage 17:266–276CrossRefPubMed

15.

Stolerman IP (1991) Drug dependence as pharmacological adaptation. In: Glass IB (ed) The international handbook of addiction behavior. Routledge, London, pp 11–19

16.

World Health Organization (1990) Cancer pain relief and palliative care: Report of a WHO expert committee (Technical report series 804). World Health Organization, Geneva

17.

Chinese Pharmacopoeia Commission (2001) Volume II pharmacopoeia of People’s Republic of China 2000. Chemical Industry Press, Beijing

18.

Dalton JA, Blau W, Carlson J, Mann JD, Bernard S, Toomey T, Pierce S, Germino B (1996) Changing the relationship among nurses' knowledge, self-reported behavior, and documented behavior in pain management: does education make a difference? J Pain Symptom Manage 12:308–319CrossRefPubMed

19.

Brietbart W, Rosenfeld B, Passik SD (1998) The Network Project: a multidisciplinary cancer education and training program in pain management, rehabilitation and psychosocial issues. J Pain Symptom Manage 15:18–26CrossRef

20.

Howell D, Butler L, Vincent L, Watt-Watson J, Stearns N (2000) Influencing nurses’ knowledge: attitudes and practice in cancer pain management. Cancer Nurs 23:55–63CrossRefPubMed

21.

Wells M, Dryden H, Guild P, Levack P, Farrer K, Mowat P (2001) The knowledge and attitudes of surgical staff towards the use of opioids in cancer pain management: can the hospital palliative care team make a difference? Eur J Cancer Care (Engl) 10:201–211CrossRef

22.

Comer SD, Sullivan MA, Whittington RA, Vosburg SK, Kowalczyk WJ (2008) Abuse liability of prescription opioids compared to heroin in morphine-maintained heroin abusers. Neuropsychopharmacology. doi:10.1038/sj.npp. 1301479

23.

McCaffery M, Ferrell B (1997) Nurses' knowledge of pain assessment and management: how much progress have we made? J Pain Symptom Manage 14:175–188CrossRefPubMed

24.

Weinstein SM, Laux LF, Thornby JI, Lorimor RJ, Hill CS Jr, Thorpe DM, Merrill JM (2000) Physicians’ attitudes toward pain and the use of opioid analgesics: results of a survey from the Texas Cancer Pain Initiative. South Med J 93:479–487PubMed

25.

Redmond K (1997) Organizational barriers in opioid use. Support Care Cancer 5:451–456CrossRefPubMed

26.

Zhang H, Gu WP, Joranson DE, Cleeland C (1996) People’s republic of China: status of cancer pain and palliative care. J Pain Symptom Manage 12:124–126CrossRefPubMed

27.

Chang YJ, Yun YH, Park SM, Lee SW, Park H-A, Ro Y-J, Huh BY (2005) Nurses willingness to maximize opioid analgesia for severe cancer pain, and its predictor. Support Care Cancer 13:743–751CrossRefPubMed

28.

Eddy NB, Halbach H, Isbell H, Seevers MH (1965) Drug dependence: its significance and characteristics. Bull Wld Hlth Org 32:721–733

29.

Porter J, Jick H (1980) Addiction rare in patients treated with narcotics. N Engl J Med 302:123PubMed

30.

Fan BF (2001) The clinical application of Morphine medicine. Medical Journal of Liaoning 15:174–176

31.

Shiying Y, Wang XS, Yuan C, Jingxiang Y, Cleeland CS (2001) Special aspects of cancer pain management in a Chinese general hospital. Eur J Pain 5:15–20CrossRef

32.

Sun Y, Gu WP (2002) The principle of the three-step analgesic ladder of cancer, 2nd edn. Peking University Medical Press, Beijing, p 70

Titel: A survey on physician knowledge and attitudes towards clinical use of morphine for cancer pain treatment in China
verfasst von: Su Yanjun
Wang Changli
Weng Ling
Jennifer Catherine Ai-lian Woo
Kwauk Sabrina
Liu Chang
Zhang Lei
Publikationsdatum: 01.11.2010
Verlag: Springer-Verlag
Erschienen in: Supportive Care in Cancer / Ausgabe 11/2010
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-009-0768-2

Neu im Fachgebiet Onkologie

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Springer Medizin

A survey on physician knowledge and attitudes towards clinical use of morphine for cancer pain treatment in China