Page 60 - CPG - Clinical Practice Guidelines - Management of Cancer Pain

Management of Cancer Pain (Second Edition)
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Pyschoeducation, psychological and spiritual interventions are
important in the management of cancer pain. Patients with cancer pain
may perceive the pain as the most feared physical consequence. The
consequences may be related to losing hope for cure or as a punishment
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and other psychological symptoms. 9

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A systematic review of four RCTs reported that educational interventions
given by healthcare providers (e.g. provision of educational information,
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included studies ranged from 2 - 4. 83, level I
In a meta-analysis of 12 RCTs, pain education (through interviews ±
phone calls) led to a small reduction in pain intensity of cancer patients
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RI WKH SULPDU\ VWXGLHV ZDV PL[HG EDVHG RQ -DGDG 6FRUH 84, level I

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Types of psychological strategies that are available include imagery,
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A large meta-analysis on psychosocial interventions (psychotherapy,
hypnosis, desensitisation or meditation) in patients with cancer showed
moderate positive effects on pain severity (Hedge’s g=0.34, 95% CI
0.23 to 0.46) and pain interference (Hedge’s g=0.40, 95% CI 0.21 to
0.60) compared with control. One of the limitations of this meta-analysis
was the heterogeneity of primary papers. 85, level I
An RCT on brief cognitive behavioural strategies intervention in
advanced cancer showed lower symptom cluster distress (pain, fatigue
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that psychological interventions (psychoeducation, problem-solving,
cognitive restructuring of dysfunctional illness-related concerns and
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bigger change in score for pain intensity compared with control that
received treatment as usual. 87, level I

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