A survey of advanced medical students’ knowledge towards cancer pain management

Objective: The aim of the study was to investigate advanced medical students' knowledge towards cancer pain management, and understand the effect of specialisms and duration of oncology rotation on the advanced medical students' cognitive level towards cancer pain management. Methods: Randomly selected the respondents from a medical school in Wuhan, China. The educational background of the respondents should belong to one of these conditions: (1) clinical master degree candidate; (2) clinical doctor degree candidate; (3) the sixth or seventh year of clinical medicine for seven years. The respondents should also spend more than one year on internship. The self-developed questionnaire papers were distributed to respondents in the unit of dorms selected randomly and recovered them immediately after they're finished. The categori- cal data were expressed at the form of frequency (rate or constituent ratio). Chi-square test was required only as needed. Results: The survey was anonymous. We distributed 300 papers, recovered 300 papers and weeded out 8 invalid papers. Finally there were 292 valid papers, and the valid recovery rate was 97.3%. The 96.7% of oncological medical students and 47.6% non-oncological medical students relied on patients' description for cancer pain assessments; 90.0% of oncological medical students and 53.0% of non-oncological medical students prescribed strong opioid drugs firstly for patients suffering severe cancer pain; only 24.1% of non-oncological medical students recognized that pethidine was not safe and effective to treat cancer pain, which was much lower than oncological medical students (90.0%); 73.3% of oncological medical students and 28.9% of non-oncological medical students had the correct impression of drug addiction; 85.5% of non-oncological medi- cal students worried about the drug addiction, while 60.0% of oncological medical students worried about the strict control over opioid. In respect of the details of cancer pain management, only 66.7% of oncological medical students recognized that there was no upper limit of opioid prescribed clinically, and 16.3% of oncological medical students recognized that there was no psychological dependence if patients took opioid orally. The 69.8% of the students from no-less-than-two-week group relied on patients' description for cancer pain assessments, 76.7% prescribed strong opioid drugs firstly for patients suffer- ing severe cancer pain, 69.8% recognized that pethidine was not safe and effective to treat cancer pain, and 55.8% had the correct impression of drug addiction. All of the data were higher than that in no-rotation group and that in less-than-two-week group. The 51.2% of the students from no-less-than-two-week worried about drug addiction, which was the lowest of all. Conclusion: The cognitive level of advanced medical students towards cancer pain management is so low that it could not satisfy the clinical requirement, especially for the non-oncological medical students and the students spending little time on oncology rotation. Though the oncological medical students know something about cancer pain treatment, they know little about the details.

Attitudes towards pain management in hospitalized cancer patients and their influencing factors

Objective： To investigate patients＇ attitudes towards cancer pain management and analyze the factors influencing these attitudes.Methods： The self-developed Demographic and Disease-Related Information Questionnaires, Pain Management Barriers Questionnaire-Taiwan form（BQT）, and Pain Knowledge Questionnaire were administered to 363 pairs of hospitalized cancer patients and their caregivers from the oncology departments of 7 hospitals in Beijing, China.Results： The average patient score for attitudes towards pain management was 2.96±0.49. The dimension scores indicated good attitudes in three areas（scores 〈2.5）, ＂Desire to be good＂（2.22±1.04）, ＂Fatalism＂（2.08±0.81） and＂Religious fatalism＂（1.86±1.00）, and poor attitudes in six areas（scores ≥2.5）, ＂Tolerance＂（3.83±0.96）, ＂Use of analgesics as needed（p.r.n.）＂（3.73±1.01）, ＂Addiction＂（3.44±1.05）, ＂Disease progression＂（3.28±1.26）, ＂Distraction of physicians＂（3.16±1.07） and ＂Side effects＂（2.99±0.68）. Two factors were entered into the regression equation：the caregivers＇ attitudes towards cancer pain management and the patients＇ pain knowledge. These two factors explained 23.2% of the total variance in the patients＇ average scores for their attitudes towards cancer pain management.Conclusions： The patients＇ attitudes towards cancer pain management were poor and could be influenced by the caregivers＇ attitudes and the patients＇ pain knowledge, and thus need to be improved.