***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: OBJECTIVE To assess the impact of a brochure supplied on pain and analgesic treatment on the knowledge , attitude , belief and perception of patients consulting oncology departments . METHOD A prospect i ve , comparative , study on patients consulting a thoracic oncology and a general oncology department , suffering from pain and motivating a treatment level > or = to 2 ( WHO scale ) . A group of patients having been given a brochure ( case ) was compared with a group who had not been given the brochure ( controls ) . The assessment question naire , developed according to the KABP ( Knowledge , Attitudes , Belief , Practice ) method , was distributed to the 2 groups . A second assessment was made 4 weeks after the patients having received the brochure .  Visual analog scales ( VAS ) followed the intensity of the pain . RESULTS Twenty-one cases and 33 controls were assessed . There was no modification in their belief ( risk of addiction ) but an improvement in their knowledge ( duration of action of morphine agents , management of treatment , multi-disciplinary management ) . This improvement in knowledge was accompanied by improved control of pain : 2/3 of the patients exhibited a VAS < 1 at the time of the second assessment versus 1/3 during the initial assessment . CONCLUSION Improvement , if only partial , in the patients ' knowledge of pain and its treatment using a brochure , is one of the routes for optimising the management of pain The problem of cancer-related pain afflicts millions of people annually . The study described here was aim ed at improving cancer patients '  pain control through a planned patient education program . A r and omized clinical trial with a Solomon Four-Group design was used to assess the effectiveness of a patient education intervention consisting of nurse counseling and printed material s.  The sample included 230 cancer patients . One month later , patients in the experimental group were more likely to have taken their pain medicine on the correct schedule and to have taken the correct dosage . The experimental group also was significantly less likely to report stopping the medicine when they felt better . In addition , they were significantly less worried about tolerance and addiction to pain medicines . Forty-four percent of the experimental group compared to 24 % of the control group reported no or mild pain at the posttest & NA ; St and ard guidelines for cancer pain treatment routinely recommend training patients to reduce barriers to pain relief , use medications appropriately , and communicate their pain‐related needs . Methods are needed to reduce professional time required while achieving sustained intervention effectiveness . In a multisite , r and omized controlled trial , this study tested a pain training method versus a nutrition control . At six oncology clinics , physicians ( N = 22 ) and nurses ( N = 23 ) enrolled patients ( N = 93 ) who were over 18 years of age , with cancer diagnoses , pain , and a life expectancy of at least 6 months .  Pain training and control interventions were matched for material s and method . Patients watched a video followed by about 20 min of manual‐st and ardized training with an oncology nurse focused on review ing the printed material and adapted to individual concerns of patients . A follow‐up phone call after 72 h addressed individualized treatment content and pain communication . Assessment s at baseline , one , three , and 6 months included barriers , the Brief Pain Inventory , opioid use , and physician and nurse ratings of their patients ’ pain . Trained versus control patients reported reduced barriers to pain relief ( P < .001 ) , lower usual pain ( P = .03 ) , and greater opioid use ( P < .001 ) . No pain training patients reported severe pain ( > 6 on a 0–10 scale ) at 1‐month outcomes ( P = .03 ) . Physician and nurse ratings were closer to patients ’ ratings of pain for trained versus nutrition groups ( P = .04 and < .001 , respectively ) . Training efficacy was not modified by patient characteristics . Using video and print material s , with brief individualized training , effectively improved pain management over time for cancer patients of varying diagnostic and demographic groups The purpose of this r and omized controlled study was to assess the effects of a structured pain education program on the pain experience of hospitalized cancer patients . Eligible cancer pain patients were r and omly assigned to either an  experimental group ( receiving pain education 10–15 min per day for 5 days , n=15 ) or a st and ard care control group ( n=15 ) . The effects of the intervention on six pain-related variables were evaluated using three instruments . Pain intensity , pain interference with daily life , negative beliefs about opioids , beliefs about endurance of pain , pain catastrophizing ( an individual ’s tendency to focus on and exaggerate the threat value of painful stimuli and negatively evaluate his or her own ability to deal with pain ) , and sense of control over pain were evaluated by the Brief Pain Inventory — Short Form Taiwanese version ( BPI-T ) , Pain and Opioid Analgesic Beliefs Scale — Cancer ( POABS-CA ) , and the Catastrophizing subscale and the sense of control over pain measure from the Coping Strategies Question naire ( CSQ ) . The results indicated that , after completing treatment , patients who had received  structured pain education  had significantly less pain intensity on average , negative pain beliefs regarding opioids , pain endurance beliefs , and pain catastrophizing than patients in the control group . In addition , patients in the pain education group showed a significant increase in their sense of control over pain . These preliminary results strongly suggest that structured pain education can effectively improve the pain experience of hospitalized cancer patients and should be further implemented clinical ly The persistence of negative attitudes towards cancer pain and its treatment suggests there is scope for identifying more effective pain education strategies . This r and omized controlled trial involving 189 ambulatory cancer patients evaluated an educational intervention that aim ed to optimize patients ' ability to manage pain . One week post-intervention , patients receiving the pain management intervention ( PMI ) had a significantly greater increase in self-reported pain knowledge , perceived control over pain , and number of pain treatments recommended . Intervention group patients also demonstrated a greater reduction in willingness to tolerate pain , concerns about addiction and side effects , being a " good " patient , and tolerance to pain relieving medication . The results suggest that targeted educational interventions that utilize individualized instructional techniques may alter cancer patient attitudes , which can potentially act as barriers to effective pain management PURPOSE To evaluate oncology out patients ' level of adherence to their analgesic regimen during a 5-week period . PATIENTS AND METHODS A r and om sample of 65 adult oncology out patients with a Karnofsky performance status score of > or= 50 , an average pain intensity score of > or= 2.5 , and radiographic evidence of bone metastasis were recruited for this longitudinal study from seven outpatient setting s. On a daily basis , patients rated their level of pain intensity and recorded pain medication intake . Adherence rates for opioid analgesics prescribed on an around-the-clock ( ATC ) and on an as-needed ( PRN ) basis were calculated on a weekly basis . RESULTS Overall adherence rates for ATC opioid analgesics ranged from 84.5 % to 90.8 % and , for PRN analgesics , from 22.2 % to 26.6 % . No significant differences over time were found in either of these adherence rates . CONCLUSION One factor that seems to contribute to ineffective cancer pain management is poor adherence to the analgesic regimen PURPOSE / OBJECTIVES To assess the effect of an educational homecare program on pain relief in patients with advanced cancer . DESIGN Quasi-experimental ( pretest post-test , nonequivalent group ) . SETTING Four community-based primary care centers providing social and healthcare services in the Quebec City region of Canada . SAMPLE 80 homecare patients with advanced cancer who were free of cognitive impairment , who presented with pain or were taking analgesics to relieve pain , and who had a life expectancy of six weeks or longer . METHODS The educational intervention included information regarding pain assessment and monitoring using a daily pain diary and the provision of specific recommendations in case of loss of pain control . Pain intensity data  were collected prior to the intervention , and re assessment s were made two and four weeks later . Data on beliefs were collected at baseline and two weeks . All data were collected by personal interviews . MAIN RESEARCH VARIABLES Patients beliefs about the use of opioids ; average and maximum pain intensities . FINDINGS Patients beliefs regarding the use of opioids were modified successfully following the educational intervention . Average pain was unaffected in the control group and was reduced significantly in patients who received the educational program . The reduction remained after controlling for patients initial beliefs . Maximum pain decreased significantly over time in both the experimental and control groups . CONCLUSIONS An educational intervention can be effective in improving the monitoring and relief of pain in patients with cancer living at home . IMPLICATION S FOR NURSING Homecare nurses can be trained to effectively administer the educational program during their regular homecare visits Abstract Previously , we demonstrated , in a r and omized clinical trial , the effectiveness of a psychoeducational intervention to decrease pain intensity scores and increase patients ’ knowledge of cancer pain management with a sample of oncology patients with pain from bone metastasis . In the present study , we evaluated for changes in mood states ( measured using the Profile of Mood States ) , quality of life ( QOL ; measured using the Medical Outcomes Study Short Form‐36 ( SF‐36 ) ) , and pain ’s level of interference with function ( measured using the Brief Pain Inventory ( BPI ) ) from baseline to the end of the intervention first between the  intervention and the st and ard care groups and then within the intervention group based on the patients ’ level of response to the intervention ( i.e. , patients were classified as non‐responders , partial responders , or responders ) . No differences were found in any of these outcome measures between patients in the st and ard care and intervention groups . However , when patients in the intervention group were categorized using a responder analysis approach , significant differences in the various outcome measures were found among the three respondent groups . Differences in the physical and mental component summary scores on the SF‐36 and the interference items on the BPI , among the three respondent groups , were not only statistically significant but also clinical ly significant . The use of responder analysis in analgesic trials may help to identify unique subgroups of patients and lead to the development of more effective psychoeducational interventions & NA ; Two hundred and sixty‐three ambulatory patients older than 21 years of age who were attending clinics at an oncology hospital in San Juan , Puerto Rico , were studied . They completed a question naire  ( BQ‐PR ) that measures 8 concerns about reporting pain and using analgesics , such as fears of addiction and tolerance and the belief that reporting pain can distract a physician from focusing on curing one 's disease . Ninety percent of the patients had at least some concern about each of the 8 topics , and mean scores on the 8 subscales were near the midpoint on a 0–5 scale . There were significant inverse relationships between level of education , income , and BQ‐PR total score . Those persons who experienced cancer‐related pain on the day they completed the question naire were categorized as using adequate versus not adequate analgesic medication , a determination that was based on a comparison of their level of pain to the medication they were using . Those who were not using adequate analgesic medication had higher BQ‐PR total scores than did those who were using adequate medication The purpose of this study was to determine if continued access to information following a baseline pain education program would increase knowledge and positive beliefs about cancer pain management , thus result ing in improved pain control during a 6-month follow-up period . Patients with cancer-related pain and their primary caregivers received a brief pain education program , and were then r and omized into one of three information groups : a ) usual care , b ) pain hot line , and c ) weekly provider-initiated follow-up calls for 1 month post-education .  Sixty-four patients and their primary caregivers were recruited . Both patients and caregivers showed an improvement in knowledge and beliefs after the baseline pain education program . Continued access to pain information with either the pain hot line or provider-initiated weekly follow-up calls did not affect long-term outcomes of pain intensity , interference because of pain , adequacy of analgesics used , or pain relief . In addition , long-term outcomes did not differ between patients who had improvement and those who showed decline in knowledge and beliefs pre-post education . These findings suggest that a brief pain education program can improve knowledge and beliefs of both patient and primary caregiver . Continued access to pain related information using either a patient- or provider-initiated format did not affect long-term pain outcomes AIM OF THE STUDY To investigate the role of  district nurses  in the care of cancer patients with chronic pain at home , as well as the effects of a Pain Education Programme for patients and their district nurses . The Pain Education Programme consisted of a tailored multi- method approach in which they were educated about pain , instructed how to report pain , and how to contact health care providers . BACKGROUND No educational programs for patients in pain have been studied in out patients nor integrated with the home care provided . DESIGN AND METHODS One hundred and four patients and their 115 district nurses were enrolled in a prospect i ve , longitudinal , r and omized controlled study . The primary outcome of interest was type of care provided by district nurses , satisfaction with the pain treatment , and agreement in estimating patients ' pain intensity . RESULTS Results showed that continuity of care was poor as only 36 % of the district nurses were informed about patients ' pain by hospital nurses . Pain was rarely the reason for referring the patient to district nursing after discharge . Although pain control was not a main reason for district nurses to visit a patient , pain was a subject for discussion in 76 % of visits . Besides discussing the pain problem with patients , district nurses provided only a few pain-relieving interventions . District nurses r and omized to the intervention group significantly better estimated patients ' pain intensity , and were more satisfied about patients ' pain treatment , but no differences were found in their assessment of patients ' pain relief . CONCLUSIONS These findings suggest a significant but moderate effect of the Pain Education Programme , with district nurses only playing a minor role in the treatment of cancer pain PURPOSE To determine the effectiveness of a multicomponent clinical intervention to reduce pain in out patients 
    Output:
    
We found equivocal evidence for the effect of education on self-efficacy , but no significant benefit on medication adherence or on reducing interference with daily activities .
Patient-based educational interventions can result in modest but significant benefits in the management of cancer pain , and are probably underused alongside more traditional analgesic approaches