***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 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE / OBJECTIVES To test the effectiveness of two interventions compared to usual care in decreasing attitudinal barriers to cancer pain management , decreasing pain intensity , and improving functional status and quality of life ( QOL ) . DESIGN R and omized clinical trial . SETTING Six outpatient oncology clinics ( three Veterans Affairs [ VA ] facilities , one county hospital , and one community-based practice in California , and one VA clinic in New Jersey ) Sample : 318 adults with various types of cancer-related pain . METHODS Patients were r and omly assigned to one of three groups : control , st and ardized education , or coaching . Patients in the education and coaching groups viewed a video and received a pamphlet on managing cancer pain . In addition , patients in the coaching group participated in four telephone sessions with an advanced practice nurse interventionist using motivational interviewing techniques to decrease attitudinal barriers to cancer pain management . Question naires were completed at baseline and six weeks after the final telephone calls . Analysis of covariance was used to evaluate for differences in study outcomes among the three groups . MAIN RESEARCH VARIABLES Pain intensity , pain relief , pain interference , attitudinal barriers , functional status , and QOL . FINDINGS Attitudinal barrier scores did not change over time among groups . Patients r and omized to the coaching group reported significant improvement in their ratings of pain-related interference with function , as well as general health , vitality , and mental health . CONCLUSIONS Although additional evaluation is needed , coaching may be a useful strategy to help patients decrease attitudinal barriers toward cancer pain management and to better manage their cancer pain . IMPLICATION S FOR NURSING By using motivational interviewing techniques , advanced practice oncology nurses can help patients develop an appropriate plan of care to decrease pain and other symptoms ABSTRACT Cancer pain management can be improved by overcoming patients ’ attitudinal barriers to reporting pain and using analgesics . A simple cost‐effective barriers intervention design ed to reach a large number of persons with cancer has not yet been tested . Such an intervention should be tested against barriers ’ assessment ‐alone , as well as no‐treatment control . The purpose of this study was to test the efficacy and the cost effectiveness of a tailored barriers intervention ( TBI ) , an educational intervention tailored to participants ’ attitudinal barriers toward reporting pain and using analgesics . This was a r and omized three‐group ( TBI , assessment ‐alone , or control ) trial with measures at baseline and 28 days later conducted at the North Central and Heartl and offices of the Cancer Information Service ( CIS ) , an NCI program that provides information to persons seeking answers to cancer‐related questions . Participants ( 1256 adult CIS callers diagnosed with cancer with moderate to severe pain in the past week ) joined the study and were r and omized . Of these participants , 970 ( 77.23 % ) provided follow‐up data . The TBI consisted of educational messages tailored to each participant ’s attitudinal barriers , delivered orally over the telephone , followed by a printed mailed copy . The outcome measures were attitudinal barriers to pain management , as well as pain outcomes ( duration , severity , and interference with life activities ) . At follow‐up the TBI group had significantly lower attitudinal barriers scores compared to assessment ‐alone and control , but the groups did not differ on the pain outcome variables . TBI and assessment ‐alone had similar cost effectiveness . The TBI needs to be strengthened to achieve reductions in pain severity & 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 CONTEXT Published literature has not defined the effectiveness of st and ardized educational tools that can be self-administered in the general oncology population with pain . OBJECTIVES We sought to determine if an educational intervention consisting of a video and /or booklet for adults with cancer pain could improve knowledge and attitudes about cancer pain management , pain levels , pain interference , anxiety , quality of life , and analgesic use . METHODS Eligible participants had advanced cancer , a pain score > /=2 of 10 in the last week , English proficiency , an estimated prognosis of more than one month , and were receiving outpatient cancer treatment at participating hospitals . Participants completed baseline assessment s and then were r and omly allocated to receive a booklet , a video , both , or neither , in addition to st and ard care . Outcome measures at two and four weeks included the Barriers Question naire ( BQ ) , Brief Pain Inventory , Global Quality of Life Scale , and Hospital Anxiety and Depression Scale . Adequacy of analgesia and severity of pain were assessed with the Pain Management Index and a daily pain diary . RESULTS One hundred fifty-eight participants were recruited from 21 sites over 42 months . Baseline mean barriers scores were lower than reported in previous Australian studies at 1.33 ( st and ard deviation : 0.92 ) . Mean average pain and worst pain scores improved significantly in patients receiving both the video and booklet by 1.17 ( st and ard error [ SE ] : 0.51 , P=0.02 ) and 1.12 ( SE : 0.57 , P=0.05 ) , respectively , on a 0 - 10 scale . The addiction subscale of the BQ score was improved by 0.44 ( SE : 0.19 ) for participants receiving any part of the intervention ( P=0.03 ) . CONCLUSION Provision of a video and /or booklet for people with cancer pain was a feasible and effective adjunct to the management of cancer pain 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 The purpose of this r and omized controlled study was to investigate the effect of a pain education program ( PEP ) on pain intensity , patients ' satisfaction with pain treatment , and patient-related barriers to pain management among Turkish patients with cancer . The study was conducted in a sample of 40 patients who were hospitalized for cancer and experiencing pain . The patients were equally r and omized to either a  PEP  or a  control group .  The data were collected by means of the McGill Pain Question naire , the Numeric Rating Scale , and the Barrier Question naire-Revised . After the completion of the question naires at the first interview , patients in the PEP group received pain education using a pain educational booklet and an explanatory slide program that discussed the booklet 's content with the patients . Patients in the control group received routine clinical care . The question naires were reapplied to the patients in both groups after 2 , 4 , and 8 weeks . Participation in a PEP was associated with decreased pain intensity scores for " present " and " least pain " during weeks 2 , 4 , and 8 ( p < .05 ) . Similarly , there were significant differences between the groups with respect to weeks 2 , 4 , and 8 satisfaction with pain treatment ( p < .05 ) . At the end of second week , the total BQ-r score decreased significantly in the PEP group from 2.12 to 1.29 compared with 2.30 to 2.28 in the control group ( p < .001 ) . The findings suggest that the PEP decreases pain intensity , improves satisfaction with treatment , and decreases barriers about cancer pain management  in cancer patients . Incorparation of PEP into the st and ard of care for cancer patients with pain may improve the quality of pain management 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 CONTEXT In Korea , many health care professionals have shown increased concern about the management of cancer pain . Five years after a pain management guideline was distributed to Korean physicians , the Korean Society of Hospice and Palliative Care evaluated the change in cancer pain management . The period evaluated was between 2001 and 2006 . METHODS We did a prospect i ve , cross-sectional cancer pain survey on the change of the pain prevalence and pain intensity , its impact on daily activities and the adequacy of pain management between 2001 and 2006 . RESULTS Overall , 7565 patients were enrolled from 72 cancer hospitals in the 2001 cancer pain survey and 7245 patients were enrolled from 63 cancer 
    Output:
    
Education intervention reduced the pain  of cancer patients .
Therefore , patient education could be considered to be an effective method of cancer pain management .