***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: OBJECTIVE This study examined the impact of a brief pain communication/education intervention on patient outcomes in breast cancer . We hypothesized that our intervention would improve patient communication and reduce misconceptions ( " Barriers " ) concerning pain management , and that patients with lower Barriers , or who perceived their physician as being more facilitative and receptive , would report better outcomes . METHODS Female breast cancer patients with persistent pain ( n=89 ) were r and omly assigned to either a 30-min in-person pain education/communication intervention or control condition and followed for 12 weeks . RESULTS Intervention group patients reported a significant decrease in pain Barriers but not in other outcomes . Overall , patients with lower barrier scores reported less distress and better emotional well-being . Patients who scored higher in active communication ( e.g. , asking questions , giving information ) reported fewer Barriers and better pain relief . Individuals who perceived their physicians as being more receptive reported better pain management while those who perceived their physicians as being both more receptive and facilitative were more satisfied with their health care . CONCLUSION A brief education/communication intervention reduced patients '  Barriers to pain management but did not impact other patient outcomes . PRACTICAL IMPLICATION S Pain outcomes may be improved by addressing patients ' pain misconceptions and emphasizing a receptive and responsive communication style Background : Pain is 1 of the most common symptoms that a cancer patient would experience . A significant barrier to positive pain management is patients ’ misconceptions regarding analgesics and inadequate use of nonpharmacological strategies as pain relief . Objective : The purpose of this study was to investigate the effectiveness of a pain management program ( PMP ) on pain intensity , use of PRN drugs  and  nonpharmacological strategies  as pain relief , and barriers to managing pain in cancer patients . Methods : The study was conducted in the palliative care and hospice ward of a public hospital in Hong Kong . Patients were r and omized to either an experimental group ( receiving the PMP ) or a control group ( routine care ) . There were 38 hospitalized patients , with 20 ( 13 males and 7 females ) in the experimental group and 18 ( 11 males and 7 females ) in the control group ; mean age was 61.95 years ( experimental group ) to 63.94 years ( control group ) . Results : Upon the completion of PMP , pain scores were significantly reduced in both groups , yet patients in the experimental group showed a significant increase in the use of PRN analgesics and nonpharmacological strategies to relieve pain ( P < .05 ) and significantly reduce barriers to managing their cancer pain ( P < .05 ) compared with the control group . Conclusion : Cancer patients should be empowered with pain management education to gain knowledge and correct misconceptions in managing their cancer pain . Implication s for Practice : Integration of the PMP into routine clinical work may help to improve the st and ard of care for cancer patients . It is recommended to provide pain management education to all cancer patients Introduction The prevalence of pain in patients with cancer is still too high . Factors relating to ineffective pain treatment fall into three categories : the health care system , professional care providers , and patients . In patients , various barriers lead to noncompliance . Previous educational interventions have increased their knowledge of pain and decreased short-term pain levels . In this r and omized controlled trial , the authors investigated how an intensive home-based education program given by nurses affected short-term and long-term pain levels . Material s and methods One hundred and twenty cancer patients were r and omized to receive either the pain education program ( PEP ) or usual care .  Pain , knowledge , quality of life , anxiety , and depression were measured at baseline and after 4 and 8 weeks . In the intervention group , effects on symptom levels were communicated to the treating physician . Results The level of pain had decreased at 4 weeks , but not at 8 weeks . Significant decreases in pain only persisted in those patients with a high pain score at baseline . Knowledge of pain significantly increased in the intervention group . No correlation was found between increased pain knowledge and decreased pain levels . Conclusions The PEP given by nurses lowered pain intensity levels in cancer patients and increased their knowledge of pain . More attention should be paid to patient education and to communication between patients and health professionals regarding pain and pain management 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 BACKGROUND Inadequate adherence to prescribed analgesics may be one of the reasons why patients with cancer experience unrelieved pain . Adherence is directly influenced by patients ' barriers about pain management . Patient pain education programs ( PEPs ) have been developed to reduce patients ' barriers and increase patients ' adherence to their analgesics . The purpose of this article was to evaluate patients ' adherence in patients receiving a pain consult and patient pain education in comparison with patients receiving st and ard pain treatment ( st and ard care [ SC ] )  , to better explore the difficulties in medication adherence in cancer-related pain and the effects of PEP . METHODS In 54 adult out patients with cancer-related pain , patients ' adherence to the prescribed around-the-clock analgesics was measured with a Medication Event Monitoring System , in the following time intervals : weeks 1 and 2 , weeks 3 and 4 , and weeks 7 and 8 after r and omization . Adherence was differentiated into taking adherence , taking the correct dose , and taking analgesics at the right time intervals . RESULTS Taking adherence increased in the intervention group compared to baseline ( from 91 % to 93 % ) and decreased in the SC group ( from 85 % to 78 % ; P < 0.05 ) . At the end of the study , more patients in the intervention group took their analgesics at the right intervals ( 78 % ) than did patients in the SC group ( 64 % , P < 0.05 ) . During the study , patients were more adherent to opioids than to World Health Organization step 1 analgesics . CONCLUSION The combined intervention can increase adherence . The true problem in pain management is that patients do not take their prescribed analgesics at the right time intervals . With the detailed adherence information from this study , it is possible to further tailor patient education to the individual patient 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 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 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 assess 
    Output:
    
CONCLUSIONS Patient-based pain educational programs may result in improvements of relevant patient-reported outcomes .