Development of the Opioid Self-Management Scale for Advanced Cancer Patients and Examination of its Validity and Reliability

Abstract Background: Approximately 60% of outpatients with advanced cancer experience pain, and self-management with opioids according to lifestyle is important for appropriate pain relief. To date, there are no studies that clearly describe the concept of opioid self-management or that have assessed the factors involved, such as improving self-management abilities. This study developed the Opioid Self-Management Scale for Advanced Cancer Patients (OSSA), and examined its validity and reliability.Methods: The scale was developed in three phases. In phase 1 the scale content was validated. In phase 2 surface validity was examined. The surface validity was examined using a draft scale that extracted qualitatively and deductively. Phase 3 validated and verified the reliability of the OSSA. The validity and reliability were examined using a factor analysis and re-testing.Results: The OSSA consists of 33 items on six subscales. The structural equation modeling was such that the χ2 value was 709.8 (p<.001, df = 467), goodness-of-fit index 0.78, adjusted goodness-of-fit index 0.73, root mean squares of approximation 0.063, and comparative fit index 0.92. Cronbach’s α was 0.93. The intraclass correlation coefficient was 0.59–0.90. The coefficient was -0.21 (p<0.05) for the total OSSA score and “Average pain over 24 hours,” and 0.26 (p<0.01) for “Rate of pain relief over 24 hours.”Conclusion: We determined that the OSSA had tolerable validity and reliability, and the results indicated that a higher self-management ability leads to greater pain relief. The OSSA scales can be considered effective for use in research. A shortened version of the OSSA is required for realistic and practical clinical use.

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Validity and reliability of Korean version of simplified nutritional appetite questionnaire in patients with advanced cancer: A multicenter, longitudinal study.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.31_suppl.211 ◽

2017 ◽

Vol 35 (31_suppl) ◽

pp. 211-211

Author(s):

Su-Jin Koh ◽

So Yeon Oh ◽

Ji Yeon Baek ◽

Kyung A. Kwon ◽

Hei-Cheul Jeung ◽

...

Keyword(s):

Weight Loss ◽

Cancer Patients ◽

Correlation Coefficient ◽

Advanced Cancer ◽

Screening Tool ◽

Intraclass Correlation ◽

Validity And Reliability ◽

Advanced Cancer Patients ◽

Korean Version ◽

The Mean

211 Background: Malnutrition and a loss of muscle mass are frequent in cancer patients and have a negative effect on clinical outcome. Nutrition risk screening aims to increase awareness and allow early recognition and treatment of cancer cachexia. Therefore, screenings should be brief, inexpensive, highly sensitive, and have good specificity. SNAQ is a simple screening tool including 4 questions, and validated to predict weight loss within 6 months in community-dwelling adults and nursing home residents. Our study aimed to translate the SNAQ into Korean, and to assess the validity and reliability of the translated screening tool in advanced cancer patients. Methods: The SNAQ was translated into Korean according to linguistic validation. The internal consistency of the SNAQ was evaluated by Cronbach’s alpha coefficient. Test–retest reliability was evaluated using the intraclass correlation coefficient. Concurrent validity was evaluated by measuring the Pearson’s correlation coefficient between the SNAQ and Mini-Nutritional Assessment (MNA) and Patient-Generated Subjective Global Assessment (PG-SGA). Results: In the 194 patients included in full analysis set, cancer stage was predominantly (98.5%) metastatic, the mean age was 60 years, and the mean BMI was 24 kg/m2. According to MNA score ≤11, 57 patients (29.3%) were malnourished. The mean score of the Korean version of the SNAQ was 13.8 (SD = 2.5) with a range of 6–19. Cronbach’s alpha coefficient was 0.74, and intraclass correlation coefficient was 0.87. The SNAQ was moderately correlated with MNA(r = 0.4043, p < 0.0001) and PG-SGA(r = -0.5297, p < 0.0001). A significant weight loss of 5% of the original body weight within 6 months occurred in 46 (24.7%) of the 186 patients. SNAQ score ≤14 predicted 5% weight loss with a sensitivity of 56.5% and a specificity of 44.3%. Conclusions: The Korean version of the SNAQ had high validity and reliability. SNAQ is useful for the screening tool for advanced cancer patients. The SNAQ had a limitation to predict impending weight loss in advanced cancer patients.

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Opioid-induced or pain relief-reduced symptoms in advanced cancer patients?

European Journal of Pain ◽

10.1016/j.ejpain.2005.02.006 ◽

2006 ◽

Vol 10 (2) ◽

pp. 153-153 ◽

Cited By ~ 26

Author(s):

Sebastiano Mercadante ◽

Patrizia Villari ◽

Patrizia Ferrera ◽

Alessandra Casuccio

Keyword(s):

Pain Relief ◽

Cancer Patients ◽

Advanced Cancer ◽

Advanced Cancer Patients

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Effectiveness of rapid titration with intravenous administration of oxycodone injection in advanced cancer patients with severe pain

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyz145 ◽

2019 ◽

Vol 49 (11) ◽

pp. 1061-1064

Author(s):

Nobuhisa Nakajima

Keyword(s):

Pain Relief ◽

Adverse Effects ◽

Cancer Patients ◽

Advanced Cancer ◽

Severe Pain ◽

Rating Scale ◽

Numeric Rating Scale ◽

Advanced Cancer Patients ◽

Morphine Group ◽

Time Required

Abstract Some cancer patients suddenly develop severe, excruciating pain that requires rapid management using opioid medication. This study aimed to evaluate the effectiveness of rapid titration using oxycodone injection. Study subjects were advanced cancer patients who experienced severe pain (numeric rating scale ≥7) and needed prompt pain relief. Primary endpoint was (i) time required for the initial sign of significant analgesia to become evident. Secondary endpoints were (ii) pain relief stabilization success rate and (iii) adverse effects. Groups treated with oxycodone (oxycodone group) and morphine (morphine group) were retrospectively compared. The oxycodone group had 33 cases and the morphine group had 32 cases: (i) 15.6 ± 4.3 min in the oxycodone group and 19.3 ± 4.7 min in the morphine group (P = 0.001); (ii) 70 and 63% within 24 hours, and 88 and 84% within 48 hours in the oxycodone group and the morphine group, respectively (P = 0.36, 0.48). Although (iii) adverse effects appeared in both groups in the form of respiratory suppression, etc., the effects were mild. Rapid titration using oxycodone injections may be considered a beneficial choice.

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Facilitation of accurate and effective radiation therapy using fentanyl pectin nasal spray (FPNS) to reduce incidental breakthrough pain due to procedure positioning

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2015.12.001 ◽

2016 ◽

Vol 11 (1) ◽

pp. 52-58 ◽

Cited By ~ 3

Author(s):

Isabel Prieto ◽

José Pardo ◽

Javier Luna ◽

Juan P. Marin ◽

Jesús Olivera ◽

...

Keyword(s):

Pain Relief ◽

Cancer Patients ◽

Advanced Cancer ◽

Rating Scale ◽

Breakthrough Pain ◽

Pharmacoeconomic Analysis ◽

Opioid Analgesic ◽

Oral Morphine ◽

Average Dose ◽

Advanced Cancer Patients

AbstractPurposeTo provide effective and accurate radiotherapy (RT) for advanced cancer patients who experience breakthrough pain (BP) due to positioning manoeuvres, through the use of FPNS. Secondary endpoints were the dose and time required to achieve a 50% numeric rating scale (NRS) reduction and conduction of a pharmacoeconomic analysis.Patients and methodsTwenty-seven advanced cancer patients with moderate-severe BP associated with routine radiotherapy procedures and manoeuvres were selected to receive FPNS. Most patients (20/27) had bone metastases. The patients showed a low Karnovsky performance status (mean 54%; range: 30–80). BP intensity was scored with the NRS before and after the procedures that triggered it. All patients were already receiving opioid baseline treatment at a total dose equivalent to 40–160 mg oral morphine. Before the procedure, BP was treated with 100-400 μg of FPNS. Data related to tolerance, pain relief, onset of the relief and efficient dose to allow RT to proceed were collected.Results In 26 patients the BP score was reduced by at least 50% as determined in 15.5 min (range 8-35 min) after fentanyl pectin intranasal administration, and pain relief started after 7 min (range 3–15 min); p <0.05 in both cases. The duration of pain reduction facilitated the proceeding of RT. The Mean NRS score before the procedure was 9 (95%CI: 8.6–9.4) and decreased during procedure to 3 (95%CI: 2.5–3.8). The average dose of FPNS for most patients was 100-200 to achieve pain control, except in three patients who required progressive doses of up to 300–400 μg. After receiving 300 μg, one patient dropped out of the study due to severe adverse effects (nausea). Seven patients reported minor undesirable effects related to FPNS administration.Conclusions and implicationsCertain necessary RT procedures in advanced cancer patients can cause severe BP episodes. A simple, safe, fast acting and strong analgesic is needed. FPNS is a rapidly absorbed opioid analgesic with a pain relief profile that would be particularly well suited for this patient population. By reducing BP, the drug enables the completion of necessary RT procedures without needless patient discomfort. When BP is attenuated, Department productivity is maintained and unnecessary delays are avoided. Further studies and clinical trials are needed to assess therapeutic FPNS dosages with a view to defining efficacy in the correct clinical context.

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Programmable Pump for Intrathecal Morphine Delivery to Cisterna Magna: Clinical Implications in Novel Management of Refractory Pain Above Middle Thoracic Vertebrae Level Utilizing a Prospective Trial Protocol and Review

Anesthesiology and Pain Medicine ◽

10.5812/aapm.115873 ◽

2021 ◽

Vol 11 (3) ◽

Author(s):

Chang Sun ◽

Yu-Tong Wang ◽

Yu-Jie Dai ◽

Zhi-Hui Liu ◽

Jing Yang ◽

...

Keyword(s):

Pain Relief ◽

Cancer Patients ◽

Advanced Cancer ◽

Short Form ◽

Intrathecal Morphine ◽

Prospective Trial ◽

Depression Scale ◽

Thoracic Vertebrae ◽

Advanced Cancer Patients ◽

Refractory Pain

Background: The cisterna Intrathecal Drug Delivery system (IDDS) with morphine has proven to be effective in treating refractory cancer pain above the middle thoracic vertebrae level in some countries. However, it has not been fully investigated in others. We designed the current project to investigate the efficacy and safety of cisterna IDDS for pain relief in refractory pain above the middle thoracic vertebrae level in advanced cancer patients. Methods: This study protocol allows for eligible cancer patients to receive the cisterna IDDS operation. Pain intensity (Visual Analogue scale, VAS), quality of life (36-Item Short-Form Health Survey, SF-36), and depression (Self-Rating Depression scale, SDS) are assessed along with side effects in the postoperative follow-up visits. Recent literature suggests a potential role for cisterna IDDS morphine delivery for refractory pain states above the middle thoracic level. Conclusion: The results of this study may provide further evidence that cisterna IDDS of morphine can serve as an effective and safe pain relief strategy for refractory pain above the middle thoracic vertebrae level in advanced cancer patients.

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Validity and Reliability of the Persian Version of Emotion Thermometers in Iranian Advanced Cancer Patients

International Journal of Cancer Management ◽

10.5812/ijcm.90504 ◽

2019 ◽

Vol 12 (7) ◽

Author(s):

Neda Shahvaroughi Farahani ◽

Malek Bastami ◽

Mahdi Alemrajabi ◽

Hanieh Alasty ◽

Mohaddeseh Rajabi

Keyword(s):

Cancer Patients ◽

Advanced Cancer ◽

Validity And Reliability ◽

Advanced Cancer Patients ◽

Persian Version

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Douleur cancéreuse en fin de vie et titration morphinique Opiod-induced or pain relief-reduced symptoms in advanced cancer patients?

Douleurs Évaluation - Diagnostic - Traitement ◽

10.1016/s1624-5687(06)77626-0 ◽

2006 ◽

Vol 7 (4) ◽

pp. 219

Author(s):

F. Clère

Keyword(s):

Pain Relief ◽

Cancer Patients ◽

Advanced Cancer ◽

Advanced Cancer Patients ◽

Fin De Vie ◽

Douleur Cancéreuse

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Validity and Reliability of the Family Inventory of Needs (FIN): Measuring the Care Needs of Families of Advanced Cancer Patients

Journal of Nursing Measurement ◽

10.1891/1061-3749.3.2.109 ◽

1995 ◽

Vol 3 (2) ◽

pp. 109-126 ◽

Cited By ~ 82

Author(s):

Linda J. Kristjanson ◽

Jan Atwood ◽

Lesley F. Degner

Keyword(s):

Construct Validity ◽

Cancer Patients ◽

Advanced Cancer ◽

Internal Consistency ◽

Family Members ◽

Validity And Reliability ◽

Alpha Coefficient ◽

Advanced Cancer Patients ◽

Care Needs ◽

The Family

Two studies balanced qualitative and quantitative data to provide evidence of satisfactory validity and reliability of the Family Inventory of Needs (FIN). The FIN is designed to measure the importance of care needs of families of advanced cancer patients (FIN-Importance of Care Needs subscale) and the extent to which families perceive that their care needs have been met (FINFulfillment of Care Needs subscale). The first study involved development of the instrument and testing for clarity, apparent internal consistency (nonquantitative assessment of homogeneity of content), and content validity using a panel of six experts (family members of advanced cancer patients). The FIN met or exceeded the preset criteria specified used in this phase of testing. The second study of the project used 109 family members of advanced cancer patients from three hospice programs to test the FIN for internal consistency and construct validity. Internal consistency of the FIN-Importance of Care Needs subscale as measured by Cronbach’s alpha coefficient was .83 without redundancy. Construct analysis was assessed using factor analysis techniques. An inability to extract a substantively meaningful minimum number of factors, together with the fact that a theta reliability coefficient of .85 was obtained (only .02 higher than the alpha coefficient), suggested that the items were parallel supporting the conclusion that the subscale is unidimensional. Support for the construct validity of the FINImportance of Care Needs subscale was also obtained using predictive modeling. The internal structure of the FIN-Fulfillment of Care Needs subscale was assessed using cluster analysis. Results suggested that the subscale is a unidimensional one. Overall, the FIN met the preset reliability and validity criteria providing promising evidence for the instrument’s sound psychometric properties for use in research and clinical settings.

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