Background

The aim of the paper is provide a critique of the article by Hughes et al. (2016) which investigated about the views of palliative care professionals regarding the self-management (SM) of pain among patients with advanced cancer. The study was conducted using qualitative research designs and the participants identified SM as a desirable yet problematic aspect for patient. The findings of the study gave insight about different aspects such as facilitators of SM process and the challenges while teaching SM to patients. Overall, the research had implications in implementing educational interventions to support SM of cancer. The topic of SM for cancer patient is considered important as it can fluctuate the trajectory of illness (Hammer et al., 2015).

The aim of the study was to explore the views of palliative care staffs on SM of pain from advanced cancer and to inform development of educational support for the client group. Hence, from the review of aim, it can be said that the study intended to improve the pain management from cancer.

Qualitative descriptive method was employed in the research article to explore the perspective of palliative care staffs on SM. Qualitative descriptive research design  is effective when research need to get all details about the what, where, when and how of a research phenomenon or event of interest. This research design is a commonly used research tradition and it is useful in developing and refining the questionnaires. The selection of research design is appropriate as per the research aim as it aimed to explore perspectives of staffs related to SM and qualitative research design is suitable to identify perception, experiences or opinion about participants related to any event of interest (Kim, Sefcik & Bradway, 2017). Views On Self-Management Of Pain In Cancer Patients Example Paper

The participants for the study included a purposive sample of health and social care professionals working in a specialist palliative care services in North England. The participants were contacted through local clinical networks and personal contacts. Thus, it is evident that purposive sampling design was used to recruit research participants. Purposive sampling is a sampling technique that relies on researcher’s judgment to choose appropriate members of the population. The advantage of using this research design is that it supports researchers in selecting information rich cases. The second advantage is that it allows selecting groups that are experiences with the phenomenon of interest (Palinkas et al., 2015). The gap in the article in reporting about the sampling design is that the authors have not justified why the specified group of sample was selected and what were the selection criteria. This aspect may influence the validity of the findings.

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The data collection was done using focus group interview methods. Single interview was conducted with each focus group and it mainly explored perceptions and experiences about what to cancer patients do to manage pain. The topics explored in the interviews were use of pharmacological and non-pharmacological measures for pain and their perception about the challenges in SM. Use of focus group interview is a common data collection method in qualitative research and the advantage of this approach is that it helps to obtain data from purposely selected samples and explore insight of 3-4 members at the same time. It allows for rich discussion that helps to uncover multiple perspectives (Andresen, Laursen & Rosenberg, 2018).

Methods

No measurement tool was used to collect data. Instead, interview process was facilitated by the first authors. In three of the four interviews, a research nurse acted as a co-moderator. The co-moderators used field notes to record body language and interaction process of sample groups. Field note is a form of written documentation and the purpose is to record contextual information about the research process (Phillippi & Lauderdale, 2018).

In the selected article, the analysis of data was done using latent content analysis process. It involves identifying all statements about self-management and inductively deriving concepts. Each of the concepts were defined in table 1 and some of the conceptual categories included autonomy, capability, control, education, motivation and responsibility. The authors gave a full detail about how each of the process was completed. For instance, the researchers first listened to the transcripts and then started reading the transcripts several times. This process helped to reinforce familiarity with the concept. This was followed by extraction of specific sections and coding the data line-by-line. The analytical memos informed the next stage of analysis and helped to gain insight about key themes identified from the interview transcripts. Latent content analysis is one form of content analysis in qualitative research and it allows researchers to identify hidden meaning from transcripts. These meaning units are mostly identified from written communications (Kyngäs, Kääriäinen & Elo, 2020). The yield coming from the above analysis process was that it gave rise to thematic pattern and increased understanding about the perspectives linked to SM for cancer patients.

Based on the latent content analysis of interview transcripts, total nine overarching concepts were identified related to the health and social care professional’s views about self-management of cancer pain. One of theme was that ‘SM of cancer pain is desirable’. Under this theme, the author reported about the participant’s perspective about SM. They regarded it as an important measure to have control over symptoms. In addition, the participants reported about the ways of control for patients. Their perception about SM has been narrated in the following ways ‘It’s asserting control of the situation….. I think it’s always appropriate [self-management] because you want the patient to still be in control’. SM was considered desirable because as it supports palliative care staffs to provide realistic solutions. The factor needed for this were patient autonomy and engaging in appropriate partnership with patients. Schulman-Green et al. (2018) argues that routine use of SM is the key to decrease SM burden and maximize the quality of life.

The trustworthiness of the findings will depend on the use of rigour during the research process and ensuring use of appropriate measures to minimize bias in the results. To improve the trustworthiness, experienced staffs were recruited for interviewing. In addition, peer debriefing session was arranged throughout the data collection method to ensure that each individual can interpret the findings in an appropriate manner. By discussion about findings at meeting, all anomalies and points of disagreement were addressed (Carton & Laszczuk, 2021). Thus, it can be concluded that the findings were credible as appropriate methods were used to ensure that the interpretation process was plausible.

The purpose behind conducting any research is to promote practice change and make improvement in current process of work. The study gave many outcomes that support nurses professionally while dealing with cancer patients. For instance, the participant’s view gave the insight that patients desire using apps and websites to know about SM practices. In addition, it was found that adherence to SM was dependent on patient’s willingness to accept the results. Hence, it gave implications to the nursing staff to consider willingness and focus on motivation building while giving education on SM practices. In addition, different participants had different views about using educational material for SM. This suggests the need to discuss with patients about their beliefs about SM and their preference with regard to learning about SM skills (Ross et al., 2019). Hence, the findings are meaningful as it change practice of nurses in related to SM education for cancer patients.

References

Andresen, K., Laursen, J., & Rosenberg, J. (2018). Outlining and dictating scientific manuscripts is a useful method for health researchers: A focus group interview. SAGE open medicine, 6, 2050312118778728.

Carton, G., & Laszczuk, A. (2021). The (undervalued) role of peer debriefing in organizational ethnography. In Academy of Management Proceedings (Vol. 2021, No. 1, p. 13466). Briarcliff Manor, NY 10510: Academy of Management.

Hammer, M. J., Ercolano, E. A., Wright, F., Dickson, V. V., Chyun, D., & Melkus, G. D. E. (2015). Self-management for adult patients with cancer: an integrative review. Cancer Nursing, 38(2), E10-E26.

Hughes, N. D., Closs, S. J., Flemming, K., & Bennett, M. I. (2016). Supporting self-management of pain by patients with advanced cancer: views of palliative care professionals. Supportive care in cancer, 24(12), 5049-5057.

Kim, H., Sefcik, J. S., & Bradway, C. (2017). Characteristics of qualitative descriptive studies: A systematic review. Research in nursing & health, 40(1), 23-42.

Kyngäs, H., Kääriäinen, M., & Elo, S. (2020). The trustworthiness of content analysis. In The application of content analysis in nursing science research (pp. 41-48). Springer, Cham.

Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research.  Views On Self-Management Of Pain In Cancer Patients Example Paper