Oncology Nurses Knowledge and Attitudes Regarding Cancer Pain Management

Background: Oncology nurses play a crucial role in cancer pain management and must be highly informed to ensure their effective practice in the cancer setting. The aim of this study was to determine the baseline level of knowledge and attitudes of oncology nurses regarding cancer pain management. Materials and Methods: A cross-sectional survey research design was employed. The sample comprised 58 cancer nurses working in Shahid Sadoughi hospital, Yazd, Iran. The ‘’Nurses Knowledge and Attitudes Survey Regarding Pain’’ (NKAS) tool and a demographic form were utilized to ascertain the knowledge and attitudes of oncology nurses working in oncology settings. Results: The average correct response rate for oncology nurses was 66.6%, ranging from 12.1% to 94.8%. The nurses mean score on the knowledge and attitudes survey regarding pain management was 28.5%. Results revealed that the mean percentage score overall was 65.7%. Only 8.6% of nurse participants obtained a passing score of 75% or greater. Widespread knowledge deficits and poor attitudes were noted in this study, particularly regard pharmacological management of pain. Conclusions: The present study provides important information about knowledge deficits in pain management among oncology nurses and limited training regarding pain management. Our results support the universal concern of inadequate knowledge and attitudes of nurses regarding cancer pain. It is suggested educational and quality improvement initiatives in pain management could enhance nurses knowledge in the area of pain and possibly improve practice.     

Factors Associated with Place of Death in Koprean Patients with Terminal Cancer

Aim: To investigate factors that affect the place of death (POD) of terminal cancer patients. Materials andMethods: We recruited 702 consecutive patients (≥18 years) from 12 centers during July 2005 to October 2006,and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patientsto the POD using the 2005-2009 death certificate data of Korea’s National Statistical Office. The primary outcomevariable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluatedusing univariate and multivariate analyses. Results: Most patients died in a hospital (91.5%, n=441) and age,education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancerawareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 ofpatients, and education and preference for place of terminal care of caregivers were significant predictors inunivariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care asthe terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18-7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers whowere highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD. Conclusions: Most of the terminalcancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preferenceof both the patient and caregiver for hospital/palliative care as the terminal care option and higher educationof the caregiver.     

Spiritual Care Needs of Terminal Ill Cancer Patients

Objective: Terminal ill cancer patients experience spiritual distress and need spiritual care. They are in need of palliative care in the long term to alleviate suffering. The aim of the study was to investigate spiritual needs of terminal ill cancer patients. Methods: This study is a cross-sectional study. The participants were Thai terminal ill cancer patients from seven hospitals in northern, northeast, central, and southern regions of Thailand. Three-hundred-and-twenty-two participants were purposively selected. The instrument used in this study was a spiritual needs scale, consisting of 41 items with 4-point rating scale. Statistical analysis was F-test for one-way analysis of variance. Results: The majority of terminal ill cancer patients aged fifty-one years old. Most of them were females with end stage cancer status that did not respond to treatment. The overall spiritual needs of terminal ill cancer patients were at the moderate level (M = 18.21, SD = 2.56). The highest mean was found in the ‘prepare for death’ dimension, followed by the ‘have meaning, values, and life purposes’ and the ‘have opportunity to pursue most important things in life’ dimensions respectively and had different spiritual needs among status (F(3,318) = 3.66, p < 0.05), number of family members (F(8,313) = 5.07,  p < 0.05), living with family (F(2,319) = 3.91, p < 0.05), and spiritual anchor (F(2,319) = 4.13, p < 0.05). Conclusion: The study results provide insight into spiritual needs of terminal ill cancer patients which assists in improving the provision of holistic care to let the patients be happy at end-of-life phase.     

A Cross-sectional Study of Knowledge,Attitude and Barriers to Colorectal Cancer Screening among Cancer Survivors

Introduction: Understanding behaviour of cancer survivors is imperative as they are at risk of recurrence or second cancers. Colorectal cancer (CRC) is one of the most common cancers globally. We aim to determine the uptake rate, barriers and predictors of CRC screening among cancer survivors. Methods: Within a public hospital in Singapore, 150 non-CRC survivors were enrolled. Questionnaire on knowledge, screening behaviour, motivators and barriers towards CRC screening was administered. Results: Majority were survivors of breast (69.3%), prostate (7.3%), endometrial (4%) and ovarian (4%) cancers. More than half had high knowledge scores for CRC symptoms, screening tests and risk factors. About a third had received physician’s recommendation on CRC screening. Approximately half had undergone screening. The most common barriers to CRC screening were lack of symptoms and physician’s recommendation. Cancer survivors with higher education, higher household income, family history and those who perceived “great need” or “some need” were more likely to have undergone screening (56.4% vs 30.6%, p=0.003; 62.2% vs 41.9%, p=0.022; 70.6% vs 45.1%, p=0.048; 70.8% vs 27.4%, p<0.001). Physician’s recommendation (76.4% vs 31.6%, p<0.001) and high CRC symptom knowledge (55.8% vs 34.5%, p=0.012) were associated with increased likelihood of screening.On multivariate analysis, physician’s recommendation, higher household income and survivors’ perceived need to undergo screening remained strong predictors for CRC screening (p<0.001; p=0.010; p<0.001). Conclusion: The uptake rate of CRC screening among non-CRC survivors was modest. Physicians need to be more active in discussing CRC screening with cancer survivors as part of the survivorship care plan.     

Relationships between family physicians' referral for palliative radiotherapy, knowledge of radiotherapy, and prior training: a survey of rural and urban family physicians

ABSTRACT: BACKGROUND: The primary objective of this research was to assess the relationship between FPs' knowledge of palliative radiotherapy (RT) and referral for palliative RT METHODS: 1001 surveys were sent to FPs who work in urban, suburban, and rural practices. Respondents were tested on their knowledge of palliative radiotherapy effectiveness and asked to report their self-assessed knowledge. RESULTS: The response rate was 33%. FPs mean score testing their knowledge of palliative radiotherapy effectiveness was 68% (SD=26%). The majority of FPs correctly identified that painful bone metastases (91%), airway obstruction (77%), painful local disease (85%), brain metastases (76%) and spinal cord compression (79%) can be effectively treated with RT, though few were aware that hemoptysis (42%) and hematuria (31%) can be effectively treated. There was a linear relationship between increasing involvement in palliative care and both self-assessed (p<0.001) and tested (p=0.02) knowledge. FPs had higher mean knowledge scores if they received post-MD training in palliative care (12% higher; p<0.001) or radiotherapy (15% higher; p=0.002). There was a strong relationship between FPs referral for palliative radiotherapy and both self-assessed knowledge (p<0.001) and tested knowledge (p=0.01). CONCLUSIONS: Self-assessed and tested knowledge of palliative RT is positively associated with referral for palliative RT. Since palliative RT is underutilized, further research is needed to assess whether family physician educational interventions improve palliative RT referrals. The current study suggests that studies could target family physicians already in practice, with educational interventions focusing on hemostatic and other less commonly known indications for palliative RT.     

Comparison of the JCAHO Scoring System and the ESAS Scoring System in Determining the Palliative Care Needs of Gynecological Cancer Patients Treated at Hasan Sadikin Hospital

Objective: The purpose of this study was to analyze the relationship between quality of life with the JCAHO and the ESAS scoring system, and to compare the JCAHO and the ESAS scoring system in determining the palliative care needs of gynecological cancer patients treated at RSHS. Method: The subjects of this study were all gynecological cancer patients who were treated at RSHS in May-August 2020. This study was an analytic study with a cross sectional design. The data of this study were obtained from interviews, questionnaires and patient medical records, the study was analyzed bivariate using chi square with α = 0.05. Results: The results showed that the quality of life of patients with gynecological cancer was associated with the JCAHO palliative score (p <0.05), the better the patient’s quality of life, the better the JCAHO palliative score. The quality of life of gynecological cancer patients was related to ESAS (p <0.05), the better the patient’s quality of life, the better the ESAS. There was difference between the JCAHO palliative score and the ESAS in determining the palliative care needs of gynecological cancer patients (p< 0.05). Conclusion: Quality of life has correlation with palliative scores, the lower the palliative score, the better the quality of life. This study showed significant difference between the JCAHO palliative score and the ESAS in determining the palliative care needs of gynecological cancer patients. The JCAHO palliative score measures objectively how the patient is on admission for treatment, this score not only measures the intensity of symptoms but measures the underlying disease, comorbid disease, functional status of the patient and other criteria for the patient.  ESAS assesses the intensity of symptoms, the assessment of palliative care needed can change rapidly if the intensity of symptoms in patients changes.     

Does Clinical Experience Help Oncology Nursing Staff to Deal with Patient Pain Better than Nurses from other Displines? Knowledge and Attitudes Survey Amongst Nurses in a Tertiary Care in Malaysia

Background: Successful implementation of pain management procedures and guidelines in an institution depends very much on the acceptance of many levels of healthcare providers. Aim: The main purpose of this study was to determine the level of knowledge and attitudes regarding pain among nurses working in tertiary care in a local setting and the factors that may be associated with this. Materials and Methods: This cross-sectional research study used a modified version of the Nurses’ Knowledge and Attitudes Survey (NKAS) regarding pain.Basic demographic data were obtained for further correlation with the level of pain knowledge. Results: A total of 566 nurses, 34 male and 532 female, volunteered to participate in this study. The response rate (RR) was 76%, with an overall mean percentage score of 42.7±10.9 (range: 5–92.5). The majority of participants were younger nurses below 40 years of age and more than 70% had worked for less than 10 years (6.6±4.45). Up to 92% had never had any formal education in pain management in general. The total mean score of correct answers was 58.6±9.58, with oncology nursing staff scoring a higher percentage when compared with nurses from other general and critical care wards (63.52±9.27, p<0.045). Only 2.5% out of all participants obtained a score of 80% or greater. The majority of the oncology nurses achieved the expected competency level (p<0.03). Conclusions:The present findings give further support for the universal concern about poor knowledge and attitudes among nurses’ related to the optimal management of pain. The results reflected that neither number of years working nor age influenced the level of knowledge or attitudes of the practising nurses. Oncology nursing staff consistently scored better than the rest of the cohort. This reflects that clinical experience helped to improve attitudes and knowledge concerning better pain management.     

Attitudes of medical oncologists toward palliative care for patients with advanced and incurable cancer: report on a survery by the European Society of Medical Oncology Taskforce on Palliative and Supportive Care

BACKGROUND AND METHODS: In part of a quality improvement program, the European Society of Medical Oncology (ESMO) surveyed its membership regarding their involvement in and attitudes toward the palliative care (PC) of patients with advanced cancer. RESULTS: Of 895 members who responded, 82.5% were European and 12.1% were American. Sixty-nine percent of respondents reported that patients with advanced cancer constituted a major proportion of their practice; for 22% of respondents, patients with advanced cancer constituted most of their practice. Only a minority of respondents collaborated often with a PC care specialist (35%), a palliative home care service (38%), an in-patient hospice (26%), or a psychologist (33%). In response to questions regarding specific involvement in PC clinical tasks, respondents were involved more commonly in treating physical symptoms, such as pain (93%), fatigue (84%), and nausea/emesis (84%), than in managing psychological symptoms and end-of-life care issues, such as depression/anxiety (65%), existential distress (29%), or delirium (12%). Forty-three percent of respondents reported that they directly administered end-of-life care often, and 74% reported that they derived satisfaction from their involvement in end-of-life care. Overall, 88.4% of respondents endorsed the belief that medical oncologists should coordinate the end-of-life care for their patients, but a substantial minority (42%) felt that they were trained inadequately for this task. Positive attitudes toward PC were correlated highly with the degree of direct involvement in PC practice. Practitioners in private practice or teaching hospitals had substantially more positive attitudes regarding PC compared with physicians based in comprehensive cancer centers (P < 0.05). Although most of the responding medical oncologists expressed positive views regarding their involvement in the PC of patients with advanced cancer and dying patients, 15% of respondents had pervasively negative views. CONCLUSIONS: Most ESMO oncologists recognize the importance of PC and supportive care for patients with advanced cancer. Despite this, many are prepared inadequately for these tasks, and actual participation levels commonly are suboptimal.     

Attitudes toward and Knowledge of Colorectal Cancer Screening among an Omani Adult Population Attending a Teaching Hospital

Objective: Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Oman after breast and thyroid. Awareness regarding the availability of CRC screening services could play a major role in promoting early detection and reducing mortality rates. The aim of this study was to identify public knowledge and attitudes toward CRC screening. Methods: This cross-sectional study was conducted among 410 members of the public attending the Sultan Qaboos University Hospital in Muscat, Oman. A questionnaire was developed to assess the participants’ general knowledge, barriers and factors affecting attitudes, beliefs and behaviors regarding CRC screening. Results: A total of 410 members of the public participated from 500 invited (response rate: 82.0%). Most of the participants had not heard of CRC screening (76.3%) and were unaware of different screening methods (92.9%). The majority (93.9%) had not undergone CRC screening in Oman; however, 70.6% reported that they would be willing to do so in the future, particularly if recommended by doctors (52.7%). Barriers to screening included feeling embarrassed by the idea of a colonoscopy (73.9%), not having any symptoms of CRC (65.1%) and a fear of being diagnosed with CRC (55.6%). A bivariate analysis indicated that males demonstrated significantly more awareness of CRC screening compared to females (64.9% versus 35.1%; p = 0.004) and younger participants (     

Truth-telling in Oncology: Egyptian Patients’ Attitudes and Preferences

Objective: Truth-telling in oncology is a major challenge, particularly in the absence of disclosure protocols in Egypt and the lack of Egyptian studies examining patients’ preferences regarding cancer disclosure. This study aimed to reveal the preferences of patients seeking care at the National Cancer Institute – Cairo University regarding disclosing cancer diagnosis and the type and amount of information to be told. Methods: This cross-sectional study was conducted on 200 patients selected consecutively from those attending the outpatient clinics of the National Cancer Institute – Cairo University. Face-to-face interviews were performed with the patients according to a structured questionnaire. The questionnaire consisted of five parts: socio-demographic characteristics, knowledge about cancer disease, attitudes towards cancer disease, experience during the disclosure of the diagnosis, and preferences regarding disclosure of cancer diagnosis. Results: Most patients (89.5%) preferred to know the diagnosis. Of them, 94.4% wished to know from the physician. No agreement was found between most patients’ preferences and physicians’ practice. On multivariate logistic regression analysis, patients’ education was the only significant predictor of the preference to know the diagnosis (OR = 5.298, 95% CI = 1.258 - 22.301, P = 0.023). Conclusion: Patients have a great desire to know the diagnosis and other information related to treatment and prognosis.     

Effect of an Educational Intervention on Knowledge of Human Papillomavirus Vaccination among Pre-University Students in Malaysia

Background: Cervical cancer is the fourth most common cancer among women worldwide. Studies evaluating the effect of health education on knowledge and perception of cervical cancer have generated conflicting results. Thus, this study aimed to evaluate the effect of educational intervention towards knowledge of HPV vacccination for cervical cancer prevention among pre-university students in Malaysia. Materials and Methods: This was an experimental before and after study performed between October 2014 and March 2015. Five hundred and eighty students were randomly assigned into intervention and control groups. All were required to complete both pre-intervention and post-intervention questionnaires. Those in the intervention group were given an information leaflet to read before answering the post-intervention questionnaire. Results: Almost half (48.3%) of the students had poor knowledge, with a score less than 5, and only 51 (8.8%) exhibited good knowledge, with a score of 11 and above. After educational intervention, the number of students with poor knowledge was reduced to 177 (29.3%) and the number of students who exhibited good knowledge increased to 148 (25.5%). Students from the intervention group demonstrated significant higher total scores in knowledge regarding ‘HPV infection and cervical cancer’ (p=0.000) and ‘HPV vaccination and cervical cancer prevention’ (p=0.000) during post-intervention as compared to the control group. Conclusions: Knowledge on HPV infection and vaccination is low among pre-university students. Educational intervention in the form of information leaflets appears effective in creating awareness and improving knowledge.     

Role Playing for Improving Women’s Knowledge of Breast Cancer Screening and Performance of Breast Self-Examination

Background: To enhance knowledge and performance of screening as a strategy to control breast cancer, use of effective teaching methods is necessary. The objective of this study was to determine the effect of role-playing on knowledge of breast cancer screening and performance of breast self-examination (BSE). Methods: A quasi experimental design was used. Women enrolled in community cultural centers (n=314) were randomly divided into two educational groups: role playing (intervention) and lecture (control). Data were collected using a structured questionnaire before and after intervention. Reliability of the questionnaire was determined as 0.80 by Cronbach’s alpha. The women were followed up regarding performance of BSE one month later. Results: Of the 314 women, 113 (36%) and 132 (42%) had low and medium levels of knowledge, respectively. More than a third (38.2%) reported that TV and radio were the most important information sources for breast cancer and screening. There were significant differences between mean scores of knowledge before and after the intervention in both groups, but change was greater with role playing (31.3±1.9 as compared to 23.5±1.3) (P=0.001). After a month of educational intervention, 75.7% and 69.8% of those in role playing and control groups had undergone BSE. Conclusion: It appears that application of a role playing method by providers improves women’s knowledge and behavior with respect to breast cancer screening.     

Knowledge, behavior and beliefs related to cervical cancer and screening among Turkish women

Objective: The aims of this study were to explore Turkish women’s knowledge, behavior and beliefs relatedto cervical cancer and screening. Methods: The study was performed in two cities in the East of Turkey betweenSeptember 2009 and April 2010, with a sampling group of 387 women. Data were collected by means of aninterview form with the Health Belief Model Scale for Cervical Cancer and Pap Smear Test - Turkish Version.Results: Women in the research group were found to have poor knowledge, inadequate health behavior andlow/medium level false beliefs regarding cervical cancer screening. There was relation between health beliefsand characteristics of women and particularly education (F = 10.80, p = 0.01). Similarly, it was found that Papsmear barriers were influenced by demographic characteristics and that women with low-level education (p =0.001), divorced women (p = 0.05), women with low-income(p = 0.05), women who gave their first birth whenthey were 18 or younger (p = 0.05) and women not applying any contraceptive method at all (p = 0.01) weredetermined to have negative Pap smear barriers. Conclusions: Primarily the knowledge, attitudes and beliefsof women in the target group should be evaluated to increase their participation in cervical cancer screeningand to prepare effective education strategies.     

Awareness of Breast Cancer among Surgical Patients in a Tertiary Hospital in Malaysia

Background: Breast cancer is the commonest cancer among women worldwide. About one in nineteen women in Malaysia are at risk, compared to one in eight in Europe and the United States. The objectives of this study were: (1) to assess patients’ knowledge on risk factors, symptoms and methods of screening of breast cancer; and (2) to determine their perceptions towards the disease treatment outcomes. Methods: A cross-sectional survey using a validated self-administered questionnaire was conducted among 119 consecutive surgical female patients admitted from 1st of September to 8th of October 2015 in Hospital Sultan Abdul Halim, Kedah. Data were analyzed using General linear regression and Spearman’s correlation with Statistical Package for Social Science (SPSS) version 20. Results: Mean (SD) age was 40.6 (15.1) years and majority of the patients were Malay (106, 89.1%). Mean scores for general knowledge, risk factors and symptoms of breast cancer were 50.2 (24.0%), 43.0 (22.9%) and 64.4 (28.4%) respectively. Mean total knowledge score was 52.1(19.7%). 80 (67.2%) and 55 (46.2%) patients were aware of breast self-examination and clinical breast examination recommendations, respectively. Generally, patients had positive perceptions towards breast cancer treatment outcomes. However, majority (59.7%) considered that it would be a long and painful process. Knowledge was significantly better among married women with spouses (p=0.046), those with personal history of breast cancer (p=0.022) and with monthly personal income (p=0.001) with the coefficient of determination, R2=0.16. Spearman’s correlation test showed a significant positive relationship between monthly personal income and breast cancer awareness (r = 0.343, p <0.001). Conclusion: Awareness on breast cancer among our patients was average. Thus, there is a need for more awareness programs to educate women about breast cancer and promote its early detection.     

Early Detection for Breast Cancer in Iran

Objectives: The present study was carried out to assess knowledge, attitudes and practice (KAP) concerningearly detection for breast cancer among Iranian health care providers (HCP). Methods: Three hundred andeighteen HCPs were selected with stratified simple random sampling and given questionnaires to determinetheir baseline KAP for breast cancer early detection. Results were compared among categories of age, educationallevel, marriage status and professional experience with the Chi square test. Results: For six knowledge questions,71.8% participants had four or more correct responses, 80.5% agreed completely with ‘women will accept thescreening program if the physicians advise it’. However, 48% of female HCPs did not carry out any method ofbreast cancer screening for themselves during the last year; 81.5% did not carry out breast examinations for themajority of female outpatients and inpatients during last year; only 5.1% recommended breast self examination(BSE) to more than 70% of their female patients. Conclusions: Knowledge and attitudes are relativelyappropriate, but practical measures are not enough. Considering the HCP’s role for implementing the nationalbreast cancer control program, improvement in knowledge and attitudes is still important, but this may not beenough to reach to an appropriate level of desired practice.     

Attitudes toward euthanasia of physician members of the Italian Society for Palliative Care

BACKGROUND:: The problems related to requests for euthanasia by terminalpatients; the variations in attitude of palliative care physiciansand the possibility that availability of the best palliativecare might obviate the problem by eliminating requests for euthanasia,are under discussion. DESIGN:: A mailed survey with no possibility of follow-up of all 685physician members of the Italian Society for Palliative Care(SICP) in 1994. RESULTS:: Of the 359 (52.4%) responders, 139 (39%) had received requestsfor euthanasia; 16 of them (4% of the responders but 11.5% ofthose who received requests) had complied at least once, while216 (60%) had not; 125 (35%) thought that euthanasia was ‘wrong’under all circumstances; 115 (32%) thought that situations couldoccur, even in the context of palliative care, in which euthanasiamight be ethically ‘correct’; 185 (52%) thoughtthat the best palliative care might solve the problem of euthanasia,while 109 (30%) believed otherwise. The variable most stronglyasscciated with a negative attitude toward euthanasia and withthe opinion that the best palliative care might be a solutionto the problem is religious belief (P < 0.0001). CONCLUSIONS:: The attitudes of physicians practising palliative care in Italyare not different from those reported by previous studies whichinvestigated the attitude of other health professionals. Therewas no agreement about whether the best palliative care mightreduce requests for euthanasia by terminal patients. attitudes, cancer, ethics, euthanasia, palliative care     

Knowledge,Attitudes and Practices of Adults in the United Arab Emirates Regarding Helicobacter pylori induced Gastric Ulcers and Cancers

Objective: The aim of this study is to assess the current level of knowledge, as well as the attitudes and practices (KAP) of the adult population in Sharjah, UAE with regards to H. pylori induced gastric ulcers and gastric cancers. Methods: A cross sectional study of 500 participants was conducted in public venues in Sharjah, UAE through the distribution of a self-administered questionnaire English and Arabic speaking residents aged 18 years and above of both sexes were invited to participate in this study via convenience sampling. Responses were collected and analyzed using SPSS. Results: General knowledge about H. pylori was poor, only 24.6% had heard of H. pylori. 61% of the participants did not know the link between H. pylori and gastric cancer. Only 3% of the participants associated psychological stress with gastric ulcer development. Females had higher knowledge scores (p = 0.008*). Participants with a medical background typically had higher knowledge scores than their peers in other fields of work (p < 0.0001*). Participants’ attitudes towards H. pylori were suboptimal with only 33% willing to seek medical help If they get symptoms. Majority of participants with an approximate of 84% showed an overall average to excellent practices towards H. pylori. Conclusion: General awareness about H. pylori induced gastric ulcers and cancers is poor. The results of this study can be a starting point to devise new education programs and campaigns that raise awareness of this health issue which could be easily avoided with prevention, early detection, and intervention.     

Attitudes towards pain management in hospitalized cancer patients and their influencing factors

Objective:To investigate patients' attitudes towards cancer pain management and analyze the factors influencing these attitudes.Methods:The self-developed Demographic and Disease-Related Information Questionnaires,Pain Management Barriers Questionnaire-Taiwan form (BQT),and Pain Knowledge Questionnaire were administered to 363 pairs of hospitalized cancer patients and their caregivers from the oncology departments of 7 hospitals in Beijing,China.Results:The average patient score for attitudes towards pain management was 2.96±0.49.The dimension scores indicated good attitudes in three areas (scores ＜2.5),"Desire to be good" (2.22±1.04),"Fatalism" (2.08±0.81) and "Religious fatalism" (1.86±1.00),and poor attitudes in six areas (scores ≥2.5),"Tolerance" (3.83±0.96),"Use of analgesics as needed (p.r.n.)" (3.73±1.01),"Addiction" (3.44±1.05),"Disease progression" (3.28±1.26),"Distraction of physicians" (3.16±1.07) and "Side effects" (2.99±0.68).Two factors were entered into the regression equation:the caregivers' attitudes towards cancer pain management and the patients' pain knowledge.These two factors explained 23.2％ of the total variance in the patients' average scores for their attitudes towards cancer pain management.Conclusions:The patients' attitudes towards cancer pain management were poor and could be influenced by the caregivers' attitudes and the patients' pain knowledge,and thus need to be improved.     

Knowledge,Attitudes, and Practices Regarding Cervical Cancer Screening among Omani Women Attending Primary Healthcare Centers in Oman: A Cross-Sectional

Background: This study aimed to assess knowledge, attitudes, and practices regarding cervical cancer, cervical cancer screening, and Papanicolaou (Pap) smear testing among Omani women attending primary healthcare centers in Oman, and to establish a correlation with various sociodemographic characteristics. Methods: A multi-center cross-sectional survey was carried out from August 2019 to January 2020 and included 805 women attending 18 primary healthcare centers. A pre-tested questionnaire was utilized to assess the participants’ sociodemographic characteristics, cervical cancer risk factors, knowledge, attitudes, and practices related to cervical cancer, cervical cancer screening, and Pap smear testing. Results: All 805 women participated in the study (response rate: 100%). Overall, 67.5% and 50.9% had heard of cervical cancer and Pap smear testing, respectively; however, only 13.4% and 10.9% demonstrated high levels of knowledge concerning these topics. Knowledge was significantly associated with educational level, type of educational qualification (i.e. if their degree was related to healthcare), monthly income, and employment status (p ≤ 0.05 each). Only 15.7% of the participants had previously undergone Pap smear testing, although 42.7% were willing to undertake such screening in future. No associations were noted between Pap smear practice or willingness and sociodemographic characteristics, family history of cervical cancer or personal history of cervical cancer or related risk factors. Conclusions: Knowledge regarding cervical cancer and Pap smear testing was suboptimal among a cohort of Omani women attending primary healthcare centers in Oman. This may be a factor behind the increased number of cervical cancer cases in Oman; as such, a well-structured awareness and educational program is needed to address this issue.