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Randomized controlled trial of standardized education and telemonitoring for pain in outpatients with advanced solid tumors

 Han Sang Kim  ;  Sang Joon Shin  ;  Sang Cheol Kim  ;  Surim An  ;  Sun Young Rha  ;  Joong Bae Ahn  ;  Byoung Chul Cho  ;  Hye Jin Choi  ;  Joo Hyuk Sohn  ;  Hyo Song Kim  ;  Hyun Cheol Chung  ;  Joo Hang Kim  ;  Jae Kyung Roh  ;  Soohyeon Lee 
 SUPPORTIVE CARE IN CANCER, Vol.21(6) : 1751-1759, 2013 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Anxiety/psychology ; Depression/psychology ; Fatigue/psychology ; Female ; Humans ; Male ; Middle Aged ; Neoplasms/complications* ; Neoplasms/psychology* ; Nurse Practitioners ; Outpatients/psychology ; Pain/etiology* ; Pain/psychology* ; Pain Management/methods* ; Patient Education as Topic/methods* ; Psychiatric Status Rating Scales ; Quality of Life/psychology ; Telephone ; Young Adult
Cancer ; Pain ; Care management ; Telemonitoring ; Quality of life
PURPOSE: Previous studies have not defined the role of telemonitoring with educational tools in outpatients with advanced cancers. We tested the effectiveness of standardized education and telemonitoring for improving pain, distress, anxiety, depression, quality of life (QoL), and performance in outpatients with advanced cancers. METHODS: A total of 108 patients were randomly assigned to receive pain education alone (control arm) or pain education plus telemonitoring (experimental arm). Nursing specialists provided video-assisted educational material in both arms and daily telemonitoring for the first week in the experimental arm. Assessment was performed at baseline and 1 week and included evaluations of pain (Brief Pain Inventory, BPI), distress (Distress Thermometer, DT), anxiety, and depression (Hospital Anxiety and Depression Scale, HADS), QoL (QLQ-C30), and a Karnofsky score. RESULTS: Overall (n = 108), pain intensity was significantly improved at 1 week, including worst pain (7.3 to 5.7, P < 0.01) and average pain (4.6 to 3.8, P < 0.01). Additionally, anxiety (HADS score ≥ 11, 75% to 56%, P < 0.01), depression (HADS score ≥ 11, 73% to 51%, P < 0.01), QoL (fatigue and insomnia), and the Karnofsky score (32 to 66, P < 0.01) were also significantly improved at 1 week. However, the level of distress did not improve. The telemonitoring plus standardized education group showed more significant improvement in portion of pain >4 on VAS scale (35% vs. 19%, P = 0.02). CONCLUSIONS: Standardized pain education using nursing specialists is an efficient way to improve not only pain itself but also anxiety, depression, performance, and QoL. The addition of telemonitoring helps to improve pain management in the outpatient setting.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Joo Hang(김주항)
Kim, Han Sang(김한상) ORCID logo https://orcid.org/0000-0002-6504-9927
Kim, Hyo Song(김효송) ORCID logo https://orcid.org/0000-0002-0625-9828
Roh, Jae Kyung(노재경)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Sohn, Joo Hyuk(손주혁) ORCID logo https://orcid.org/0000-0002-2303-2764
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Lee, Soo Hyeon(이수현)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Cho, Byoung Chul(조병철) ORCID logo https://orcid.org/0000-0002-5562-270X
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
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