Santos Salas, A., Fuentes Contreras, J., Armijo-Olivo, S., Saltaji, H., Watanabe, S., Chambers, T., . . . Cummings, G.G. (2016). Non-pharmacological cancer pain interventions in populations with social disparities: A systematic review and meta-analysis. Supportive Care in Cancer, 24, 985–1000. 

DOI Link

Purpose

STUDY PURPOSE: To examine the evidence for nonpharmacological cancer pain interventions in populations with disparities of income, ethnicity, or gender
 
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: MEDLINE, CINAHL, Cochrane Collaboration, Health Technology Assessment, Database of Abstracts of Reviews of Effects, Proquest Dissertations and Theses
 
KEYWORDS: Search terms used for MEDLINE are provided in an appendix
 
INCLUSION CRITERIA: Patients 18 years and older, nonpharmacologic cancer pain interventions, randomized controlled trials, controlled trials and pre-/post designs
 
EXCLUSION CRITERIA: Not specified

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 4,623
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Cochrane Collaboration risk of bias tool

Sample Characteristics

FINAL NUMBER STUDIES INCLUDED = 3
 
TOTAL PATIENTS INCLUDED IN REVIEW = 232
 
SAMPLE RANGE ACROSS STUDIES: 67–97 patients
 
KEY SAMPLE CHARACTERISTICS: One study was of varied cancer types, looking at ethnicity and income; one examined Hispanic women with breast cancer; and one included several minority group patients with various tumor types.

Phase of Care and Clinical Applications

APPLICATIONS: Palliative care

Results

Interventions included pain education, culturally sensitive online support and education, and coaching versus controls. Meta-analysis of pooled results from these three studies did not show a significant overall effect on pain intensity. Interventions across studies varied in terms of frequency, duration, and intensity.

Conclusions

This analysis did not demonstrate a significant impact of psychosocial/psychoeducational types of interventions on pain intensity among disadvantaged patient groups. There is insufficient evidence to draw any firm conclusions.

Limitations

  • Few studies were included.
  • Generally high risk of bias in included studies

Nursing Implications

No firm conclusions can be drawn regarding the effectiveness of psychosocial interventions for pain management among disadvantaged patient groups. There is a lack of research in this area. Findings here point to the need to develop and test these types of interventions for potentially vulnerable patient populations.

Legacy ID

5848