Self-management of chronic disease and related symptoms provides a framework for understanding the contextual factors that influence self-management knowledge and skills that patients and families require to manage their condition on a day-to-day basis. The management of cancer pain is a significant issue for patients and families, and their experience can provide insight on cancer pain self-management support needs and preferences. A meta-synthesis of 20 qualitative research articles on self-management of cancer pain was conducted to gain a deeper understanding of the self-management support needs of patients with cancer pain. Noblit and Hare’s meta-ethnographic model was used. The meta-synthesis resulted in increased understanding of the needs and preferences for self-management support of cancer pain and the role of the health care practitioner. Practical implications are presented.
AdamR.de BruinM.BurtonC. D.BondC. M.Giatsi ClausenM.MurchieP. (2018, June). What are the current challenges of managing cancer pain and could digital technologies help?BMJ Supportive & Palliative Care, 8(2), 204–212. https://doi.org/10.1136/bmjspcare-2016-001232
2.
AppleyardS. E.ClarkeC. (2018). An interpretative phenomenological analysis of the experiences of older people self-managing cancer pain at home. Journal of Psychosocial Oncology, 36(3), 333–349. https://doi.org/10.1080/07347332.2017.1417949
3.
ArmanM.GebhardtA.Hök NordbergJ.AndermoS. (2020, April). Women’s lived experiences of chronic pain: Faces of gendered suffering. Qualitative Health Research, 30(5), 772–782. https://doi.org/10.1177/1049732319888478
4.
AtkinsS.LewinS.SmithH.EngelM.FretheimA.VolminkJ. (2008, April16). Conducting a meta-ethnography of qualitative literature: Lessons learnt. BMC Medical Research Methodology, 8, Article 21. https://doi.org/10.1186/1471-2288-8-21
5.
BoothA. (2013). Acknowledging a dual heritage for qualitative evidence synthesis: Harnessing the qualitative research and systematic review research traditions [PhD thesis, Sheffield University, Sheffield, UK].
6.
BoothA.NoyesJ.FlemmingK.GerhardusA.WahlsterP.van der WiltG. J.MozygembaK.RefoloP.SacchiniD.TummersM.RehfuessE. (2018, July). Structured methodology review identified seven (RETREAT) criteria for selecting qualitative evidence synthesis approaches. Journal of Clinical Epidemiology, 99, 41–52. https://doi.org/10.1016/j.jclinepi.2018.03.003
7.
BrittenN.CampbellR.PopeC.DonovanJ.MorganM.PillR. (2002, October). Using meta ethnography to synthesise qualitative research: A worked example. Journal of Health Services Research & Policy, 7(4), 209–215. https://doi.org/10.1258/135581902320432732
8.
BrittenN.PopeC. (2012). Medicine taking for asthma: A worked example of meta-ethnography (Chapter 3) (LockwoodK. H. C., Ed.). Wiley-Blackwell.
9.
CampbellR.PoundP.MorganM.Daker-WhiteG.BrittenN.PillR.YardleyL.PopeC.DonovanJ. (2011, December). Evaluating meta-ethnography: Systematic analysis and synthesis of qualitative research. Health Technology Assessment, 15(43), 1–164. https://doi.org/10.3310/hta15430
10.
CampbellR.PoundP.PopeC.BrittenN.PillR.MorganM.DonovanJ. (2003, February). Evaluating meta-ethnography: A synthesis of qualitative research on lay experiences of diabetes and diabetes care. Social Science & Medicine, 56(4), 671–684. https://doi.org/10.1016/s0277-9536(02)00064-3
11.
CamplingN.RichardsonA.MulveyM.BennettM.JohnstonB.LatterS. (2017, November). Self-management support at the end of life: Patients’, carers’ and professionals’ perspectives on managing medicines. International Journal of Nursing Studies, 76, 45–54. https://doi.org/10.1016/j.ijnurstu.2017.08.019
DeandreaS.MontanariM.MojaL.ApoloneG. (2008, December1). Prevalence of undertreatment in cancer pain. A review of published literature. Annals of Oncology, 19(12), 1985–1991. https://doi.org/10.1093/annonc/mdn419
14.
DunhamM.AllmarkP.CollinsK. (2017, June30). Older people’s experiences of cancer pain: A qualitative study. Nursing Older People, 29(6), 28–32. https://doi.org/10.7748/nop.2017.e943
15.
EkstedtM.RustøenT. (2019, April). Factors that hinder and facilitate cancer patients’ knowledge about pain management-a qualitative study. Journal of Pain and Symptom Management, 57(4), 753–760.e751. https://doi.org/10.1016/j.jpainsymman.2018.12.334
16.
ErasmusE. (2014, December). The use of street-level bureaucracy theory in health policy analysis in low- and middle-income countries: A meta-ethnographic synthesis. Health Policy and Planning, 29(Suppl. 3), iii70–ii78. https://doi.org/10.1093/heapol/czu112
17.
FenwickC.ChaboyerW.St JohnW. (2012, December17). Decision-making processes for the self-management of persistent pain: A grounded theory study. Contemporary Nurse, 42(1), 53–66. https://doi.org/10.5172/conu.2012.42.1.53
18.
Finfgeld-ConnettD. (2014, November). Metasynthesis findings: Potential versus reality. Qualitative Health Research, 24(11), 1581–1591. https://doi.org/10.1177/1049732314548878
19.
FletcherS.KulnikS. T.DemainS.JonesF. (2019). The problem with self-management: Problematising self-management and power using a Foucauldian lens in the context of stroke care and rehabilitation. PLoS One, 14(6), e0218517. https://doi.org/10.1371/journal.pone.0218517
20.
FranceE. F.CunninghamM.RingN.UnyI.DuncanE. A. S.JepsonR. G.MaxwellM.RobertsR. J.TurleyR. L.BoothA.BrittenN.FlemmingK.GallagherI.GarsideR.HannesK.LewinS.NoblitG. W.PopeC.ThomasJ.VanstoneM.HigginbottomG. M. A.NoyesJ. (2019, January31). Improving reporting of meta-ethnography: The eMERGe reporting guidance. BMC Medical Research Methodology, 19(1), Article 25. https://doi.org/10.1186/s12874-018-0600-0
21.
FranceE. F.UnyI.RingN.TurleyR. L.MaxwellM.DuncanE. A. S.JepsonR. G.RobertsR. J.NoyesJ. (2019, February18). A methodological systematic review of meta-ethnography conduct to articulate the complex analytical phases. BMC Medical Research Methodology, 19(1), Article 35. https://doi.org/10.1186/s12874-019-0670-7
22.
FunkG. F.KarnellL. H.ChristensenA. J. (2012, February). Long-term health-related quality of life in survivors of head and neck cancer. Archives of Otorhinolaryngology-Head & Neck Surgery, 138(2), 123–133. https://doi.org/10.1001/archoto.2011.234
23.
GibbinsJ.BhatiaR.ForbesK.ReidC. M. (2014). What do patients with advanced incurable cancer want from the management of their pain? A qualitative study. Palliative Medicine, 28(1), 71–78.
24.
GrecoM. T.RobertoA.CorliO.DeandreaS.BandieriE.CavutoS.ApoloneG. (2014, December20). Quality of cancer pain management: An update of a systematic review of undertreatment of patients with cancer. Journal of Clinical Oncology, 32(36), 4149–4154. https://doi.org/10.1200/JCO.2014.56.0383
25.
GreyM.KnaflK.McCorkleR. (2006, September–October). A framework for the study of self- and family management of chronic conditions. Nursing Outlook, 54(5), 278–286. https://doi.org/10.1016/j.outlook.2006.06.004
GrotmolK. S.LieH. C.HjermstadM. J.AassN.CurrowD.KaasaS.MoumT. A.PigniA.LogeJ. H. & European Palliative Care Research, C. (2017, December). Depression—A major contributor to poor quality of life in patients with advanced cancer. Journal of Pain and Symptom Management, 54(6), 889–897. https://doi.org/10.1016/j.jpainsymman.2017.04.010
28.
HaozousE. A.KnobfM. T.BrantJ. M. (2011). Understanding the cancer pain experience in American Indians of the Northern Plains. Psycho-Oncology, 20(4), 404–410. https://doi.org/10.1002/pon.1741
29.
HartmannM.BäznerE.WildB.EislerI.HerzogW. (2010). Effects of interventions involving the family in the treatment of adult patients with chronic physical diseases: A meta-analysis. Psychotherapy and Psychosomatics, 79(3), 136–148.
30.
HoS. S. M.KwongA. N. L.WanK. W. S.HoR. M. L.ChowK. M. (2017, December). Experiences of aromatherapy massage among adult female cancer patients: A qualitative study. Journal of Clinical Nursing, 26(23–24), 4519–4526. https://doi.org/10.1111/jocn.13784
31.
HovindI. L.BredalI. S.DihleA. (2013, April). Women’s experience of acute and chronic pain following breast cancer surgery. Journal of Clinical Nursing, 22(7–8), 1044–1052. https://doi.org/10.1111/jocn.12167
32.
HughesN.ClossS.FlemmingK.BennettM.HughesN. D.ClossS. J.BennettM. 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. https://doi.org/10.1007/s00520-016-3372-2
33.
ImE. O. (2006, November–December). White cancer patients’ perception of gender and ethnic differences in pain experience. Cancer Nursing, 29(6), 441–450. https://doi.org/10.1097/00002820-200611000-00002
34.
ImE. OGuevaraE.CheeW. (2007). The pain experience of Hispanic patients with cancer in the United States. Oncology Nursing Forum, 34(4), 861–868. https://doi.org/10.1188/07.ONF.861-868
JørgensenC. R.ThomsenT. G.RossL.DietzS. M.TherkildsenS.GroenvoldM.RasmussenC. L.JohnsenA. T. (2018, January). What facilitates “patient empowerment” in cancer patients during follow-up: A qualitative systematic review of the literature. Qualitative Health Research, 28(2), 292–304. https://doi.org/10.1177/1049732317721477
38.
KirshbaumM. N.SteadM.BartysS. (2016, April). An exploratory study of reiki experiences in women who have cancer. International Journal of Palliative Nursing, 22(4), 166–172. https://doi.org/10.12968/ijpn.2016.22.4.166
39.
KumbamuA.GellerG.LeppinA.FernandezC.TilburtJ.KoenigB. (2018, September/October). Contending worldviews in the clinical encounter: An empirical study of complementary and alternative medicine deliberations in contemporary medical oncology. Journal of Alternative and Complementary Medicine, 24(9–10), 996–1002. https://doi.org/10.1089/acm.2018.0200
40.
LeppinA.JamesK.GellerG.TilburtJ. (2014). Missed opportunities: A descriptive analysis of CAM discussions and practices in the management of pain in oncology patients. Journal of Alternative and Complementary Medicine, 20(5), A111–A111. https://doi.org/10.1016/j.jpainsymman.2016.05.025
41.
LiangS. Y.YatesP.EdwardsH.TsayS. L. (2008, August). Opioid-taking tasks and behaviours in Taiwanese outpatients with cancer. Journal of Clinical Nursing, 17(15), 2079–2088. https://doi.org/10.1111/j.1365-2702.2008.02332.x
42.
LorM.XiongP.ParkL.SchweiR. J.JacobsE. A. (2017). Western or traditional healers? Understanding decision making in the Hmong population. Western Journal of Nursing Research, 39(3), 400–415. https://doi.org/10.1177/0193945916636484
43.
LovellM. R.LuckettT.BoyleF. M.PhillipsJ.AgarM.DavidsonP. M. (2014, June1). Patient education, coaching, and self-management for cancer pain. Journal of Clinical Oncology, 32(16), 1712–1720. https://doi.org/10.1200/JCO.2013.52.4850
44.
MalpassA.ShawA.SharpD.WalterF.FederG.RiddM.KesslerD. (2009, January). “Medication career” or “moral career”? The two sides of managing antidepressants: A meta-ethnography of patients’ experience of antidepressants. Social Science & Medicine, 68(1), 154–168. https://doi.org/10.1016/j.socscimed.2008.09.068
45.
MannE. G.LefortS.VandenkerkhofE. G. (2013, May). Self-management interventions for chronic pain. Pain Management, 3(3), 211–222. https://doi.org/10.2217/pmt.13.9
46.
MehtaA.CohenS. R.EzerH.CarnevaleF. A.DucharmeF. (2011, January). Striving to respond to palliative care patients’ pain at home: A puzzle for family caregivers. Oncology Nursing Forum, 38(1), E37–E45. https://doi.org/10.1188/11.ONF.E37-E45
47.
MoherD.LiberatiA.TetzlaffJ.AltmanD. G.GroupP. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Open Medicine, 3(3), e123–130. https://www.ncbi.nlm.nih.gov/pubmed/21603045
48.
MooreA.GrimeJ.CampbellP.RichardsonJ. (2013, March). Troubling stoicism: Sociocultural influences and applications to health and illness behaviour. Health (London), 17(2), 159–173. https://doi.org/10.1177/1363459312451179
49.
MorganH. M.EntwistleV. A.CribbA.ChristmasS.OwensJ.SkeaZ. C.WattI. S. (2017, April14). We need to talk about purpose: A critical interpretive synthesis of health and social care professionals’ approaches to self-management support for people with long-term conditions. Health Expectations, 20(2), 243–259. https://doi.org/10.1111/hex.12453
50.
NoblitG. W. (2016, June). How qualitative (or interpretive or critical) is qualitative synthesis and what we can do about this? eMERGE Project, Edinburgh.
51.
NoblitG. W.HareR. D. (1988). Meta-ethnography: Synthesizing qualitative studies. SAGE.
52.
PattisonN.BrownM. R.GubbayA.PeacockJ.RossJ. R.ChapmanS.SauzetO.WilliamsJ. (2016, February). Towards a pain free hospital: An in-depth qualitative analysis of the pain experiences of head and neck cancer patients undergoing radiotherapy. British Journal of Pain, 10(1), 29–37. https://doi.org/10.1177/2049463715599995
53.
RingN.JepsonR.HoskinsG.WilsonC.PinnockH.SheikhA.WykeS. (2011, November). Understanding what helps or hinders asthma action plan use: A systematic review and synthesis of the qualitative literature. Patient Education and Counseling, 85(2), e131–143. https://doi.org/10.1016/j.pec.2011.01.025
54.
SandA. M.HarrisJ.RoslandJ. H. (2009, Summer). Living with advanced cancer and short life expectancy: Patients’ experiences with managing medication. Journal of Palliative Care, 25(2), 85–91. https://www.ncbi.nlm.nih.gov/pubmed/19678459
55.
Schulman-GreenD.BradleyE. H.KnobfM. T.PrigersonH.DiGiovannaM. P.McCorkleR. (2011, October). Self-management and transitions in women with advanced breast cancer. Journal of Pain and Symptom Management, 42(4), 517–525. https://doi.org/10.1016/j.jpainsymman.2010.12.007
56.
SchumacherK. L.Plano ClarkV. L.WestC. M.DoddM. J.RabowM. W.MiaskowskiC. (2014a, November). Pain medication management processes used by oncology outpatients and family caregivers part I: Health systems contexts. Journal of Pain and Symptom Management, 48(5), 770–783. https://doi.org/10.1016/j.jpainsymman.2013.12.242
57.
SchumacherK. L.Plano ClarkV. L.WestC. M.DoddM. J.RabowM. W.MiaskowskiC. (2014b, November). Pain medication management processes used by oncology outpatients and family caregivers part II: Home and lifestyle contexts. Journal of Pain and Symptom Management, 48(5), 784–796. https://doi.org/10.1016/j.jpainsymman.2013.12.247
58.
SchutzA. (1971). Collected papers (Vol. 1). Martinus Nijhoff.
59.
Te BoveldtN.Vernooij-DassenM.LeppinkI.SamwelH.VissersK.EngelsY. (2014, November). Patient empowerment in cancer pain management: An integrative literature review. Psycho-Oncology, 23(11), 1203–1211. https://doi.org/10.1002/pon.3573
60.
ThorneS. E. (2015, November). Qualitative metasynthesis: A technical exercise or a source of new knowledge?Psycho-Oncology, 24(11), 1347–1348. https://doi.org/10.1002/pon.3944
61.
TorresanM. M.GarrinoL.BorraccinoA.MacchiG.De LucaA.DimonteV. (2015, August). Adherence to treatment in patient with severe cancer pain: A qualitative enquiry through illness narratives. European Journal of Oncology Nursing, 19(4), 397–404. https://doi.org/10.1016/j.ejon.2015.01.001
62.
ToyeF.SeersK.AllcockN.BriggsM.CarrE.BarkerK. (2014, June21). Meta-ethnography 25 years on: Challenges and insights for synthesising a large number of qualitative studies. BMC Medical Research Methodology, 14, Article 80. https://doi.org/10.1186/1471-2288-14-80
63.
ValebergB. T.MiaskowskiC.HanestadB. R.BjordalK.MoumT.RustoenT. (2008, September). Prevalence rates for and predictors of self-reported adherence of oncology outpatients with analgesic medications. The Clinical Journal of Pain, 24(7), 627–636. https://doi.org/10.1097/AJP.0b013e31816fe020
64.
VallurupalliM.LauderdaleK.BalboniM. J.PhelpsA. C.BlockS. D.NgA. K.KachnicL. A.VanderweeleT. J.BalboniT. A. (2012, March–April). The role of spirituality and religious coping in the quality of life of patients with advanced cancer receiving palliative radiation therapy. The Journal of Supportive Oncology, 10(2), 81–87. https://doi.org/10.1016/j.suponc.2011.09.003
65.
Van den Beuken-van EverdingenM. H.HochstenbachL. M.JoostenE. A.Tjan-HeijnenV. C.JanssenD. J. (2016, June). Update on prevalence of pain in patients with cancer: Systematic review and meta-analysis. Journal of Pain and Symptom Management, 51(6), 1070–1090. e1079. https://doi.org/10.1016/j.jpainsymman.2015.12.340
66.
WestC. M.DoddM. J.PaulS. M.SchumacherK.TripathyD.KooP.MiaskowskiC. (2003, January–February). The PRO-SELF(c): Pain Control Program–an effective approach for cancer pain management. Oncology Nursing Forum, 30(1), 65–73. https://doi.org/10.1188/03.ONF.65-73
67.
ZwakmanM.JabbarianL. J.van DeldenJ.van der HeideA.KorfageI. J.PollockK.RietjensJ.SeymourJ.KarsM. C. (2018). Advance care planning: A systematic review about experiences of patients with a life-threatening or life-limiting illness. Palliative Medicine, 32(8), 1305–1321. https://doi.org/10.1177/0269216318784474
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
