Posted: October 31st, 2023

Pain management and quality of life are significant concern

You are part of an interprofessional team working on a study that looks at the relationship of perception of pain severity and quality of life in advanced cancer patients. Some of your colleagues think it is a cross-sectional design but others think it is a quasi-experimental design because it has several specific hypotheses. How would each group support their argument and how would you collaborate to resolve your differences? Why do you think it is important to have an team made of interprofessional members reviewing and being a part of your study?

Pain management and quality of life are significant concerns for patients living with advanced or terminal cancer. While medical interventions can help alleviate physical symptoms, perceptions of pain severity and resulting impacts on well-being are highly individualized experiences. This paper will explore the relationship between these factors through a discussion of relevant literature and analysis of a proposed study’s design elements.
Relationship Between Pain and Quality of Life
Several studies have found an inverse correlation between pain severity and quality of life indicators for cancer patients.(1,2) Higher reported pain is associated with poorer physical, psychological, and social/family well-being.(3) However, the nature of this relationship is complex, as individual differences in pain tolerance, coping mechanisms, social support networks, and other medical/psychosocial factors all influence subjective experiences of pain and quality of life.(4)
Proposed Study Design
An interprofessional research team proposes a study examining the relationship between perceived pain severity and quality of life scores in advanced cancer patients. The study would involve surveying patients using validated measurement tools for pain (e.g. Brief Pain Inventory) and quality of life domains (e.g. EORTC QLQ-C30/QLQ-BN20 for brain cancer patients).(5,6)
Differing Perspectives on Design
Some team members characterize the proposed study as having a cross-sectional design, as it involves collecting data from participants at a single time point to analyze relationships between variables.(7) However, others argue it has elements of a quasi-experimental design since it involves testing specific hypotheses about how perceived pain impacts quality of life domains through statistical analysis.(8) Both perspectives raise valid points regarding key aspects of the study’s methodology.
Value of Interprofessional Teams
Interprofessional collaboration brings together experts from different disciplines who can provide diverse insights into research design, implementation, and interpretation of findings. For this study, team members from fields like nursing, psychology, social work, and palliative care can offer nuanced perspectives on factors like pain assessment and quality of life constructs from their practice experience. Their collaborative input will strengthen various phases of the project, from refining hypotheses and measures to ensuring ethical recruitment of vulnerable patients and dissemination of meaningful results.
Conclusion
In summary, while an inverse relationship exists between pain and quality of life for cancer patients, the nature of this association involves complex individual experiences. The proposed study aims to further elucidate these relationships through validated measurement tools and statistical analysis, with the goal of informing improved clinical care and support for patients. An interprofessional research team is well-suited to carry out this work through integration of diverse expertise and viewpoints.
References:
Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287-333. doi:10.1016/j.ejpain.2005.06.009
van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 2007;18(9):1437-1449. doi:10.1093/annonc/mdm056
Cleeland CS, Gonin R, Hatfield AK, et al. Pain and its treatment in outpatients with metastatic cancer. N Engl J Med. 1994;330(9):592-596. doi:10.1056/NEJM199403033300902
Ward SE, Donovan HS, Owen B, et al. The subjective experience of pain in women with metastatic breast cancer. Pain. 2002;99(1-2):223-231. doi:10.1016/s0304-3959(02)00208-6
Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore. 1994;23(2):129-138.
Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365-376. doi:10.1093/jnci/85.5.365
Setia MS. Methodology Series Module 3: Cross-sectional Studies. Indian J Dermatol. 2016;61(3):261-264. doi:10.4103/0019-5154.182410
Harris DJ, et al. “Quasi-experimental design.” The SAGE encyclopedia of educational research, measurement, and evaluation (2018): 1418-1420.
Reeves, S., et al. “Interprofessional education: effects on professional practice and healthcare outcomes (update).” Cochrane Database of Systematic Reviews 2017.3 (2017).