Effects of coaching patients with lung cancer to report cancer pain

Abstract

The authors have examined the effects of coaching sensory self-monitoring and reporting on pain-related variables in patients with lung cancer. Randomly assigned to coached or not-coached groups, 215 patients have their interactions with their providers audiotaped and complete study measures pre- and postintervention. Of the 151 patients who complete the 4-week study, those coached are more likely than those not coached to give their providers unsolicited sensory pain information and to mention it before their providers ask for it. The mean number of pain parameters discussed during the audiotaped clinic visit is statistically larger at study end for the coached group. Scores for analgesic adequacy, all pain indices except one, anxiety, depression, and catastrophizing coping are not significantly different. Although coaching increases the amount of pain data communicated to providers by patients with lung cancer, the magnitude is small and does not lead to improved adequacy of analgesics prescribed for each patient's pain level.

Figure 1

Initial Coaching Intervention Components: Coaching Video and Coaching Tool.

Figure 2

The Pain Report and Color-Coded Note Cards. The Pain Report was a four-page carbonless packet. The white page was mailed to the patient one week after the initial Coaching Intervention to reinforce the phone call. The light yellow page was delivered at the in-person session (week 2). The pink page was delivered by mail (week 3) to reinforce the phone call. The yellow page was retained in the research records and contained all the information delivered to the patient during reinforcement Coaching. Note cards were color-coded to The Pain Report to allow the patient to take notes to the next clinic visit.