| Overall | Public General Hospital | Public Cancer Hospital | Private Cancer Hospital | Hospice | |||||
---|---|---|---|---|---|---|---|---|---|---|
100% (92) | 29% (27) | 33% (30) | 30% (28) | 8% (7) | ||||||
Role | Total | Nurse | Physician | Nurse | Physician | Nurse | Physician | Nurse | Physician | Nurse |
%(n) | 100%(92) | 70%(64) | 30% (28) | 78% (21) | 22% (6) | 47% (14) | 53% (16) | 79% (22) | 21% (6) | 100% (7) |
Barriers to cancer pain management | Mean(n) | Mean(n) | Mean(n) | Mean(n) | Mean(n) | Mean(n) | Mean(n) | Mean(n) | Mean(n) | Mean(n) |
Personal Factors (overall) | 3.04(91) | 2.97(64) | 3.22(27) | 5.08(21) | 2.2(5) | 3.08(14) | 4.39(16) | 0.77(22) | 0.95(6) | 3.30(7) |
I am not sure of the best action to take to manage cancer pain | 3.51(91) | 3.36(64) | 3.85(27) | 6.00(21) | 2.00(5) | 2.71(14) | 5.81(16) | 1.18(22) | 0.17(6) | 3.57(7) |
I do not have enough time | 2.97(91) | 2.78(64) | 3.41(27) | 5.90(21) | 2.40(5) | 2.79(14) | 4.94(16) | 0.36(22) | 0.17(6) | 1.00(7) |
I have to care for too many patients | 4.19(91) | 3.94(64) | 4.78(27) | 6.86(21) | 2.20(5) | 4.36(14) | 6.31(16) | 0.82(22) | 2.83(6) | 4.14(7) |
I cannot obtain the proper order for pain management from the physician | 3.21(85) | 3.21(63) | 3.23(22) | 5.05(21) | 2.25(4) | 3.64(14) | 4.92(12) | 1.14(22) | 0.50(6) | 3.33(6) |
I worry patients will get addicted to pain medication | 2.30(91) | 2.14(63) | 2.64(28) | 3.48(21) | 3.33(6) | 2.38(13) | 3.25(16) | 0.45(22) | 0.33(6) | 3.00(7) |
I worry patients will suffer side effects from pain medication | 3.12(91) | 3.28(64) | 2.74(27) | 4.52(21) | 2.40(5) | 3.71(14) | 3.25(16) | 1.05(22) | 1.67(6) | 5.71(7) |
I worry I will get in trouble for giving patients pain medication | 2.15(91) | 2.06(64) | 2.37(27) | 3.76(21) | 2.20(5) | 1.86(14) | 2.94(16) | 0.41(22) | 1.00(6) | 2.57(7) |
Institutional Factors (overall) | 3.71(91) | 3.46(63) | 4.26(28) | 6.13(20) | 5.40(6) | 3.65(14) | 5.20(16) | 0.85(22) | 0.65(6) | 3.65(7) |
The proper therapies of medications are not always available at my institution | 3.21(92) | 2.89(64) | 3.93(28) | 5.05(21) | 3.50(6) | 3.79(14) | 5.44(16) | 0.41(22) | 0.33(6) | 2.43(7) |
The proper therapies or medications are too expensive for my patients to afford | 3.28(92) | 2.97(64) | 4.00(28) | 5.24(21) | 5.17(6) | 2.79(14) | 4.38(16) | 0.59(22) | 1.83(6) | 4.00(7) |
Lack of palliative care or pain management training offered | 3.99(91) | 4.03(63) | 3.89(28) | 6.25(20) | 5.00(6) | 4.79(14) | 4.94(16) | 0.95(22) | 0.00(6) | 5.86(7) |
Nurses and doctors do not communicate well | 3.09(92) | 2.73(64) | 3.89(28) | 4.48(21) | 4.83(6) | 4.57(14) | 5.00(16) | 0.36(22) | 0.00(6) | 1.29(7) |
Volume of patients seen at the institution is too high | 3.90(90) | 3.50(62) | 4.79(28) | 5.05(20) | 4.67(6) | 5.07(14) | 6.38(16) | 1.23(22) | 0.67(6) | 3.00(6) |
No/too few trained palliative care or pain management providers on staff | 3.86(92) | 3.63(64) | 4.39(28) | 5.24(21) | 5.17(6) | 3.50(14) | 5.38(16) | 1.91(22) | 1.00(6) | 4.43(7) |
No separate beds or wards for palliative care | 3.98(90) | 3.60(62) | 4.82(28) | 8.11(19) | 7.83(6) | 2.43(14) | 5.13(16) | 0.64(22) | 1.00(6) | 3.00(7) |
No palliative care outpatient department | 4.22(91) | 4.14(63) | 4.39(28) | 9.00(20) | 7.00(6) | 2.29(14) | 4.94(16) | 0.68(22) | 0.33(6) | 4.86(7) |
Country / Cultural Factors (overall) | 6.36(92) | 6.55(64) | 5.94(28) | 7.37(21) | 5.00(6) | 5.93(14) | 6.16(16) | 6.24(22) | 6.29(6) | 6.27(7) |
Patient or patient family worries the patient will get addicted to pain medication | 6.00(92) | 6.38(64) | 5.14(28) | 7.67(21) | 3.17(6) | 6.21(14) | 5.38(16) | 5.45(22) | 6.50(6) | 5.71(7) |
Patient believes they should bear pain without complaint | 5.11(92) | 5.53(64) | 4.14(28) | 5.86(21) | 2.83(6) | 6.00(14) | 4.69(16) | 4.86(22) | 4.00(6) | 5.71(7) |
Patient believes pain is deserved for wrongs committed in past lives | 4.35(92) | 4.58(64) | 3.82(28) | 5.05(21) | 2.67(6) | 5.43(14) | 4.81(16) | 3.64(22) | 2.33(6) | 4.43(7) |
Patient family does not want the patient to know their diagnosis or prognosis | 6.52(92) | 6.75(64) | 6.00(28) | 7.05(21) | 4.67(6) | 6.79(14) | 6.50(16) | 6.82(22) | 6.00(6) | 5.57(7) |
Patients live in rural areas and have trouble accessing healthcare services | 7.33(92) | 7.19(64) | 7.64(28) | 8.43(21) | 7.50(6) | 5.36(14) | 7.38(16) | 7.23(22) | 8.50(6) | 7.00(7) |
Stigma and fear of cancer causes patients to delay treatment until the disease is very advanced and pain is very difficult | 7.27(92) | 7.38(64) | 7.04(28) | 8.29(21) | 6.33(6) | 6.57(14) | 6.94(16) | 7.27(22) | 8.00(6) | 6.57(7) |
Nursing and medical school curriculums in Nepal do not contain enough content about palliative care and pain management | 7.96(92) | 8.03(64) | 7.79(28) | 9.29(21) | 7.83(6) | 5.14(14) | 7.44(16) | 8.41(22) | 8.67(6) | 8.86(7) |