Yildirim, Y.K., Cicek, F., & Uyar, M. (2009). Effects of pain education program on pain intensity, pain treatment satisfaction, and barriers in Turkish cancer patients. Pain Management Nursing, 10, 220–228.

To investigate the effect of a pain education program on pain intensity, satisfaction with pain treatment, and barriers to pain management

Patients were randomly assigned to a group that received the education program or to a control group. Patients in the education group received written materials and an educational slide program. They received a booklet covering the same content as the other components. Content included the definition of pain; a list of its causes; discussion of pain-related pharmacologic treatment, side effects, myths, and misconceptions (e.g., misconceptions about addiction, drug dependence, tolerance); noncompliance; and nonpharmacologic pain treatment and pain assessment. The initial session took 30–40 minutes and was provided to each patient individually, in his or her hospital room. The education session was repeated after three and seven days, as needed. Patients in the control group received standard care and answers to relevant questions but did not receive specialized education. Assessments were done at baseline and at weeks 2, 4, and 8.

• The sample was composed of 40 patients.
• Of all patients, 85% were over age 60.
• Of all patients, 55% were male and 45% were female.

• Single site
• Inpatient
• Turkey

Phase of treatment: active treatment

Randomized controlled study

• McGill Pain Questionnaire 
• Numeric rating scale
• Barriers Questionnaire, Revised

• Compared to controls at weeks 2, 4, and 8, patients in the education group had a significant decrease in mean scores regarding present pain (p < 0.001), least pain (P < 0.05), and satisfaction with pain treatment (p < 0.001).
• At the end of week 2, the barriers score decreased significantly in the education group, dropping from 2.12 to 1.29; in the control group, the barriers score decreased from 2.3 to 2.28 (p < 0.001). Compared to controls, patients who received the education had lower barrier scores, in subscales regarding use of analgesics (p = 0.023) and communication related to pain (p = 0.000).

Pain education was helpful in reducing pain intensity; education improved satisfaction with pain management and reduced barriers to pain management.

• The study had a small sample, with fewer than 100 patients.
• The study had a risk of bias due to no attentional control or blinding.
• Authors provided no information regarding analgesic use or changes in analgesics over the course of the study. Such changes could have influenced results.
• The individual education session was to have been repeated every 3–7 days as needed. However, authors did not state how many sessions were repeated.
• Whether patients were in the hospital for the duration of the study, in a controlled environment, is unclear.

Findings suggest that pain education is effective at reducing pain intensity, increasing patient satisfaction, and reducing barriers to pain management. Specifically addressing misconceptions about analgesic use and the need to communicate regarding the pain experience can be expected to help reduce barriers to effective pain management by means of analgesics. Patients' active involvement in their own pain management can improve the quality of this aspect of care.