Perceived Feasibility of Nurse-Led Cognitive Behavioral Therapy for Cancer Pain.

PURPOSE: Experts have called for systematic implementation of cognitive behavioral therapy (CBT)-based interventions for cancer pain; however, implementation of CBT for cancer pain has been extremely limited. DESIGN: We explored nurses' perceptions of implementing a brief, evidence-based pain CBT protocol using a mixed-methods analysis. METHODS: Registered nurses working within ambulatory oncology/infusion clinics were recruited. Survey items and interviews focused on familiarity and current use of pain self-management strategies and attitudes toward the CBT protocol. We used univariate descriptive statistics to analyze the survey and rapid qualitative analysis for interview data. RESULTS: Ninety-nine nurses participated in the survey (46% response rate) and 13 nurses participated in the follow-up interviews. Most survey respondents (between 51% and 84%) were moderately/very familiar with nearly all pain self-management strategies mentioned. The three strategies that nurses described as using to a moderate/great extent were advising patients about lifestyle changes (54%), problem-solving (43%), and coping with difficult pain-related emotions (39%). CONCLUSION: Respondents generally viewed an oncology nurse-led model of pain CBT as acceptable and appropriate. Future studies will need to provide support for a nurse/nurses dedicated to pain CBT and should evaluate the clinical effectiveness of that model while also testing practical strategies for training/supervision. CLINICAL IMPLICATIONS: Oncology nurses are generally supportive of implementing a brief, evidence-based CBT protocol for cancer pain management. Despite some uncertainty about feasibility, positive attitudes highlight the potential for enhancing cancer pain care through nurse-led behavioral interventions.

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