Behaviour change function | Strategies for overcoming barriers to cancer pain assessment and management | ||
---|---|---|---|
Patient level | Clinician level | Service/system levels | |
Education - Increasing knowledge or understanding | Information on types of pain, medications and side-effects (including low risk of opioid addiction) (OVERCOMING CANCER PAIN BOOKLET) | Information on opioid dosage, conversion and use in patients who are older and/or have renal failure (GUIDELINES, SPACED LEARNING) | Data on prevalence of cancer pain enabling comparison between services (AUDIT) |
Persuasion - Using communication to induce positive or negative feelings or stimulate action | Goal setting, reflection on exacerbating/alleviating factors, management strategies, when/from whom to seek help aimed at reframing pain and promoting sense of control (SELF-MANAGEMENT RESOURCE) | Patient advocacy for person-centred care (SELF-MANAGEMENT RESOURCE) Local data on prevalence of cancer pain and performance on quality indicators (SCREEING, AUDIT) | Data on hospitalisations and other healthcare costs resulting from cancer pain (ECONOMIC EVALUATION) |
Incentivisation - Creating expectation of reward/Coercion Creating expectation of punishment or cost | Goal setting, monitoring of pain (SELF-MANAGEMENT RESOURCE) | Quality improvement targets on pain assessment, management and outcomes (AUDIT) | |
Training - Imparting skills | Skills development in rating pain severity and self-managing pain (SELF-MANAGEMENT RESOURCE) | Skill development in assessment, management and providing patient education (SPACED LEARNING, SELF-MANAGEMENT RESOURCE) | Development of service capacity to routinely screen for pain (SCREENING) |
Environmental restructuring - Changing the physical or social context | Encouraging reporting of pain (SCREENING, SELF-MANAGEMENT RESOURCE) | Increased focus on cancer pain care (SCREENING, GUIDELINES, PATHWAY, AUDIT, SPACED LEARNING, SELF-MANAGEMENT RESOURCE) | |
Modelling - Providing an example for people to aspire to or imitate | Personal stories of well managed pain (OVERCOMING CANCER PAIN DVD) | League table (SPACED LEARNING,) Modelling change (CLINICAL CHANGE CHAMPIONS) | Community of practice |
Enablement - Increasing means/reducing barriers to increase capability or opportunity | Tools for promoting pain reporting, enhancing doctor/patient communication, and increasing priority/time accorded pain (SCREENING, SELF-MANAGEMENT RESOURCES) | Patient-held record supports information transfer and care coordination between providers (SELF-MANAGEMENT RESOURCES) |