مقالات پذیرفته شده در نهمین کنگره بین المللی زیست پزشکی
The Effect of Nursing Interventions Based on Multimodal Pain Assessment on Chronic Pain Management in Patients with Metastatic Cancer
The Effect of Nursing Interventions Based on Multimodal Pain Assessment on Chronic Pain Management in Patients with Metastatic Cancer
Mohammad Reza Shabani,1Neda Pashaei,2,*Narjes sadat farizani gohari,3
1. Instructor of Operating Room,Department of Operating Room, kerman University of Medical Sciences, kerman, iran. 2. Department of Nursing, Urmia Branch, Islamic Azad University, Urmia, Iran. 3. International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Introduction: Chronic pain is among the most debilitating symptoms faced by patients with metastatic cancer, significantly impairing functional capacity and quality of life. While pharmacological therapy remains central to pain control, inadequate assessment often limits treatment efficacy. Multimodal pain assessment integrating physical, psychological, and functional dimensions offers an evidence based framework to enhance clinical decision-making. However, its consistent application in oncology nursing practice remains limited. This systematic review aims to synthesize recent evidence on nursing interventions guided by multimodal pain assessment for chronic pain management in metastatic cancer patients.
Methods: A systematic search of PubMed, CINAHL, Scopus, and Cochrane Library was conducted for articles published between January 2014 and August 2024. Studies were included if they examined nursing led interventions applying multimodal pain assessment in adults diagnosed with metastatic cancer. Inclusion criteria emphasized intervention studies, observational research, or qualitative reports with structured pain outcomes. Studies focusing purely on pharmacological dosage trials without nursing specific components were excluded. Screening followed PRISMA guidelines, with two independent reviewers conducting selection and data extraction.
Results: Twenty-four studies met the inclusion criteria, encompassing randomized controlled trials, quasi experimental designs, and qualitative analyses. Nursing interventions integrated patient-centered education, tailored non pharmacological strategies such as relaxation therapy, guided imagery, and supportive counseling, coupled with close collaboration with oncology teams for medication optimization. Evidence indicated that multimodal assessment facilitated early identification of breakthrough pain, improved analgesic regimen adjustments, and enhanced adherence to non-pharmacological approaches. Several studies reported significant improvements in patient reported pain intensity scores, reduced interference of pain with daily activities, and better psychological well being. Qualitative findings emphasized the role of trust based nurse–patient relationships and ongoing assessment in sustaining positive outcomes.
Conclusion: Nursing interventions grounded in multimodal pain assessment offer a comprehensive and adaptable approach to chronic pain management in metastatic cancer patients. Incorporating these strategies into standard oncology care can optimize pain control, improve functional status, and elevate overall quality of life. Future clinical guidelines should emphasize structured training for oncology nurses on multimodal assessment techniques and integration into multidisciplinary care plans.