Cargando…
A survey of cancer care institutions in Nepal to inform design of a pain management mobile application
BACKGROUND: One way to improve the delivery of oncology palliative care in low and middle-income countries (LMICs) is to leverage mobile technology to support healthcare providers in implementing pain management guidelines (PMG). However, PMG are often developed in higher-resourced settings and may...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8570036/ https://www.ncbi.nlm.nih.gov/pubmed/34740339 http://dx.doi.org/10.1186/s12904-021-00824-0 |
_version_ | 1784594762067607552 |
---|---|
author | LeBaron, Virginia Adhikari, Abish Bennett, Rachel Chapagain Acharya, Sandhya Dhakal, Manita Elmore, Catherine E. Fitzgibbon, Kara Gongal, Rajesh Kattel, Regina Koirala, Ganesh Maurer, Martha Munday, Daniel Neupane, Bijay Sagar Sharma, Krishna Shilpakar, Ramila Shrestha, Sudip Thapa, Usha Zhang, Hexuan Dillingham, Rebecca Dutta Paudel, Bishnu |
author_facet | LeBaron, Virginia Adhikari, Abish Bennett, Rachel Chapagain Acharya, Sandhya Dhakal, Manita Elmore, Catherine E. Fitzgibbon, Kara Gongal, Rajesh Kattel, Regina Koirala, Ganesh Maurer, Martha Munday, Daniel Neupane, Bijay Sagar Sharma, Krishna Shilpakar, Ramila Shrestha, Sudip Thapa, Usha Zhang, Hexuan Dillingham, Rebecca Dutta Paudel, Bishnu |
author_sort | LeBaron, Virginia |
collection | PubMed |
description | BACKGROUND: One way to improve the delivery of oncology palliative care in low and middle-income countries (LMICs) is to leverage mobile technology to support healthcare providers in implementing pain management guidelines (PMG). However, PMG are often developed in higher-resourced settings and may not be appropriate for the resource and cultural context of LMICs. OBJECTIVES: This research represents a collaboration between the University of Virginia and the Nepalese Association of Palliative Care (NAPCare) to design a mobile health application (‘app’) to scale-up implementation of existing locally developed PMG. METHODS: We conducted a cross-sectional survey of clinicians within Nepal to inform design of the app. Questions focused on knowledge, beliefs, and confidence in managing cancer pain; barriers to cancer pain management; awareness and use of the NAPCare PMG; barriers to smart phone use and desired features of a mobile app. FINDINGS: Surveys were completed by 97 palliative care and/or oncology healthcare providers from four diverse cancer care institutions in Nepal. 49.5% (n = 48) had training in palliative care/cancer pain management and the majority (63.9%, n = 62) reported high confidence levels (scores of 8 or higher/10) in managing cancer pain. Highest ranked barriers to cancer pain management included those at the country/cultural level, such as nursing and medical school curricula lacking adequate content about palliative care and pain management, and patients who live in rural areas experiencing difficulty accessing healthcare services (overall mean = 6.36/10). Most nurses and physicians use an Android Smart Phone (82%, n = 74), had heard of the NAPCare PMG (96%, n = 88), and reported frequent use of apps to provide clinical care (mean = 6.38/10, n = 92). Key barriers to smart phone use differed by discipline, with nurses reporting greater concerns related to cost of data access (70%, n = 45) and being prohibited from using a mobile phone at work (61%; n = 39). CONCLUSIONS: Smart phone apps can help implement PMG and support healthcare providers in managing cancer pain in Nepal and similar settings. However, such tools must be designed to be culturally and contextually congruent and address perceived barriers to pain management and app use. |
format | Online Article Text |
id | pubmed-8570036 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-85700362021-11-08 A survey of cancer care institutions in Nepal to inform design of a pain management mobile application LeBaron, Virginia Adhikari, Abish Bennett, Rachel Chapagain Acharya, Sandhya Dhakal, Manita Elmore, Catherine E. Fitzgibbon, Kara Gongal, Rajesh Kattel, Regina Koirala, Ganesh Maurer, Martha Munday, Daniel Neupane, Bijay Sagar Sharma, Krishna Shilpakar, Ramila Shrestha, Sudip Thapa, Usha Zhang, Hexuan Dillingham, Rebecca Dutta Paudel, Bishnu BMC Palliat Care Research BACKGROUND: One way to improve the delivery of oncology palliative care in low and middle-income countries (LMICs) is to leverage mobile technology to support healthcare providers in implementing pain management guidelines (PMG). However, PMG are often developed in higher-resourced settings and may not be appropriate for the resource and cultural context of LMICs. OBJECTIVES: This research represents a collaboration between the University of Virginia and the Nepalese Association of Palliative Care (NAPCare) to design a mobile health application (‘app’) to scale-up implementation of existing locally developed PMG. METHODS: We conducted a cross-sectional survey of clinicians within Nepal to inform design of the app. Questions focused on knowledge, beliefs, and confidence in managing cancer pain; barriers to cancer pain management; awareness and use of the NAPCare PMG; barriers to smart phone use and desired features of a mobile app. FINDINGS: Surveys were completed by 97 palliative care and/or oncology healthcare providers from four diverse cancer care institutions in Nepal. 49.5% (n = 48) had training in palliative care/cancer pain management and the majority (63.9%, n = 62) reported high confidence levels (scores of 8 or higher/10) in managing cancer pain. Highest ranked barriers to cancer pain management included those at the country/cultural level, such as nursing and medical school curricula lacking adequate content about palliative care and pain management, and patients who live in rural areas experiencing difficulty accessing healthcare services (overall mean = 6.36/10). Most nurses and physicians use an Android Smart Phone (82%, n = 74), had heard of the NAPCare PMG (96%, n = 88), and reported frequent use of apps to provide clinical care (mean = 6.38/10, n = 92). Key barriers to smart phone use differed by discipline, with nurses reporting greater concerns related to cost of data access (70%, n = 45) and being prohibited from using a mobile phone at work (61%; n = 39). CONCLUSIONS: Smart phone apps can help implement PMG and support healthcare providers in managing cancer pain in Nepal and similar settings. However, such tools must be designed to be culturally and contextually congruent and address perceived barriers to pain management and app use. BioMed Central 2021-11-05 /pmc/articles/PMC8570036/ /pubmed/34740339 http://dx.doi.org/10.1186/s12904-021-00824-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research LeBaron, Virginia Adhikari, Abish Bennett, Rachel Chapagain Acharya, Sandhya Dhakal, Manita Elmore, Catherine E. Fitzgibbon, Kara Gongal, Rajesh Kattel, Regina Koirala, Ganesh Maurer, Martha Munday, Daniel Neupane, Bijay Sagar Sharma, Krishna Shilpakar, Ramila Shrestha, Sudip Thapa, Usha Zhang, Hexuan Dillingham, Rebecca Dutta Paudel, Bishnu A survey of cancer care institutions in Nepal to inform design of a pain management mobile application |
title | A survey of cancer care institutions in Nepal to inform design of a pain management mobile application |
title_full | A survey of cancer care institutions in Nepal to inform design of a pain management mobile application |
title_fullStr | A survey of cancer care institutions in Nepal to inform design of a pain management mobile application |
title_full_unstemmed | A survey of cancer care institutions in Nepal to inform design of a pain management mobile application |
title_short | A survey of cancer care institutions in Nepal to inform design of a pain management mobile application |
title_sort | survey of cancer care institutions in nepal to inform design of a pain management mobile application |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8570036/ https://www.ncbi.nlm.nih.gov/pubmed/34740339 http://dx.doi.org/10.1186/s12904-021-00824-0 |
work_keys_str_mv | AT lebaronvirginia asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT adhikariabish asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT bennettrachel asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT chapagainacharyasandhya asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT dhakalmanita asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT elmorecatherinee asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT fitzgibbonkara asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT gongalrajesh asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT kattelregina asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT koiralaganesh asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT maurermartha asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT mundaydaniel asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT neupanebijay asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT sagarsharmakrishna asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT shilpakarramila asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT shresthasudip asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT thapausha asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT zhanghexuan asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT dillinghamrebecca asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT duttapaudelbishnu asurveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT lebaronvirginia surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT adhikariabish surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT bennettrachel surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT chapagainacharyasandhya surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT dhakalmanita surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT elmorecatherinee surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT fitzgibbonkara surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT gongalrajesh surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT kattelregina surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT koiralaganesh surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT maurermartha surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT mundaydaniel surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT neupanebijay surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT sagarsharmakrishna surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT shilpakarramila surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT shresthasudip surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT thapausha surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT zhanghexuan surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT dillinghamrebecca surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication AT duttapaudelbishnu surveyofcancercareinstitutionsinnepaltoinformdesignofapainmanagementmobileapplication |