Development of a Short Version of the Barriers Questionnaire

Abstract

Among the reasons that cancer pain is not controlled adequately are patient-related barriers. Patient beliefs that may contribute to poor outcome have been measured in previous research with the Barriers Questionnaire (BQ). The purpose of this study was to examine the internal consistency of a shortened version of the BQ. A sample of 217 outpatients with cancer completed a 17-item version of the scale. Factor analysis suggested two subscales, one reflecting beliefs about communication about pain and the other reflecting beliefs about the use of analgesics. Both subscales demonstrated adequate internal consistency. Beliefs did not differ between patients who had and those who had not experienced pain within the previous two weeks. Findings suggest the shortened BQ provides an internally consistent measure of two broad patient barriers to pain management.

Cancer pain management at home (II): does age influence attitudes towards pain and analgesia?

“…Earlier work has indicated that communication of pain presented a considerable barrier [11,21,27]. Very encouragingly, the least important barrier in this study for both age groups was the issue of communicating pain to healthcare professionals.…”

“…Fatalism, including the beliefs that pain is inevitable, painkillers do not work, and that God decides who has pain, was also far less of a barrier than in other studies [14,26,27]. It is encouraging that the majority of this sample felt that something could be done about their pain, perhaps making it more likely that most would seek help when they needed it.…”

“…Other studies have tended to consider these concerns together with beliefs about use of analgesics [27], but they appeared to be two separate issues in this study, with the latter issue being of greatest importance for older patients. This finding suggests that assessing and managing adverse effects of analgesics is an important component of successful pain management.…”

“…Subsequent studies using factor analyses have indicated that the items group into different numbers of factors in different ways. One study using a version of the BQ has identified four factors: physiological effects, fatalism, communication, and harmful drug effects [11]; another has identified three: fear of consequences of analgesic use, fatalism, and communication [12]; and another reduced the number yet further to two: beliefs about communication about pain and beliefs about the use of analgesics [27]. This suggests that the key problems experienced by patients were focused in the areas of communicating with healthcare professionals about their pain and concerns about the undesirable effects of analgesics drugs.…”

Cancer Health Empowerment for Living without Pain (Ca-HELP): study design and rationale for a tailored education and coaching intervention to enhance care of cancer-related pain

“…Patients frequently harbor false or exaggerated beliefs that can interfere with effective management of cancer-related pain[2,20,21] Using patients' responses to the Short Barriers Questionnaire,[22] the HE reviews specific pain-related misconceptions and offers an algorithm-based corrective. For example, if a patient were to believe that effective pain medicine should be withheld until the pain is so bad the patient "really needs it,", then the HE would respond that pain is easier to control when treated early, and while the dose might need to increase over time, there is no reason to hold treatment in reserve.…”