Clinicians' practice and attitudes toward cancer pain management in Korea

The purposes of this study were to assess clinicians' (n = 250) current practices and attitudes about cancer pain management and to identify perceived concerns about and barriers to pain control in urban cancer-treatment settings in Korea.

Survey data (20 items) were collected either by mail or interview. Approximately 40% of the sample were nurses. More medical clinicians than surgical clinicians had more than 5 years of experience with cancer care (43 vs 31%) and committed more than 30% of their working hours to palliation (61 vs 19%). Significantly more medical clinicians claimed to be somewhat more or much more liberal than their professional peers in using analgesics compared with surgical clinicians (54 vs 35%). The liberal sample was more likely to be male (OR = 3.3, p < 0.001) and to be more experienced with cancer care (OR = 1.2, p < 0.001). Medical clinicians also reported more adequate pain-management training and a more proactive approach to assessing and treating pain.

Overall, the greatest concerns regarding opioid use were safety, side effects, and fear of addiction. Inadequate pain assessment and lack of staff knowledge and time were identified as barriers to pain management. Unrealistic expectations and denial from both patient and family were the most troublesome issues for delivery of care to dying patients. This study suggests a more conservative attitude toward cancer pain management in Korea than in other countries surveyed in a similar manner.

A combination of routine professional education and dissemination of guidelines is needed to bring about significant improvement in cancer pain control in Korea.