A survey of cancer care institutions in Nepal to inform design of a pain management mobile application

Abstract 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...

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Autores principales:	Virginia LeBaron, Abish Adhikari, Rachel Bennett, Sandhya Chapagain Acharya, Manita Dhakal, Catherine E. Elmore, Kara Fitzgibbon, Rajesh Gongal, Regina Kattel, Ganesh Koirala, Martha Maurer, Daniel Munday, Bijay Neupane, Krishna Sagar Sharma, Ramila Shilpakar, Sudip Shrestha, Usha Thapa, Hexuan Zhang, Rebecca Dillingham, Bishnu Dutta Paudel
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Palliative care Cancer Mobile health Pain Pain management guidelines Nepal Special situations and conditions RC952-1245
Acceso en línea:	https://doaj.org/article/507042165f7146dc87cb11eec8eb7a20
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spelling	oai:doaj.org-article:507042165f7146dc87cb11eec8eb7a202021-11-07T12:18:50ZA survey of cancer care institutions in Nepal to inform design of a pain management mobile application10.1186/s12904-021-00824-01472-684Xhttps://doaj.org/article/507042165f7146dc87cb11eec8eb7a202021-11-01T00:00:00Zhttps://doi.org/10.1186/s12904-021-00824-0https://doaj.org/toc/1472-684XAbstract 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.Virginia LeBaronAbish AdhikariRachel BennettSandhya Chapagain AcharyaManita DhakalCatherine E. ElmoreKara FitzgibbonRajesh GongalRegina KattelGanesh KoiralaMartha MaurerDaniel MundayBijay NeupaneKrishna Sagar SharmaRamila ShilpakarSudip ShresthaUsha ThapaHexuan ZhangRebecca DillinghamBishnu Dutta PaudelBMCarticlePalliative careCancerMobile healthPainPain management guidelinesNepalSpecial situations and conditionsRC952-1245ENBMC Palliative Care, Vol 20, Iss 1, Pp 1-21 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Palliative care Cancer Mobile health Pain Pain management guidelines Nepal Special situations and conditions RC952-1245
spellingShingle	Palliative care Cancer Mobile health Pain Pain management guidelines Nepal Special situations and conditions RC952-1245 Virginia LeBaron Abish Adhikari Rachel Bennett Sandhya Chapagain Acharya Manita Dhakal Catherine E. Elmore Kara Fitzgibbon Rajesh Gongal Regina Kattel Ganesh Koirala Martha Maurer Daniel Munday Bijay Neupane Krishna Sagar Sharma Ramila Shilpakar Sudip Shrestha Usha Thapa Hexuan Zhang Rebecca Dillingham Bishnu Dutta Paudel A survey of cancer care institutions in Nepal to inform design of a pain management mobile application
description	Abstract 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	article
author	Virginia LeBaron Abish Adhikari Rachel Bennett Sandhya Chapagain Acharya Manita Dhakal Catherine E. Elmore Kara Fitzgibbon Rajesh Gongal Regina Kattel Ganesh Koirala Martha Maurer Daniel Munday Bijay Neupane Krishna Sagar Sharma Ramila Shilpakar Sudip Shrestha Usha Thapa Hexuan Zhang Rebecca Dillingham Bishnu Dutta Paudel
author_facet	Virginia LeBaron Abish Adhikari Rachel Bennett Sandhya Chapagain Acharya Manita Dhakal Catherine E. Elmore Kara Fitzgibbon Rajesh Gongal Regina Kattel Ganesh Koirala Martha Maurer Daniel Munday Bijay Neupane Krishna Sagar Sharma Ramila Shilpakar Sudip Shrestha Usha Thapa Hexuan Zhang Rebecca Dillingham Bishnu Dutta Paudel
author_sort	Virginia LeBaron
title	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_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_sort	survey of cancer care institutions in nepal to inform design of a pain management mobile application
publisher	BMC
publishDate	2021
url	https://doaj.org/article/507042165f7146dc87cb11eec8eb7a20
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A survey of cancer care institutions in Nepal to inform design of a pain management mobile application

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