ArticleBMJ open2025
Pain management and its challenges in Iranian cancer patients: a mixed-method study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo identify and explain the challenges of effective pain management in patients with cancer in Iran.
designA convergent mixed-methods study.
settingOncology departments and palliative care units across multiple healthcare institutions in Iran.
participantsQuantitative phase: 320 healthcare providers, including anaesthesiologists, general practitioners, oncologists, nurses and pharmacists, selected via convenience sampling. Qualitative phase: 10 stakeholders, including patients, caregivers, policy makers and clinicians.
methodsQuantitative data were collected using a psychometrically validated 23-item questionnaire assessing knowledge, attitudes and perceived barriers to cancer pain management. Qualitative data were obtained through semistructured interviews and analysed using Graneheim and Lundman's content analysis method with MaxQDA software. Integration was performed using a side-by-side approach.
resultsQuantitative data showed that over 65% of providers did not routinely assess pain, and only 29.1% believed pharmacological treatments were effective. Qualitative analysis identified 13 barriers across three domains-professional, patient and organisational-spanning physical, psychological, social and spiritual dimensions. Integrated findings revealed consistent patterns of underassessment, legal and cultural resistance and lack of interdisciplinary collaboration. These converging challenges highlight the need for holistic, system-level reform.
conclusionsThe convergence of quantitative and qualitative data reveals a multilayered system of barriers, professional, patient-related and organisational-rooted in physical, psychological, social and spiritual dimensions. These interlinked challenges contribute to fragmented pain management and limited interdisciplinary coordination. Addressing them requires a holistic reform strategy that integrates structural, cultural and clinical solutions.
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