Concerns about reporting pain and using analgesics. A comparison of persons with and without cancer.

Cancer pain is not adequately managed, and patients' reluctance to report pain and to use analgesics contribute to this problem. The Barriers Questionnaire (BQ) assesses eight patient concerns about reporting pain and using analgesics. This study was designed to determine (a) whether such concerns differ for persons who have cancer versus those who do not, (b) whether the BQ has test-retest reliability, and (c) whether concerns are related to reticence in reporting pain and using analgesics. Two groups, 53 adults with cancer and 40 without, completed the BQ twice at a 1-week interval. The BQ has eight subscales (e.g., concerns about addiction) and a total scale score (alpha = 0.89). There were no differences between persons with and without cancer on BQ total or subscale scores. Test-retest reliability of the total scale was r = 0.90, whereas the subscales showed r = 0.60-0.81. At Time 1, 16% said they hesitated to report pain, and 12% hesitated to use analgesics; at Time 2, 15% hesitated to report pain, and 10% hesitated to use analgesics. At Time 2, those who hesitated to report pain had higher BQ total scores than those who did not hesitate to report it (p < 0.05). We discuss the results of this study with respect to patient and public education.