Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
Development of a self-management manual for patients with refractory cancer pain treated with a semi-implantable intrathecal drug delivery system: a Delphi study.
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Shen Lanlan, Chu Yachen, Li Ying, Ni Yong, Zhang Yue, Song Xiaomei, Pan Xuling
Аннотация
OBJECTIVE: The aim of this study was to develop a self-management manual for individuals with refractory cancer pain treated with a semi-implantable intrathecal drug delivery system (IDDS), using the Delphi method.
METHODS: An initial draft of the self-management manual was developed through a comprehensive literature review and expert panel discussions. The Delphi method was used to conduct two rounds of expert consultations with a total of 23 experts covering pain management, oncology, palliative care, and oncology nursing aimed at refining and finalizing the content of the manual, which fully guarantees the professionalism and comprehensiveness of expert opinions.
RESULTS: Two rounds of expert consultation were completed, yielding a 100% response rate in both instances. The authority coefficients for the participating experts were 0.881 and 0.890, respectively. Coefficients of variation ranged from 0.09 to 0.24 in the first round and 0.06-0.18 in the second. Kendall's coefficients of concordance were 0.174 and 0.215, respectively (both p < 0.001), indicating statistically significant agreement among experts. The finalized manual comprised 5 primary domains, 22 secondary domains, and 40 tertiary items.
CONCLUSION: The development of the self-management manual through the Delphi method demonstrated high levels of expert engagement, authority, and consensus. The resulting manual is systematic and comprehensive, providing practical guidance for home-based analgesia management in patients with semi-implantable IDDSs, and may support multidisciplinary care teams in clinical practice. While the current study establishes proof-of-concept for the manual, its clinical translation will involve subsequent pilot testing in clinical settings, prospective validation in large patient cohorts, and iterative optimization based on clinical feedback and real-world application effects.
METHODS: An initial draft of the self-management manual was developed through a comprehensive literature review and expert panel discussions. The Delphi method was used to conduct two rounds of expert consultations with a total of 23 experts covering pain management, oncology, palliative care, and oncology nursing aimed at refining and finalizing the content of the manual, which fully guarantees the professionalism and comprehensiveness of expert opinions.
RESULTS: Two rounds of expert consultation were completed, yielding a 100% response rate in both instances. The authority coefficients for the participating experts were 0.881 and 0.890, respectively. Coefficients of variation ranged from 0.09 to 0.24 in the first round and 0.06-0.18 in the second. Kendall's coefficients of concordance were 0.174 and 0.215, respectively (both p < 0.001), indicating statistically significant agreement among experts. The finalized manual comprised 5 primary domains, 22 secondary domains, and 40 tertiary items.
CONCLUSION: The development of the self-management manual through the Delphi method demonstrated high levels of expert engagement, authority, and consensus. The resulting manual is systematic and comprehensive, providing practical guidance for home-based analgesia management in patients with semi-implantable IDDSs, and may support multidisciplinary care teams in clinical practice. While the current study establishes proof-of-concept for the manual, its clinical translation will involve subsequent pilot testing in clinical settings, prospective validation in large patient cohorts, and iterative optimization based on clinical feedback and real-world application effects.