Cancer pain knowledge and attitudes of healthcare professionals: A systematic review of surveys and their measurement properties

Background: Effective management of cancer-related pain (CRP) requires support from knowledgeable healthcare professionals. Existing literature states that healthcare professionals' knowledge of CRP is poor. However, there is no consistency in how knowledge and attitudes are assessed or the standards against which they are measured. This systematic review evaluates the cancer-related content and psychometric properties of surveys used to assess knowledge of CRP. Method: Using JBI methodology for Systematic Reviews of Measurement Properties, the search was conducted in MEDLINE, EMBASE, CINAHL and PsycINFO (limited to 2011-2024). Screening and extraction were completed by two researchers using the COVIDENCE system. The COSMIN Risk of Bias checklist was used to assess psychometric properties, and additional data were extracted on content feasibility. Results: A total of 1024 papers were identified, and 37 were included in the final analysis. Sixteen different surveys were found, with four being used in multiple studies. No survey was deemed superior, and all were rated poorly using the COSMIN Risk of Bias checklist. The CRP content within the surveys varied significantly, with none capturing the complexity of CRP. The feasibility of administering these surveys in practice was not reported in the studies examined. Conclusion: The wide variation in the design and content of surveys identified makes it difficult to assess the current state of healthcare professionals' knowledge of CRP. This raises questions about the validity and reliability of their conclusions, as they lack a robust evaluation of psychometric properties. Further research is needed to accurately assess healthcare professionals' knowledge of CRP.