{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T22:32:52Z","timestamp":1788906772768,"version":"build-2803163510"},"reference-count":15,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004886","name":"Cancer Research Foundation in Northern Sweden","doi-asserted-by":"publisher","award":["AMP 24-1167"],"award-info":[{"award-number":["AMP 24-1167"]}],"id":[{"id":"10.13039\/501100004886","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Regional Cancer Centre","award":["no specific grant number"],"award-info":[{"award-number":["no specific grant number"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,12,19]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to describe palliative medicine physicians\u2019 experiences performing pain assessment using the Numeric Rating Scale (NRS)\u2014one of the most widely used pain assessment tools\u2014for patients with cancer receiving specialised palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>This qualitative study used reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted in specialised palliative care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Semi-structured interviews were conducted with 14 palliative medicine physicians in specialised palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>The interviews were transcribed and analysed using reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four themes were identified: \u2018Striving to create a shared understanding\u2019, \u2018Meeting individual needs\u2019, \u2018Interpreting and managing ratings\u2019 and \u2018Importance of organizational structures\u2019. This can be seen as a process that moves from creating a shared foundation through individual patient meetings and handling NRS ratings to organisational-level challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study shows the complexity needed within palliative cancer care when using the most common pain assessment tool in Sweden, the NRS. The tool may seem simplistic, but, as shown in this study, the physicians found interpreting the assessments challenging for the whole team. This complexity should be incorporated into future healthcare education and training within the palliative care area, where patients often have chronic pain conditions in combination with cognitive impairment. Future research needs to focus on developing reliable pain assessment methods for patients who are cognitively impaired because of the cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-102830","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T05:15:20Z","timestamp":1767762920000},"page":"e102830","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Palliative medicine physicians\u2019 experiences using the Numeric Rating Scale for pain assessment in patients with advanced cancer: a qualitative study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4126-2675","authenticated-orcid":false,"given":"Lisa","family":"Martinsson","sequence":"first","affiliation":[{"name":"Diagnostics and Intervention, Oncology, Ume\u00e5 University, Ume\u00e5, Sweden"},{"name":"Clinical Sciences, Professional Development, Ume\u00e5 University, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta","family":"Br\u00e4nnstr\u00f6m","sequence":"additional","affiliation":[{"name":"Nursing, Ume\u00e5 Universitet, Skellefte\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Fransson","sequence":"additional","affiliation":[{"name":"Nursing, Ume\u00e5 Universitet, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Andersson","sequence":"additional","affiliation":[{"name":"Nursing, Ume\u00e5 Universitet, Skellefte\u00e5, Sweden"},{"name":"Regional Cancer Centre North, Norrlands universitetssjukhus, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"2026010621151188000_16.1.e102830.1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jpainsymman.2013.02.016","article-title":"Prevalence of symptoms in older cancer patients receiving palliative care: a systematic review and meta-analysis","volume":"47","author":"Van Lancker","year":"2014","journal-title":"J Pain Symptom Manage"},{"key":"2026010621151188000_16.1.e102830.2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216316628407"},{"key":"2026010621151188000_16.1.e102830.3","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdy152"},{"key":"2026010621151188000_16.1.e102830.4","unstructured":"Regionala cancercentrum i samverkan [Regional cancer center in collaboration] . Nationellt v\u00e5rdprogram palliativ v\u00e5rd i livets slutskede [national guidelines palliative end-of-life care]. Sweden Regionala cancercentrum i samverkan [Regional cancer center in collaboration]; 2016. Available: https:\/\/kunskapsbanken.cancercentrum.se\/diagnoser\/palliativ-vard\/vardprogram\/"},{"key":"2026010621151188000_16.1.e102830.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2010.08.016"},{"key":"2026010621151188000_16.1.e102830.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2005.01121.x"},{"key":"2026010621151188000_16.1.e102830.7","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1177\/1049909120945599","article-title":"How Should We Assess Pain: Do Patients Prefer a Quantitative or Qualitative Scale? 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A prospective single center study","volume":"21","author":"Willems","year":"2021","journal-title":"Pain Pract"},{"key":"2026010621151188000_16.1.e102830.9","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.ejon.2018.01.005","article-title":"Pain experiences of patients with advanced cancer: A qualitative descriptive study","volume":"33","author":"Erol","year":"2018","journal-title":"Eur J Oncol Nurs"},{"key":"2026010621151188000_16.1.e102830.10","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2026010621151188000_16.1.e102830.11","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"2026010621151188000_16.1.e102830.12","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.ijnurstu.2015.08.007","article-title":"Postoperative patients\u2019 perspectives on rating pain: A qualitative study","volume":"53","author":"van Dijk","year":"2016","journal-title":"Int J Nurs Stud"},{"key":"2026010621151188000_16.1.e102830.13","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.apnr.2013.10.006","article-title":"Numeric rating scale: patients\u2019 perceptions of its use in postoperative pain assessments","volume":"27","author":"Eriksson","year":"2014","journal-title":"Appl Nurs Res"},{"key":"2026010621151188000_16.1.e102830.14","doi-asserted-by":"publisher","DOI":"10.1177\/0269216310395985"},{"key":"2026010621151188000_16.1.e102830.15","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1080\/0284186X.2023.2228992","article-title":"The Abbey Pain Scale: not sufficiently valid or reliable for assessing pain in patients with advanced cancer","volume":"62","author":"Tegenborg","year":"2023","journal-title":"Acta Oncol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-102830","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T05:15:24Z","timestamp":1767762924000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-102830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,6]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bmjopen-2025-102830"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-102830","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}