Challenging the representations of cancer pain: Experiences of a multidisciplinary pain management group in a palliative care unit

2005 ◽  
Vol 3 (1) ◽  
pp. 43-49 ◽  
Author(s):  
ELIZABETH CHAPMAN ◽  
DAVID HUGHES ◽  
ANNETTE LANDY ◽  
JUDITH WHALE ◽  
MARGARET SAUNDERS
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Palliative Care Unit ◽  
Important Distinction ◽  
Extensive Experience ◽  
Management Group ◽  
Number Of Factors ◽  
Pain Experiences ◽  
Set Up ◽  
Multidisciplinary Pain Management

Objective:This article describes how a Multidisciplinary Pain Management Group was set up in a palliative care unit, and outlines the ways that the group works with different patients. We place these comments in the context of the wider representations of pain.Methods:Our observations of patients seen by the multidisciplinary team.Results:We tentatively propose that where the patient's pain has certain characteristics it may require a different approach. Patients who are older, with a lengthy treatment history, may require a different input than younger patients, who may have a number of factors that further complicate their experience of pain. We use our extensive experience with mesothelioma patients to draw a further important distinction between this patient group and other patients.Significance of research:Our observations suggest the need to allow sufficient time for intensive psychological work to be done with mesothelioma patients in order for pharmacological interventions to be effective.

A Survey of Knowledge and Attitudes of Nurses About Pain Management in End-Stage Liver Disease in a Geriatric Palliative Care Unit

2016 ◽  
Vol 35 (1) ◽  
pp. 92-99 ◽  
Author(s):  
Giulia-Anna Perri ◽  
Herman Yeung ◽  
Yoel Green ◽  
Abby Bezant ◽  
Carman Lee ◽  
...  
Keyword(s):  
Palliative Care ◽  
Liver Disease ◽  
Pain Management ◽  
Care Facility ◽  
Palliative Care Unit ◽  
Or Education ◽  
Cross Sectional ◽  
End Stage Liver Disease ◽  
Knowledge And Attitudes ◽  
End Stage

Background: Palliative care is often initiated late for patients with end stage liver disease (ESLD) with pain being a common morbidity that is under-treated throughout the disease trajectory. When admitted to a palliative care unit (PCU), nurses play a pivotal role and must be highly informed to ensure effective pain management. The aim of this study is to determine the baseline level of knowledge and attitudes of PCU nurses regarding pain management in patients with ESLD. Methods: A descriptive, cross-sectional self-administered survey design was used for this study. The sample comprised 35 PCU nurses working at a continuing chronic care facility in Toronto, Ontario, Canada. Data on the knowledge and attitudes of the nurses regarding pain management in patients with ESLD, was obtained using a modified version of the “Nurses Knowledge and Attitudes Survey Regarding Pain” (NKASRP) tool. Results: Thirty-one PCU nurses were included for the analysis, giving a response rate of 89%. The mean total percentage score for the nurses on the modified version of the NKASRP was 72%. Only 26% of the nurse participants obtained a passing score of 80% or greater. There were no significant differences in mean total scores by age, gender, years of nursing experience or education level. Conclusions: The findings of this study provide important information about the inadequate knowledge and attitude in nurses regarding pain management for patients with ESLD. It is suggested that targeted educational programs and quality improvement initiatives in pain management for patients with ESLD could improve knowledge and attitudes for PCU nurses.

scholarly journals Support practices by an interdisciplinary team in a palliative-care unit for relatives of patients in agonal phase

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
M. Mélin ◽  
H. Amieva ◽  
M. Frasca ◽  
C. Ouvrard ◽  
V. Berger ◽  
...  
Keyword(s):  
Palliative Care ◽  
Interdisciplinary Team ◽  
Palliative Care Unit ◽  
Team Members ◽  
Helping Relationship ◽  
Interview Guide ◽  
Secondary Objective ◽  
Support Practices ◽  
Set Up

Abstract Background In the absence of extant recommendations, the aim of this study was to formalise support practices used by an interdisciplinary team in a palliative-care unit (PCU) for the relatives of patients in the agonal phase preceding death. The secondary objective was to understand the expectations of relatives during this phase in terms of the support provided by professionals and volunteers. Methods Thirty-two people took part in this study; all were interviewed through focus groups (FGs). Each FG comprised one category of individuals working in the PCU: nurses, care- assistants, doctors, psychologists, other professionals, palliative-care volunteers, and relatives. Groups were surveyed using an interview guide, and the interviews were recorded and transcribed to enable identification and characterization of all practices. Care practices were classified into four categories: current consensual practices (i.e. performed by all team members), occasional consensual practices, non-consensual practices (performed by one or a few participants), and practices to be developed. Results In total, 215 practices were mentioned by professionals and palliative-care volunteers: 150 current consensual practices, 48 occasional consensual practices, 1 non-consensual practice, 16 practices yet to be developed, and 29 practices for relatives. Many practices were mentioned by different categories of participants; thus, after cross-checking, the number of practices decreased from 215 to 52. A list of practices deemed desirable by all was drawn up and then validated by the entire interprofessional team. These practices were organised around four themes: providing care and ensuring comfort; communicating, informing, and explaining; interacting; and mobilising interdisciplinary skills. Conclusions These results underline the importance of the quality of care provided to patients, the attention given to the relatives themselves, and they highlight the importance of the helping relationship. Following this study, which established a list of varied practices aimed at supporting the relatives of patients in agonal phase, it will be important to set up a broader study seeking to establish a consensus on these practices with an interprofessional group of experts from other PCUs using broad surveys and an adapted methodology. Such studies will make it possible to develop training modules for teams working with relatives.

scholarly journals Cancer pain management in an oncological ward in a comprehensive cancer center with an established palliative care unit

2013 ◽  
Vol 21 (12) ◽  
pp. 3287-3292 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Costanza Guccione ◽  
Simona Di Fatta ◽  
Valentina Alaimo ◽  
Giovanna Prestia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Cancer Pain ◽  
Palliative Care Unit ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cancer Pain Management

scholarly journals Correlation of Plasma Kynurenic Acid Level with the Severity of Depression, Pain, And the Need of Opioids for Pain Management in Cancer Patients in Palliative Care Unit in Dr. Soetomo General Hospital Surabaya

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Rizky Iman Kurniawan ◽  
Arie Utariani ◽  
Dedi Susila
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Cancer Patients ◽  
General Hospital ◽  
Acid Level ◽  
Kynurenic Acid ◽  
Rating Scale ◽  
Palliative Care Unit ◽  
Pain Level ◽  
Severity Of Depression

Introduction: Most cancer cases in Indonesia are diagnosed at an advanced stage, and the cure rate and life expectancy are not as expected. Depression and pain are the most common problems that arise in cancer patients. Kynurenic acid and quinolinic acid are neuroactive metabolites produced in the kynurenine pathway. Decreased kynurenic acid levels have been reported to be associated with depression, pain, and pathology in cancer. Objective: This study aims to determine the correlation between kynurenic acid levels and the severity of depression, pain level, and opioid need in cancer patients undergoing palliative treatment. Material and Method: This study was an observational analytic study with a retrospective cohort design. The study population was adult patients with malignancy in the palliative care unit of Dr. Soetomo General Hospital Surabaya that received opioid treatment during the study period. The sample of this study was 54 patients. Plasma kynurenic acid levels were measured using the ‘Human Kynurenic acid ELISA kit’ from BT Lab. The severity of depression was measured by the Hamilton Depression Rating Scale (HDRS). Pain level was scored with Pain Numeric Rating Scale (NRS), while the opioid use was collected from the patient’s medical record. Result and Discussion: There was a significant relationship between kynurenic acid levels and the severity of depression (p<0.001), pain level (p<0,001), and opioid need (p=0,007). Simple linear regression analysis showed that the lower the kynurenic acid level, the more severe the depression (p<0.001) and the higher the opioid dose needed (p=0,004). Moderate pain has a lower median kynurenic acid level than mild pain, 12.32 nmol/L, and 16.29 nmol/L, respectively. Patients with a lower level of kynurenic acid require a higher dose of the same type of opioid. Conclusion: The lower level of plasma kynurenic acid is associated with more severe depression, more pain level, and more opioid need for pain management in malignancy patients in the palliative care unit of Dr. Soetomo General Hospital Surabaya.

On the palliative care unit.

2016 ◽  
Vol 34 (2) ◽  
pp. 179-179
Author(s):  
Peter A. Selwyn
Keyword(s):  
Palliative Care ◽  
Palliative Care Unit
Sign in / Sign up

Export Citation Format

Share Document