scholarly journals Pain assessment and registration in medical oncology clinics: operationalised through the lens of health care professionals and patients

2021 ◽  
Vol 4 ◽  
pp. 86
Author(s):  
Laserina O'Connor ◽  
Aileen Hassett ◽  
Noeleen Sheridan
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Cancer Treatment ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Medical Oncology ◽  
Pain Treatment ◽  
Self Report ◽  
Common Symptom

Background: Pain is a common symptom in patients who survive cancer and in those who live with progressive advanced disease. Systematic screening and documentation of pain are necessary to improve the quality of cancer pain treatment, because a key pain-related barrier is that patients are reluctant to discuss pain, due to fear that reporting pain will distract the healthcare professional from their cancer treatment. Methods: This study adopted an explanatory sequential mixed-methods design. Data collection incorporated three strands. The first strand involved a quantitative enquiry in which medical chart reviews of patients (n=100) attending the medical oncology outpatient clinic were examined. The second qualitative strand comprised of semi-structured interviews with patients (n=10) attending that service. The third strand was qualitative and consisted of focus group discussions with healthcare professionals (n=12). Results: All 100 patients had cancer. The quantitative findings confirmed the suboptimum assessment and subsequent recording of patient’s pain, that seemed to afford a reality check for all healthcare professionals. For patients, the outcomes of the anti-cancer treatment were their priority, and pain was perceived as inevitable, being associated with a cancer diagnosis. There were multifaceted complexities voiced amongst healthcare professionals associated with balancing the benefits and harms aligned with treating cancer pain. Conclusions: Pain assessment in medical records was not systematically recorded by healthcare professionals. Patients were reluctant to self-report pain during their medical oncology outpatient review. The expectation that patients will self-report pain can be accommodated by healthcare professionals if a personalized pain goal is part of the cancer pain management plan during each clinical encounter. Healthcare professionals reported a need to take distinct responsibility for supplementing their dearth of knowledge, skills and beliefs regarding assessing and managing patients’ cancer pain. Optimal pain management stems from an interprofessional approach that was applied in this study design.

Overcoming Barriers in Cancer Pain Management

2014 ◽  
Vol 32 (16) ◽  
pp. 1727-1733 ◽  
Author(s):  
Jung Hye Kwon
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Cancer Pain ◽  
Health Care Professionals ◽  
Pain Treatment ◽  
Educational Interventions ◽  
Cognitive Factors ◽  
Cancer Pain Management ◽  
Affective Factors

Pain is a devastating symptom of cancer that affects the quality of life of patients, families, and caregivers. It is a multidimensional symptom that includes physical, psychosocial, emotional, and spiritual components. Despite the development of novel analgesics and updated pain guidelines, cancer pain remains undermanaged, and some patients with moderate to severe pain do not receive adequate pain treatment. Inadequate pain management can be attributed to barriers related to health care professionals, patients, and the health care system. Common professional-related barriers include poor pain assessment, lack of knowledge and skill, and the reluctance of physicians to prescribe opioids. Patient-related barriers include cognitive factors, affective factors, and adherence to analgesic regimens. System-related barriers such as limits on access to opioids and the availability of pain and palliative care specialists present additional challenges, particularly in resource-poor regions. Given the multidimensional nature of cancer pain and the multifaceted barriers involved, effective pain control mandates multidisciplinary interventions from interprofessional teams. Educational interventions for patients and health care professionals may improve the success of pain management.

scholarly journals ABOUT THE PAIN IN CHILDREN

2019 ◽  
Vol 32 (2) ◽  
pp. 281-284
Author(s):  
Svetla Ivanova
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Pain Treatment ◽  
Emotional Experience ◽  
Behavioral Assessment ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Self Report ◽  
Pediatric Care ◽  
First Pain

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain for pediatric patients is more difficult to evaluate and treat than in adults. Its assessment and management are key components of pediatric care which aim to reduce subjective sensation and to improve the satisfaction of medical specialists and parents. The assessment of pain depends on the cognitive development of the child , the clinical context and the type of pain. Pain management in children improves physiological, behavioral and hormonal results, leads to faster recovery, less complications, and reduced healthcare resources. Ineffective and untimely treatment of pain in children can cause long-lasting physical and psychological consequences. This article aims to determine the importance of adequate pain control in children. For children over the age of 6, pain assessment is based on self-assessment, whereas children under the age of 6 require behavioral scales for pain assessment. Behavioral assessment scales include child monitoring as well as basic characteristics of pain such as intensity, location, duration. The nurses are in a position to meet the child's first pain caused by fear and anxiety in the hospital, but parents who take care of the child are an important assistant in assessing, especially in children with special needs. Some children may find it difficult to do a distinction between pain, anxiety and stress. Effective pain assessment leads to more satisfied children and families. Prolonged inadequate treatment of pain in children may be due to the lack of knowledge and failure of nurses to appreciate and manage pain effectively. Medical specialist should be able to detect the symptoms and signs of pain in different age groups and determine whether these symptoms are caused by pain or other factors. The methods used for pain assessment have proven clinical efficacy, reliability and usability, making them an integral part of the treatment and management of pain. Three are the ways to measure it in children: self-report, behavioral evidence, and physiological-clinical observations. After processing the collected information, the data are entered into the required documentation which provides continuous ,safe and qualified care. Documentation of the children’s pain is a key factor in pain managing. Low level of nurses’ knowledge of assessing pain, inappropriate use of pain scales or lack of documentation could affect pain treatment. Assessment is performed if a child complains of pain, after surgery, if a procedure would cause discomfort or at least once a shift to check if children have any pain. The main subject of pain management strategy is pain prevention and modification of techniques used for diagnostic procedures for infant.

scholarly journals Improving the Quality of Care for Acute Pain Management in Recovery Room at the Georgetown Public Hospital Corporation

2019 ◽  
pp. 13-14
Author(s):  
Dorette Husbands-Anderson ◽  
Jennifer Szerb ◽  
Alexandra Harvey
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Assessment Tool ◽  
Standards Of Care ◽  
Average Dose ◽  
Management Intervention ◽  
Pain Medications ◽  
Post Operative Pain ◽  
Pain Intervention

Objectives: To observe the method of pain assessment and pain management intervention performed by nurses in the PACU. Methods and Design: A QI prospective observational study was conducted to observe nurse’s pain assessment and management of thirty (30) patients from the time of PACU admission to discharge. The sample size was determined using the sealed envelope power calculator. Data Collection Included: patients demographics, the method and frequency of pain assessments as well as modalities of the pain intervention and the type and average dose of pain medications administered by PACU nurses. Data analysis was done using Microsoft excel. Results: No validated pain assessment tool was used in the PACU.  The majority of patients 67%, n=20) had no pain assessments or pain interventions. When performed, the frequency of pain assessments recorded were low, 70% of patients had 1-2 assessments. The principal pain management intervention was pharmacological with the use of opioids, accounting for 96%. Conclusion: Post-operative pain management in the PACU at GPHC does not meet accepted standards of care. More frequent nursing pain assessment using a validated pain assessment tool is required. Monotherapy with the opioid was the main pain intervention for pain management. Recommendations: Effective pain management begins with the appropriate pain assessment; therefore pain management education programs for health care professionals are essential. Also, the implementation of a standardized pain assessment tool, a standardized post anesthetic order sheet with a multimodal approach to pain management and restructuring the post-anesthetic record to allow for documentation of pain assessment will greatly improve pain management in the PACU.

Health-Care Professionals Perceived Barriers to Effective Cancer Pain Management in the Home Hospice Setting: Is Dying at Home Really Best?

2019 ◽  
pp. 003022281985787
Author(s):  
Lee A. Johnson ◽  
Cynthia J. Bell ◽  
Sheila Ridner ◽  
Barbara Murphy
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Cancer Pain ◽  
Health Care Professionals ◽  
Cultural Beliefs ◽  
Comparative Approach ◽  
Unexpected Finding ◽  
Convenience Sample ◽  
Alternative Placement ◽  
Patients At Risk

Hospice health-care professionals (HCP) evaluate and manage cancer pain in patient homes. This study explores HCP’s perceptions of barriers that affect pain management for home hospice cancer patients. A convenience sample of 20 experienced hospice HCP were recruited from a regional hospice agency. Data were collected through two focus groups using semistructured interviews and analyzed using a constant comparative approach to generate themes. An unexpected finding revealed patient’s religious and cultural beliefs about suffering and family caregiver’s beliefs that patients deserve to suffer due to past actions are barriers to pain management in home hospice. Hospice HCP can identify patients at risk for suffering at the end of life. Interventions targeting spiritual suffering and needs are needed. Home hospice HCP have an ethical obligation to address undue suffering through family’s withholding of necessary pain medications and should consider alternative placement when home is not suitable for a peaceful death.

scholarly journals Cancer Pain Management and Pain Interference with Daily Functioning among Cancer Patients in Gondar University Hospital

2017 ◽  
Vol 2017 ◽  
pp. 1-12
Author(s):  
Henok Getachew Tegegn ◽  
Eyob Alemayehu Gebreyohannes
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Pain Treatment ◽  
Pain Interference ◽  
University Hospital ◽  
Public Health Burden ◽  
Pain Management Index ◽  
Experienced Pain ◽  
Pain Prevalence

Cancer is an increasing public health burden for Ethiopia. Pain is among the most common symptoms in patients with cancer. Hence, we aimed to assess cancer pain prevalence, cancer pain interference, and adequacy of cancer pain treatment in the oncology ward of an Ethiopian teaching hospital. Of 83 patients, total of 76 (91.6%) cancer patients experienced pain with varying degree of severity, and 7 (8.4%) patients experienced severe pain. Of the 76 cancer patients with pain, 68 (89.2%) experienced pain interference with their daily activities. Fifty-four (65%) patients were receiving inadequate cancer pain treatment with negative Pain Management Index. Therefore, it is vital to anticipate and assess pain of the cancer patients as routine clinical practice, to optimize analgesic therapy, and to identify and overcome barriers to adequate pain management.

Pain assessment and post-operative pain management in orthopedic patients

2017 ◽  
Vol 16 (1) ◽  
pp. 181-181
Author(s):  
W. Schmelling ◽  
J.N. Poulsen ◽  
L. Christrup ◽  
P. Gazerani
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Postoperative Pain ◽  
Potential Risk ◽  
Health Care Professionals ◽  
Sleep Disturbances ◽  
Pain Treatment ◽  
Early Mobilization ◽  
Postoperative Pain Management ◽  
Orthopedic Patients

Abstract Aims A fast-track based surgical treatment reduces morbidity and hospital stay by providing early mobilization. Sufficient postoperative pain management is mandatory for early mobilization and optimal utilization of rehabilitation measures. Insufficient postoperative pain management is however a widespread problem. Lack of knowledge about pain and pain treatment among health care professionals and general community has been considered as a major potential contributor in insufficient pain management. It has been suggested that severe postoperative pain might imply a potential risk of developing chronic pain. The purpose of this study was to examine this problem in acute and elective surgical patients in department of orthopedic surgery at Bispebjerg Hospital in order to identify obstacles and possibilities for future improvement. Methods Questionnaires were developed and distributed to patients consisted of 10 acute admitted and 10 elective orthopedic patients. The patients’ pain scores were recorded with a 0–10 NRS scale. The scores were obtained for current pain in rest, current pain in activity, and the highest and lowest pain intensity for the last 24 hours. Data were handled using descriptive statistics. Results The goal for sufficient pain treatment was patients with pain score at ≤ 3 NRS at rest and ≤ 5 in activity. For pain at rest 45% of the patients were within the goal range and 55% for the current pain in activity. For the mildest pain experienced in the last 24 h, 75% and for the worst pain experienced 30% of the patients reached the goal. Conclusions Corresponding to similar studies, half of the patients received a sufficient pain treatment at the time of examination. The consequences for insufficient pain management would be reduced effect of the physiotherapy, reduced ability to handle every day activity, sleep disturbances, and potential risk of developing chronic pain.

scholarly journals Neurophysiological Mechanisms Related to Pain Management in Bone Tumors

2020 ◽  
Vol 18 ◽  
Author(s):  
Pablo Romero-Morelos ◽  
Erika Ruvalcaba-Paredes ◽  
David Garciadiego-Cázares ◽  
Martín PérezSantos ◽  
Samuel Reyes-Long ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Management ◽  
Cancer Pain ◽  
Bone Tumors ◽  
Bone Cancer ◽  
Bone Cancer Pain ◽  
Peripheral Sensitization ◽  
Related Factor ◽  
Common Symptom

Background: Primary and metastatic bone tumor incidence has increased in the last years. Pain is a common symptom and is one of the most important related factor to the decrease of quality of life in these patients. Different pain management strategies are not completely effective and many patients afflicted by cancer pain cannot be controlled properly. In this sense we need to elucidate the neurophysiology of cancer-induced pain contemplating other quality of life components such as inflammation, neuropathies and cognitive components regarding bone tumors, and thus pave the way for novel therapeutic approaches in this field. Aim: Identify the neurophysiology of the mechanisms related to pain management in bone tumors. Method: Advanced searches were performed in scientific databases: PubMed, ProQuest, EBSCO, and the Science Citation index to get information about the neurophysiology mechanisms related to pain management in bone tumors. Results: The central and peripheral mechanisms that promote bone cancer pain are poorly understood. Studies have shown that bone cancer could be related to neurochemicals produced by tumor and inflammatory cells, coupled with peripheral sensitization due to nerve compression and injury caused by tumor growth. Activity of mesolimbic dopaminergic neurons, substance P, cysteine/glutamate antiporter, and other neurochemical dynamic’s brings us putative strategies to suggest better and efficient treatments against pain in cancer patients. Conclusion: Cancer-induced bone pain could include neuropathic and inflammatory pain, but with different modifications to the periphery tissue, nerves and neurochemical changes in different neurological levels. In this sense, here we explore opportunity areas in pharmacological and non-pharmacological pain management, according to pain-involved mechanisms.

scholarly journals NCCN Guidelines Insights: Survivorship, Version 2.2019

2019 ◽  
Vol 17 (7) ◽  
pp. 784-794 ◽  
Author(s):  
Tara Sanft ◽  
Crystal S. Denlinger ◽  
Saro Armenian ◽  
K. Scott Baker ◽  
Gregory Broderick ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pain Management ◽  
Cancer Treatment ◽  
Weight Management ◽  
Care Coordination ◽  
Healthcare Professionals ◽  
Treatment Recommendations ◽  
Adult Onset ◽  
Nccn Guidelines

The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for consequences of cancer and cancer treatment to aid healthcare professionals who work with survivors of adult-onset cancer. Guidance is also provided to help promote physical activity, weight management, and proper immunizations in survivors and to facilitate care coordination to ensure that all needs are addressed. These NCCN Insights summarize some of the topics discussed by the NCCN Survivorship Panel during the 2019 update of the guidelines, including the survivorship population addressed, ways to improve care coordination, and pain management.

Pain in children

2018 ◽  
Author(s):  
Julia Wager ◽  
Boris Zernikow
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Cancer Pain ◽  
Acute Pain ◽  
Pain Assessment ◽  
Education For All ◽  
Special Focus ◽  
Assessment And Treatment ◽  
Specialized Service ◽  
Pain Patients

Pain management in children is a specialized service. Pain aetiology, assessment, and treatment vary at every age from pre-term foetuses at 23 weeks gestation to adolescence. In this chapter of European Pain Management advances in our understanding of pain assessment are reviewed, particularly in the use of developmentally relevant technology. Advances in acute pain, cancer pain, and in chronic pain are also reviewed, with a special focus on innovations in multidisciplinary treatments for chronic pain. There is a need to raise awareness and understanding of the needs of paediatric pain patients, and their family members. Education for all professionals who interact with pain patients is essential, as is the need to invest in specialized pain management services, and professionals, across Europe.

scholarly journals The role of Emotional Intelligence in health care professionals burnout

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Arnone ◽  
M I Cascio ◽  
I Parenti
Keyword(s):  
Health Care ◽  
Emotional Intelligence ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Protective Factor ◽  
Healthcare Professionals ◽  
Self Report ◽  
Length Of Service ◽  
The Relationship

Abstract The purpose of this study is to explore the relationship between Emotional Intelligence (EI) and burnout in health care professionals. More specifically, this survey has the purpose of demonstrating the role of EI as a protective factor against the risk of burnout. Health professionals (doctors, nurses, and other caregivers) composed the sample. Health care professionals were invited to complete the following tests: Self Report Emotional Intelligence Test (Schutte et al., 1998; it. ad. Craparo, et al.[35]); Link Burnout Questionnaire,LBQ; Other variables, such as gender, lenght of service (years of professional experience) and organizational department. Major results of this survey underline the relationship between EI and burnout. More specifically, there is a negative and significant correlation between burnout and Emotional Intelligence. Moreover, burnout varies depending on length of service: burnout increases between 5 and 10 years of experience and decreases over 10 years. Indeed, burnout is differently expressed amongst healthcare professionals: more specifically, Psycho-physical exhaustion, Detriment of the relationships and Burnout (total score) impact physician (doctors) more than other investigated health professionals. These findings seem to suggest the opportunity to improve Emotional Intelligence abilities through specific training programs, useful to promote the ability to cope with stress and to enrich the relationships in the workplace. Key messages Burnout is more diffuse among health professionals working in emergency departments. Emotional intelligence has the role to cope with burnout.

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