Introduction
This essay will aim to look at the main principles of cancer pain management on an acute medical ward in a hospital setting. My rational for choosing to look at this is to expend my knowledge of the chosen area. Within this pieces of work I will look to include physiological, psychological and sociological aspects of pain management.
Pain, which is defined in its widest sense as an emotion which is the opposite of pleasure (White, 2004, p.455), is one of the major symptoms of cancer, affecting a majority of sufferers at some point during their condition (De Conno & Caraceni, 1996, p.8). The World Health Organization (WHO, 2009, online) suggests that relief from pain may be achieved in more than 90 percent of patients;
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De Wit et al (2001) state that the cognitive dimension of cancer pain deals with what patients pain means to them and how they think of it in terms of beliefs, attitudes and thoughts. This is to do with their personality. A patient’s beliefs effect how they cope with pain. They can initiate coping strategies and their level of adjustment to pain. Sofaer (1992) notes that pain causes anxiety and in turn anxiety can heighten pain.
Guidelines for Treatment
Provision of pain relief is a shared responsibility of the interdisciplinary health care team. For example it may initially form part of the oncologist’s remit to determine the most effective pain management plan for the patient. After treatment has been initiated, oncology nurses may then adopt responsibility for ensuring that pain relief is adequate via regular assessment and action (NICE, 2004, p.80).
Aside from determining the type of pain suffered, the other major consideration in treating pain for cancer patients is to determine the level of pain. A significant proportion of patients experiencing pain would grade this as moderate to severe, but some may have only mild to moderate pain which may respond to lower risk treatment options (van den Beuken-van Everdingen et al., 2007, p.1437).
Drug therapy is described by Fitzgibbon and Loeser (2010, p.190) as the cornerstone of treating cancer pain. There is currently no specific NICE guidance on pain management on cancer. However, opioids
Having a personalised and holistic approach to a persons pain and discomfort needs good teamwork. E.g. Nurses and care workers may be able to help to support the person with physical pain. By using effective
Many individuals who are in their early stages of cancer do not experience any pain because cancer can induce its signs and symptoms. The reason behind this can be the location, size of the cancer. Also, the addition, some cancers will not show signs and symptoms. These diseases, such as pancreatic cancer, are sometimes referred to as "silent." They are often diagnosed at a late stage when the disease is much more difficult to treat or even cure (Cancer Signs and Symptoms Overview, 2013). Furthermore, if cancer is invading location of the body the patient can suffer from pain effect that the cancer can cause depend on the surrounding environment. In such as, bone metastases and prostate cancer that can cause a severe
pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain
The change which is outlined in this paper relates to how early referral of terminally ill patients into a hospice program results in better patient outcomes, in particular, with regard to pain management. PICO format question will be used , along with a supportive body of evidence regarding the fact that early onset into a hospice program is helpful with providing end of life pain
The movie “Wit” is a great educational tool for healthcare professionals in terms of dealing with terminally ill patients. It teaches that nurses and medical professionals should always remember that their patients are not a case nor illness nor experiment but rather human beings with souls and pains. Palliative care is one of the most disputed issues of worldwide importance. While bureaucrats in different countries are making laws on the use of palliative drugs, patients with excruciating pains learn how to “take deep breaths and be strong” (Nichols & Brokaw, 2001). That is what nurse Susie Monahan from “Wit” advises her dying patient Vivian Bearing suffering from unbearable pains due to stage IV ovarian cancer after eight painful rounds
A search of the Cinahl, Medline, Embase, BNI, psycINFO databases were made using the following key words, pain assessment, pain management, elderly, dementia and palliative care. The reference lists of identified papers were also searched for relevant articles. The use of many databases was deemed necessary due to
Pain can be acute or chronic. Acute pain is intense, short in duration and generally a reaction to trauma. Chronic pain does not go away, and can range from a dull ache to excruciating agony. Terminal and non-terminal illnesses can both be causes of chronic pain. Tissue damage is not always found in chronic pain, but those who suffer from it are rendered "nonfunctional by incapacitating pain," (Murphy, 1981).
The selected policy Essence of Care 2010: Benchmarks for the Prevention and Management of Pain, includes the latest benchmarks on the management of pain and its prevention. It presents up to date reviewed views, with the aim to deliver
Pain is one of the most common and feared complications of cancer. It is exacerbated by stress, anxiety, fatigue, and malaise which accompany advanced cancer. Pain is generally absent in the early stages of cancer, but it is a significant factor as the illness progresses to advanced stages. Cancer-associated pain can arise from a variety of direct and indirect mechanisms including direct pressure, obstruction, and invasion of a sensitive structure, stretching of visceral surfaces, tissue destruction, infection, and inflammation (McCance 2010). Pain is generally accepted as whatever the patient says it is, wherever the patient says it is. Treatment of pain and its associated symptoms is a primary responsibility of the healthcare team. Treatment modalities for pain include the use of opioid analgesics, patient-controlled analgesia, psychological interventions, and preventing recurrence of pain. Reinforcing the reporting of pain by the patient is important, as is a respect for the social and cultural differences with respect to pain perception.
Trossman (2006) states that at least 50% of patients are suffering from moderate to severe pain at their time of death, that 70 million Americans experience pain throughout their activities of daily living and that nurses hold the keys to pain management. According to Abdalrahim et al. (2010) there have been countless evidence-based studies regarding pain management; nevertheless, the inability to control the patients’ pain has increased due to nurses often devaluing the information they receive from the patients about their current pain level, these actions are directly related to a withholding of
The author indicates that specialists in controlling certain types of pain, such as the pain of terminally ill cancer patients, believe that there are very few patients whose pain could not be adequately controlled. Although there are some ways to help a patient's pain, these methods unfortunately do not help. Many patients become sedated and cannot interact with other people or their environment (Hawkins 22). Clearly, all of these reasons are examples of self- deliverance and a liberty to choose. No patient should have to undergo a prolonged painful death.
Pain and comfort as a rule are considered opposing in the needs of human beings. Pain is defined as an unpleasant sensory or emotional experience associated with potential tissue damage. Pain can be divided into categories of long-term pain or short-term pain and by the type of pain, level of pain, location of pain, and ease of solving the pain. Frequently, there is no way to completely manage pain, specifically in end-of-life care. Pain is at
Multimodal intervention along with attentive care and patient participation is necessary to achieve a balance between analgesia and side effects. Assumptions to the conceptual framework must be identified to understand the specific relevance of the theory to pain
The case study based on the palliative patient Mrs. Mavis looks at issues both the family and the patient are dealing with in regards to the end of life treatment Mrs. Mavis is receiving. Mrs. Mavis is a palliative patient, currently unconscious, who is dying and only wants comfort measures within her nursing care. This was made clear through her advanced care directive, which was made weeks before beginning to receive her end of life care. Mrs. Mavis’ comfort measures include pain relief, hygiene and keeping her comfortable. Mrs. Mavis’ family want her to have fluids and medications to help improve her health. They also want oxygen and pain relief to help with her breathing. Issues such as educating and supporting the family, pain management, the effectiveness of having an advanced care directive and pain assessment will be evaluated to determine the best effective interventions for Mrs. Mavis and her families care. Interventions that will be discussed through-out this essay include the use of analgesia medication, the use of subcutaneous injections and syringe drivers, emotional support for the family, effective communication, educating the family on Mrs. Mavis’ wishes and the importance of having an advanced care directive. These interventions will be evaluated to ensure they are the best practice for Mrs. Mavis’ care.
The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.