This is why the health care needs of cancer patients are unique, and many are at risk for developing late or long- ERM side effects and pain from their primary treatments. These long-term effects may also hinder optimal physical, psychological, and cognitive functioning for patients (Sun et al. , 2008). Pain Is experienced by 30% to 50% of cancer patients receiving treatment and by 70% to 90% of patients with metastasis or advanced disease. In almost every cancer-related case pain is inadequately managed due too lack of patient and professional knowledge of optimum management (Sun et al. , 2008).
This paper will discuss how nurses can help provide adequate pain management in advanced cancer patients. Patient and family needs skills, counseling and psychotherapy, and family meetings, etc. Patients, as well as their family have psychological needs. Family members’ psychological distress can be as severe as that of the patient. Studies of psychological distress have found that the psychological distress of patients and their family paralleled over time so when you help the family to manage their distress may have a beneficial effect on the distress level of patients (Horseback, Keller, Knight, Huber, Henries & Marten-Mintage, 2004).
Psychological/Psychosocial/Physical concerns One third of patients with cancer will experience distress which requires evaluation and treatment, patients and their families must cope with the stresses induced by physically demanding treatments for the illness and the permanent health impairment and disability, fatigue, and pain that can result (National Cancer Institute, 2012).
These effects contribute to emotional distress (guilt, feelings of loss of control, anger, sadness, confusion, and fear) and mental health problems (depression, anxiety and adjustment disorders) and together can lead to substantial social problems, such s the inability to work and reduced income (National Cancer Institute, 2012). Impact of culture/ethnicity on issue Some pain studies show that pain is greatly influenced by cultural factors. Members of some ethnic groups have a higher tolerance for pain than others and can endure increasing levels off pain stimulus for longer periods (Nary, 2010).
Thus, people of different cultures respond differently to pain for example people from cultures that value stoicism tend to avoid visualizing with moans or screams when they are in pain. They may strive to keep their faces “masked,” trying not to show their pain even y grimacing. They may feel that they’ll be perceived as weak if they admit to or show pain, and they may deny having pain when asked. They may prefer to be left alone to bear their pain without bothering others and may have learned to cope without seeking attention or care (AY-Tatty, 2009).
Nurses need to remember that patients’ cultural background can have a big influence on how pain is perceived. Barriers to Care Overcoming barriers to pain management in cancer care is critical to improving quality of life in patients living with cancer but first we must understand the reasons or unrelieved pain symptoms (Ares, 2012). There are three types of barriers to pain management: patient, professional and system related. Patient-related barriers include reluctance to report pain, attitude about pain and its treatment, and fear of addiction or side effects from medication.
Professional barriers include lack of knowledge of pain relief, side effect management, poor pain assessment, and fear of patient addiction/tolerance. System-related barriers include access to treatment, inadequate reimbursement and regulatory constraints (Sun et al. , 2008). Clinical Evaluation Pain is a common symptom experienced by cancer patients. Inadequate treatment of pain is a serious clinical problem and has been well documented for over 25 years (Illegible, Maltese, Grilles, & Mutually, 2011).
Cancer pain is frequently assessed and treated inadequately. Preventing and managing pain without intolerable side effects from treatment is the goal of care. Because nurses are often the first to hear a critical. Tools used to assess pain should cover pain intensity, location, and characteristics, as well as pain-related hindrance with activity (Starts, Sherwood & Adams-McNeill, 2000). Pain assessment tool may include verbal descriptor scales, pain thermometers, numeric rating scales, and facial pain scales (Hanks-Bell, Halley, & Peace, 2004).
Expressions of pain behavior include agitation, confusion, social withdrawal, or apathy. Other signs of pain include the following: facial expressions, visualization, body movements, changes in interpersonal interactions, changes in activity, or mental status changes (Hanks-Bell, et al. , 2004). Management The data obtained from the pain assessment helps form the plan of care, including pharmacological and nonparametric therapies. Pharmacological therapies include: non-avoids; avoids, nerve blocks and adjunct drugs.
Non-pharmacological therapies include various physical, cognitive-behavioral and emotional therapies for both acute and persistent pain (Starts et al. , 2000). Advance Practice Nurses (Pans) and other health care providers should make appropriate referrals for pain which cannot be managed by traditional means. As members of interdisciplinary teams (DID) involved in patient care, education & training, management, and research, nurses are in a pivotal position to improve cancer pain assessment and management (Starts, et al. 2000).
Advance Practice Specific Role Functions Pans are vital members within the health care team who deliver high-quality, evidence-based interventions to patients who are experiencing unrelieved pain from advanced illnesses like cancer by reducing discomfort and promoting quality of life. The Pans are prepared to identify, support, and make the appropriate referrals that address the patient’s pain management needs (Quibbler, 2003). As a Nurse Leader, Pans mentor and empower other DID members in providing effective pain assessment and management.
As Nurse Educators, Pans educate other disciplines guarding pain and symptom management. As clinicians, we utilize appropriate techniques to assess, evaluate and manage pain as mentioned above. Pans work together with other members of the DID to create and implement a comprehensive treatment plan for meeting the needs of the patient and family (Matzo & Sherman, 2010). Standard pain assessment tools can be used to document the location, intensity, and quality of pain.
A competent nurse will ask the patient : “How bad is the pain, for example on a 0-10 scale, what aggravates or relieves discomfort? ” The ruse will then provided pain assessment is the first and most crucial step in trying to bring comfort and analgesia to a cancer patient. Without this step, the clinician will never know if the patient is in pain, according to Patrick Cone of the Medical College of Virginia. Standard pain assessment tools can be used to document the location, the pain, for example on a 0-10 scale, what aggravates or relieves discomfort? A pain assessment is the first and most crucial step in trying to bring comfort and analgesia to a cancer patient. Without this step, the clinician will never know if the patient is in main, according to Patrick Cone of the Medical College of Virginia. Standard pain assessment tools can be used to document the location, intensity, and quality of pain. A competent nurse will ask the patient : “How bad is the pain, for example on a 0-10 scale, what aggravates or relieves discomfort? Summary Managing cancer pain functional, cognitive, emotional, and societal consequences. Pain can markedly impact the quality of an individual’s life, increase vulnerability in certain populations, and create reliance on healthcare providers to access for adequate pain management (Hanks-Bell, et al. , 2004). Pans and other nurses play a crucial role in pain management process but first we have to overcome barriers which hinder effective pain management. There are a variety of tools used to assess pain and the accuracy of pain management.
