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; however, Fitzgibbon and Loeser (2010, p.190) stress that pain may often be undertreated, even in the UK. Foley and Abernathy (2008, p.2759) identify numerous barriers to effective pain management, among which are professional barriers such as inadequate knowledge of pain mechanisms, assessment and management strategies. Physiology of Cancer Pain There are different types of pain which may be suffered by an individual with cancer, with some patients suffering only one type of pain, but others experiencing a range of all three types. Identifying the type of pain suffered is the first major step in ensuring effective treatment, as not all respond to different treatments in the same way (De Conno & Caraceni, 1996, p.9). Somatic pain is that in which nociceptors in the cutaneous or deep tissues are activated by noxious stimuli. This is usually characterized by dull, aching pain which is well localized. This type of pain may be commonly experienced by individuals with metastatic bone pain or those who h... ... middle of paper ... ...newicht and Dunford (2004), physiotherapists, occupational therapists, Doctors, nurses, specialist pain teams and dieticians all care for the patient at once. Effective treatment of cancer pain is essential for ensuring the best outcomes for cancer patients, in terms of physical, psychological and social aspects. Although there are no NICE guidelines for management of cancer pain, WHO guidance should be used to inform clinical practice. Careful assessment is a critical element of the process to ensure that patients are offered the treatment which is likely to offer the best outcomes, yet without providing a greater than necessary risk of complications such as tolerance and addiction to opioids. The main outcome that this paper highlights is that “Pain is what the patient says it is and exists when he says it does” (McCaffery 1983 cited in Sofaer 1992 pp14).
Ferrell, B., Levy, M. H., & Paice, J. (2008). Managing pain from advanced cancer in the
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 control. Hospice programs available, and options associated with them will be discussed as well as common concerns associated with early admission to hospice. The methods used for payment of hospice, and how one qualifies for entrance into a hospice program will be explored. A literature search will be performed and its results detailed within the body of this paper. Recent publications on the subject matter and associated issues such as moral and ethical questions as well as the change question will be discussed. Planning, implementing and evaluation of the change proposed will be explored within this paper.
on Pain Care will evaluate the adequacy of pain assessment, treatment, and management; identify and
According to World Health Organization, cancer pain can be controlled effectively with oral morphine in up to 90% of individuals with cancer (Ahmed, et al. 2010). Cancer patients benefit significantly from the effects of morphine on severe or chronic pain (Weil and Winifred 2004). A common treatment plan for cancer patients is to follow the “analgesic ladder” approach. The first step in this approach is to administer a non-opioid analgesic, such as aspirin, paracetamol, or a non-steroidal anti-inflammatory drug (Hanks, et al., 1996). Secondly, a week opioid is administered to the individual. Once the weak opioid is proven inadequate the third step is followed and a strong opioid is administered. ...
It is difficult for a medical professional to physically see a patient 's pain unless the source is on the exterior of their bodies. According to the American College of Emergency Physicians, “Some health personnel mistakenly believe that appearance, vital signs, and the ability to sleep correlate with the presence or absence of pain. Appearance, nonetheless, is a poor predictor of pain intensity, particularly in those with chronic pain.” Doctor’s and nurses alike must put aside their bias’, predisposed beliefs, along with judgements to treat a patient experiencing pain fairly. It is a medical professional 's duty to assess and treat each patient to their fullest ability in addition to prescribing the correct medication free from bias and stereotypes. If Medical professionals have difficulty in assessing pain along with fairly prescribing medication on a case-by-case basis, then there needs to be a movement in the medical world for better teaching on this
Conclusions. An adequate and clear understanding of the concept of pain and implementing interventions of pain treatment and management is essential in the clinical settings. Understanding the concept of pain is necessary for its relationships with other concepts that are related and similar to the pain experience for theory building. The in the end, understanding the concept of pain will ultimately benefit the patient and lead to better and approp...
Pain is subjective, acknowledging the level of the pain as reported by the patient is important. (Pellico p. 1242)
Bao, T., Ye X., Skinner, J., Cao, B., Fisher, Joy., Nesbit, S., …Grossman, S. A., (2011). The analgesic effect of magnetic acupressure in cancer patients undergoing bone marrow aspirations and biopsy: A randomized, blinded, controlled study. Journal of Pain and Symptom Management, 41(6), 995-1002. Retrieved from http://www.jpsmjournal.com/article/S0885-3924(10)01054-7/fulltext
My mother is one of the millions of people throughout the United States that had to suffer through her chronic pain because the doctor didn’t prescribe enough medication to make her condition bearable. Throughout America, around 50 to 75 million people suffer from moderate to severe chronic pain. Despite this fact, only 25% of those with this kind of chronic pain are provided with sufficient treatment to control it (Roget and Fisher). This kind of ongoing pain decreases progress in work and daily activities, and as a result it can reduce a person’s overall quality of life (Chronic Pain). This kind of undertreatment of pain happens all the time, yet most people are left to trust the authority of the physician to prescribe the right amount for their pain. The undertreatment of moderate to severe chronic pain is an issue that should be eradicated from the medical field by properly educating physicians about how to evaluate p...
In my opinion cancer patients can alternative pain management and higher dose of pain medicine so that they can have some comfort during their stage of dying.
Pain affects everyone; it sends thousands of people to hospitals, clinics and private care providers daily. A primitive warning system, pain is an unpleasant but important function for survival. In the physiological sense pain is the uncomfortable sensation felt by the sensory nerves (Taber’s). Pain can be described in a number of ways such as burning, aching or crushing. When assessing pain in her patient, a nurses first measure would be a question; “are you having pain”? No one will dispute the fact that this is the most reliable method of assessment, because pain is exclusively subjective in nature. Most schools teach that ‘pain is present when the patient says it is’.
Despite the aforementioned psychological mechanisms associated with pain perception, it is important to mention that pain is first and foremost a biological sensation processed initially by a response in the nerve endings attached to the tissue in the affected area of tissue damage (Moseley, 2017). It is important to identify that there are multiple processes involved in the biological definition of pain, different types of pain are more complex than others and two types of pain are never chemically processed the same way. Stimuli is processed in three ways: Transduction, transmission and perception. Transduction is the process of stimulus being converted into “receptor membrane depolarisation and nerve impulses” (Fields, 2013) this occurs in the ‘primary afferents’ (Pas) these PAs
The nurse should educate the patient of the importance of pain control and how controlling pain is essential to a patient’s wellbeing and recovery. It needs to be a balance of what the patient says and what the nurse observes and interprets while always respecting the wishes of the patient. Nurses have a variety of assessment tools available to assess pain in their patients. One dimensional pain scales such as visual analog scale, verbal descriptor scale, numeric pain intensity scale and the combined thermometer scale all measure the intensity of the pain (Jensen, 2011). Other pain scales such as McGill pain questionnaire, brief pain inventory, and brief pain impact questionnaire take into account aspects beyond intensity (Jensen 2011). There are additional pain assessments specialized for children, older adults, patients who are unable to respond, and patients with opioid tolerance (Jensen, 2011). The nurse should be familiar with these methods of pain assessment and know the appropriate use of each. Incorrect medication and treatment choices due to inaccurate or poor pain assessment cause patient suffering (Jensen,
The author Abdalrahim et al. (2010) stated that nurses are not being properly educated in pain and pain management; in an effort to better form an opinion on this theory, it is imperative that we have an accurate and consistent definition of pain. According to Engebretson, Monsivais, & Mahoney (2006), “Pain results from somatosensory, cognitive and emotional events, and, in the case of chronic pain, neuroplastic changes that alter the physiology and change nervous system responses to various stimuli”. There are two distinct types of pain, acute and chronic. Ferrell (2005) suggest that acute pain can be manifested by different types of trauma (sprained ankle, broken leg, stubbed toe, pulled muscle, etc.), surgical incisions or body parts manipulated during surgery, and even the effects of a cold. Chronic pain can be portrayed as many medical conditions, some examples are: migraine headaches, arthritis, clinical depression, fibromyalgia, and spinal stenosis (Ferrell, 2005). The best definition of pain for nurses to adhere to was stated by Margo McCaffrey (1968), “Pain is whatever the experiencing person says it is, existing whenever the experiencing person says it does”.
Marion Good, PhD, RN, has focused her study, “A Middle-Range Theory of Acute pain Management: Use in Research,” on complementary medicine for pain and stress, acute pain, and stress immunity. The purpose of this theory is to put into practice guidelines for pain management. Good, 1998, noted the need for a balance between medication usage and side effects of pain medications. The theory also promoted patient education related to pain management following surgery and encouraged plan development for acceptable levels of pain management. This theory was developed through deductive reasoning. Chinn & Kramer, 2008, defined deductive reasoning as going from a general concept to a more specific concept. Good, 1998, related that there was a balance between analgesia and side effects in which two outcomes can be deduced: (1) a decrease in pain, and (2) a decrease in side effects. These outcomes can be studied further or more detailed concepts can be deduced from them.