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Cancer patients' experiences of care related to pain management before and after palliative care referral
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
Halmstad University, School of Social and Health Sciences (HOS).
Halmstad University, School of Social and Health Sciences (HOS).
2004 (English)In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 13, no 3, p. 238-245Article in journal (Refereed) Published
Abstract [en]

Pain is the main problem for patients with cancer referred to palliative care (PC). Pain management in PC requires a multidimensional approach. A questionnaire was used to determine cancer patients' experiences of care related to pain management, before and after being referred to PC, and to also discover possible correlations between pain control and other aspects of care. Seventy-five consecutive patients from two PC teams were included in the study. The patients had experienced a statistically significant (P < 0.01) improvement in care after being referred to PC, despite the fact that pain control had not been optimized. Patients' description of 'pain control' after being referred to PC had a statistically significant correlation with their 'feeling of security' and 'continuity of care' throughout the same period. The conclusion is that care provided in PC is vital to successful pain management. Pain control depends not only on analgesics but also on many other aspects of care provided by the nurse. Continuity of care and the opportunity to talk increases the patients' feeling of security, which is also of utmost importance to successful pain management.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2004. Vol. 13, no 3, p. 238-245
Keywords [en]
Cancer-related pain, Dimensions of pain, Pain management, Palliative care
National Category
Other Medical Sciences not elsewhere specified
Identifiers
URN: urn:nbn:se:hh:diva-357DOI: 10.1111/j.1365-2354.2004.00465.xISI: 000222050800004PubMedID: 15196227Scopus ID: 2-s2.0-3042557812Local ID: 2082/676OAI: oai:DiVA.org:hh-357DiVA, id: diva2:237536
Available from: 2012-02-01 Created: 2006-12-22 Last updated: 2018-03-23Bibliographically approved
In thesis
1. Acute postoperative and cancer-related pain management: Patients experiences and perceptions in relation to health-related quality of life and the multidimensionality of pain
Open this publication in new window or tab >>Acute postoperative and cancer-related pain management: Patients experiences and perceptions in relation to health-related quality of life and the multidimensionality of pain
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis describes patients in acute postoperative pain as well as patients with acute cancer-related pain in palliative care, and their experiences and perceptions of pain management in relation to HRQOL and the multidimensionality of pain. A combination of qualitative and quantitative methods was chosen. Data were collected using interviews and questionnaires; APS, SF:36 and a new developed questionnaire PC-PPQ measuring care related to pain management in palliative care. For assessing pain VAS and Pain-o-Meter were used. The study group consisted of 100 patients on their second postoperative day, and of 75 patients with cancer-related pain from two palliative care teams. The result showed that at the time of the interview 29 of the patients with postoperative pain reported a pain > 3 on VAS and 79 reported VAS > 3 as worst pain past 24 hours. The higher the intensity of pain the less satisfied the postoperative patients were with the nurses´ way of treating their pain. Thirty-three patients stated that they had received information regarding the importance of pain relief. Patients with postoperative pain as well as patients with cancer-related pain had been prescribed analgesics mostly a combination of Paracetamol, NSAID and opioid. Of the 75 patients with cancer-related pain and in palliative care 22 patients reported pain >3 on POM-VAS and 47 patients reported >3 on POM-VAS as worst pain past 24 hours. Twenty-eight patients reported an average pain > 3 on POM-VAS past 24 hours. Twenty-four patients used the words troublesome or tiring when describing their affective pain. Sensory pain was described as prickling or sore by 15 patients. The patients perceived their pain as “aching all over” and expressed a wish for pain relief as well as a fear for increased pain. HRQOL especially physical functioning decreased for patients with average pain > 3. Being cared for by a nurseled or a physician-led palliative care team indicated no statistically significant differences for patients´ HRQOL or pain intensities. The patients had experienced a statistically significant better care after being referred to a palliative care team, despite that pain control had not been optimized. Patients expressed a need for communication, planning and trust in order to improve pain management. Continuity of care and the opportunity to talk increase the patients feeling of security, as well as improved their perceived pain control. Structured ongoing discussion concerning pain management from an early stage of the disease or already preoperatively can provide an important intervention to meet the results of this thesis. Pain assessment covering the multidimensionality of pain, and pain treatment plans including both pharmacological and non-pharmacological treatment are further important interventions.

Place, publisher, year, edition, pages
Lund: Lunds Universitet, 2003. p. 144
Keywords
American Pain Society, Postoperative pain, Palliative care, Neoplasms, Health-Related Quality of life, Patient care management, Patients, Pain management, Pain-o-Meter, nursing care, SF-36
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-1906 (URN)2082/2301 (Local ID)91-628-5575-1 (ISBN)2082/2301 (Archive number)2082/2301 (OAI)
Public defence
(English)
Available from: 2008-09-15 Created: 2008-09-15 Last updated: 2018-02-27Bibliographically approved

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Boström, BarbroSandh, MarieFridlund, Bengt

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