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Hackett, J; Godfrey, M; Bennett, MI (2016)
Publisher: SAGE Publications
Languages: English
Types: Article
Background: Despite advances in treatment of pain in advanced cancer, it remains a major source of suffering with adverse effects on patients’ life quality. There is increasing understanding of its multi-dimensional nature and the variable responsiveness of medication to complex pain. Less clear is how patients and their caregivers respond to and manage pain complexity. Aim: To explore patients’ and carers’ experiences of advanced cancer pain and the processes that they engage in to manage pain. Design: Qualitative study employing face-to-face interviews at two time points and audio diaries. Data were analysed using grounded theory strategies. Setting/participants: Purposive sample of 21 advanced cancer patients and 16 carers from oncology outpatients in a tertiary cancer centre and a hospice. Results: Three distinct patterns of pain were discerned in patients’ accounts, distinguishable in terms of complexity, severity, transiency and degree of perceived control over pain. Pain was dynamic reflecting changes in the disease process, access to and effectiveness of pain relief. For patients and carers, neither pain relief nor expertise in pain management is secured once and for all. The main drivers of help-seeking and action by patients to manage pain were the sensory experiences of pain and meaning attached to it, not beliefs about analgesia. Conclusion: The complex and dynamic nature of pain and how it was understood shaped help-seeking and pain management. Variable effectiveness of pain relief for different pain types were challenging for patients and professionals in achieving relief.
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    • 1. Ferrell BR. The impact of pain on quality of life: a decade of research. The Nursing Clinics of North America. 1995; 30: 609-24.
    • 2. Portenoy R and Lesage P. Management of cancer pain. The Lancet. 1999; 353: 1695- 700.
    • 3. Grant M, Rhiner M and Padilla G. Home care: mainting quality of life for patient and family. Oncology. 1992; 6: 1421-8.
    • 4. Yates PM, Aranda S and Edwards EA. Family caregivers experiences and invovlement with cacner pain management. Journal of Palliative Care. 2004; 20: 287-96.
    • 5. Wittenberg-Lyles E, Demiris G, Parker CR, Oliver D and Burt S. Reciprocal suffering: caregiver concerns during hospice care. Journal of Pain and Symptom Management. 2011; 41: 383-93.
    • 6. Ferrell B, Grant M, Borneman T, Juarez G and ter Veer A. Family caregiving in cancer care management. Journal of Palliative Medicine. 1999; 2: 185-95.
    • 7. van den Beuken-van Everdingen M, de Rijke J, Kessels A, Schouten H, Kleef van M and Patijn M. Prevalence of pain in patients with cancer: a systmeatic review of the past 40 years. Annals of Oncology. 2007; 18: 1437-9.
    • 8. Davis M and Walsh D. Epidemiology of cancer pain and factors influencing poor pain control. American Journal of Hospice and Palliative Medicine. 2004; 21: 137-42.
    • 9. Rayment C, Hjermstad M, Aass N, et al. Neuropathic cancer pain: Prevalence, severity, analgesics and impact from the European Palliative Care Research Collaborative - Computerised Symptom Assessment Study. Palliative Medicine. 2013; 27: 714-21.
    • 10. Falk S and Dickenson AH. Pain and nociception: mechanisms of cancer-induced bone pain. Journal of Clinical Oncology. 2014; 32: 1647-54.
    • 11. Portenoy RK. Treatment of cancer pain. The Lancet. 2011; 377: 2236-47.
    • 12. Green CR, Montague L. and Hart-Johnson TA. Consistent and breakthrough pain in diverse advanced cancer patients: a longitudinal examination. Journal of Pain and Symptom Management 2009; 37: 831-847
    • 13. Reid C, Gooberman-Hill R and Hanks GW. Opioid analgesics for cancer pain: symptom control for the living or comfort for the dying? A qualitative study to investigate the factors influencing the decision to accept morphine for pain caused by cancer. Annals of Oncology. 2008; 19: 44-8.
    • 14. Coyle N. In their own words: seven advanced cancer patients describe their experience with pain and the use of opioids. Journal of Pain and Symptom Management. 2004; 27: 300-9.
    • 15. Paice J, Toy C and Shott S. Barriers to cancer pain relief: fear of tolerance and addiction. Journal of Pain and Symptom Management. 1998; 16: 1-9.
    • 16. Jacobsen R, Moldrup C, Christrup C and Sjogren P. Patient-related barriers to cancer pain management: a systematic exploratory review. Scand J Caring Sci. 2009; 23: 190-208.
    • 17. Deandrea S, Montanari M, Moja L and al e. Prevalence of undertreatment in cancer pain: A review of the published literature. Annals of Oncology. 2008; 19: 1985-91.
    • 18. Flemming K. The use of morphine to treat cancer-related pain: a synthesis of quantitative and qualitative research. Journal of Pain and Symptom Management. 2010; 39: 139-54.
    • 19. Adam R, Bond C and Murchie P. 'Educational interventions for cancer pain: A systematic review of systematic reviews with nested narrative review of randomized controlled trials'. Patient Education and Counseling. 2015; 98: 269-82.
    • 20. Morris SM. Joint and individual interviewing in the context of cancer. Qualitative Health Research. 2001; 11: 553-567.
    • 21. Polak L and Green J. Using joint interviews to add analytic value. Qualitative Health Research. 2015; DOI: 10.1177/1049732315580103
    • 22. Charmaz K. Constructing Grounded Theory 2nd Edition. London: SAGE pUblications Ltd, 2014.
    • 23. Corbin M, J and Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory. 3rd ed. London: SAGE, 2008.
    • 24. Kwon J. Overcoming barriers in cancer pain management. Journal of Clinical Oncology. 2014; 32: 1727-2117.
    • 25. Edrington J, Sun A, Wong C, et al. Barriers to pain management in a community sample of chinese american patients with cancer. Journal of Pain and Symptom Management. 2008.
    • 26. Pargeon K and Hailey B. Barriers to effective cancer pain management: a review of the literature. Journal of Pain and Symptom Management. 1999; 18: 358-68.
    • 27. Ersek M, Miller Kraybill B and Du Pen A. Factors hindering patients' use of medications for cancer pain. Cancer Practice. 1999; 7: 226-32.
    • 28. Ward S, Berry P and Misiewicz H. Concerns about analgesics among patients and family caregivers in a hospice setting. Research in Nursing and Health. 1996; 19: 205-11.
    • 29. Ward S, Carlson-Dakes K, Hughes S, Kwekkeboom K and Donovan H. The impact on quality of life of patient-related barriers to pain management. Research in Nursing and Health. 1998; 21: 405-13.
    • 30. Ward S and Gatwood J. Concerns about reporting pain and using analgesics: a comparison of persons with and without cancer. Cancer Nursing. 1994; 17: 200-6.
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