Cancer Pain Management
Cancer Pain Management
Cancer is rapidly becoming a chronic illness, and an estimated that 10 million individuals in the United States are survivors of cancer (Sun, Borneman, Piper, Koczywas, & Ferrell, 2008). According to 2008, cancer statistics from the American Cancer Society, about 565,650 people die in the United States from cancer every year. Approximately 1.6 million new cases of cancer are expected to be diagnosed in the United States this year (American Cancer Society, 2012). This is why the health care needs of cancer patients are unique, and many are at risk for developing late or long-term 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 metastatic or advanced disease. In almost every cancer-related case pain is inadequately managed due to a 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
Support for the patient and family may include education and information, coping 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 (Herschbach, Keller, Knight, Huber, Henrich & Marten-Mittag, 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 as 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 of a pain stimulus for longer periods (Narayan, 2010). Thus, people of different cultures respond differently to pain for example people from cultures that value stoicism tend to avoid vocalizing with moans or screams when they are in pain. They may strive to keep their faces "masked," trying not to show their pain even by 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 (Al-Atiyyat, 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 for unrelieved pain symptoms (Ayres, 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...
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