Journal of Pain and Symptom Management
Volume 23, Issue 5 , Pages 369-382, May 2002

Putting Cancer Pain Management Regimens into Practice at Home

  • Karen L Schumacher, RN, PhD

      Affiliations

    • School of Nursing, University of Pennsylvania, Philadelphia, PA USA
    • ,
  • Setsuko Koresawa, RN, MS

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • Claudia West, RN, MS

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • Christopher Hawkins, RN, MS

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • Carol Johnson, RN, BS
    • ,
  • Evalyn Wais, RN, BS

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • Marylin Dodd, RN, PhD

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • Steven M Paul, PhD

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • Debu Tripathy, MD

      Affiliations

    • School of Medicine, University of California, San Francisco, CA, USA
    • ,
  • Peter Koo, PharmD

      Affiliations

    • School of Pharmacy, University of California, San Francisco, CA, USA
    • ,
  • Christine Miaskowski, RN, PhD

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • Corresponding Author InformationAddress reprint requests to: Christine Miaskowski, RN, PhD, FAAN, Department of Physiological Nursing, University of California, 2 Koret Way, Box 0610, San Francisco, CA 94143-0610, USA

Accepted 4 September 2001.

Abstract 

The purpose of this study was to describe the difficulties with pain management that patients and family caregivers bring to a nurse's attention during a teaching and coaching intervention. Data were obtained from audiotaped and transcribed interactions between intervention nurses and patients (n = 52) and their family caregivers (n = 33) who were participating in a randomized clinical trial of a nursing intervention called the PRO-SELF© Pain Control Program. Using qualitative content analysis, we found that patients had difficulty in seven areas when they attempted to put a pain management regimen into practice, namely: obtaining the prescribed medication(s), accessing information, tailoring prescribed regimens to meet individual needs, managing side effects, cognitively processing information, managing new or unusual pain, and managing multiple symptoms simultaneously. The findings from this study suggest that the provision of information about cancer pain management to patients and their family caregivers is not sufficient to improve pain control in the home care setting. Patients and their family caregivers require ongoing assistance with problem-solving to optimize their pain management regimen.

Keywords:  Cancer pain, barriers to pain management, bone metastasis, pain management at home, side effects

 

PII: S0885-3924(02)00385-8

Journal of Pain and Symptom Management
Volume 23, Issue 5 , Pages 369-382, May 2002

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