Abstract
Context
Patients with cancer face symptoms because of disease and treatment, and pain is common
and complex. The opioid crisis may complicate patients' and clinicians' experiences
of managing pain in cancer care.
Objectives
In our study of perceptions and experiences with palliative care (PC) at an outpatient
cancer center, we examined communication around symptom management throughout cancer
care, and pain and its management emerged as particularly salient. The objective of
this article is to describe, from the perspectives of patients, caregivers, and oncology
health care professionals, the role of PC in navigating the complicated dynamics of
pain management amidst the opioid crisis.
Methods
A qualitative descriptive study with grounded theory components was designed to investigate
experiences with and perceptions of specialist PC and symptom management, including
pain. Interviews were audiorecorded and transcribed, and focused coding identified
themes related to pain and pain management from all three perspectives.
Results
About 44 patients, caregivers, and non-PC health care professionals completed interviews.
Patients with cancer and their caregivers had many concerns about pain management
and were specifically concerned about opioid use and stigma. For patients, PC improved
pain management and helped to destigmatize appropriate pain management. Oncology clinicians
reported that partnering with PC facilitated complex pain management and also provided
moral support around difficult opioid recommendations for patients.
Conclusion
PC offers the potential to uniquely support both patients and other oncology professionals
in optimally navigating the complexity around pain management for cancer care in the
midst of the opioid crisis.
Key Words
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Article info
Publication history
Published online: July 05, 2020
Accepted:
June 25,
2020
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine.
