Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-25T04:44:05.490Z Has data issue: false hasContentIssue false

Challenging the representations of cancer pain: Experiences of a multidisciplinary pain management group in a palliative care unit

Published online by Cambridge University Press:  24 August 2005

ELIZABETH CHAPMAN
Affiliation:
Arthur Rank Hospice, Cambridge, UK
DAVID HUGHES
Affiliation:
Arthur Rank Hospice, Cambridge, UK
ANNETTE LANDY
Affiliation:
Arthur Rank Hospice, Cambridge, UK
JUDITH WHALE
Affiliation:
Arthur Rank Hospice, Cambridge, UK
MARGARET SAUNDERS
Affiliation:
Arthur Rank Hospice, Cambridge, UK

Abstract

Objective: This article describes how a Multidisciplinary Pain Management Group was set up in a palliative care unit, and outlines the ways that the group works with different patients. We place these comments in the context of the wider representations of pain.

Methods: Our observations of patients seen by the multidisciplinary team.

Results: We tentatively propose that where the patient's pain has certain characteristics it may require a different approach. Patients who are older, with a lengthy treatment history, may require a different input than younger patients, who may have a number of factors that further complicate their experience of pain. We use our extensive experience with mesothelioma patients to draw a further important distinction between this patient group and other patients.

Significance of research: Our observations suggest the need to allow sufficient time for intensive psychological work to be done with mesothelioma patients in order for pharmacological interventions to be effective.

Type
Research Article
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Breitbart, W.S. & Payne, D.K. (2004). Psychological and psychiatric dimensions of palliative care. In Psychosocial Aspects of Pain: A Handbook for Health Care Providers, Dworkin, R.H. & Breitbart, W.S. (eds.). Seattle: IASP Press.
Cherny, N.I., Coyle, & N., Foley K.M. (1994). Suffering in the advanced cancer patient: A definition and taxonomy. Journal of Palliative Care, 10, 5770.Google Scholar
de Rond, M.E., de Wit, R., van Dam, F.S., et al. (2000). A pain monitoring program for nurses: Effects on communication, assessment and documentation of patients' pain. Journal of Pain Symptom Management, 20, 424439.Google Scholar
Foster, N.E., Pincus, T., Underwood, M., et al. (2003). Treatment and the process of care in musculoskeletal conditions: A multidisciplinary perspective and integration. The Orthopedic Clinics of North America, 34, 239244.Google Scholar
Gunnarsdottir, S., Donovan, H.S., Serlin, R.C., et al. (2002). Patient-related barriers to pain management: The Barriers Questionnaire II (BQ-II). Pain, 99, 385396.Google Scholar
Higginson, I., Vachon, M.L.S., & Kristjanson, L. (1995). Psychosocial issues in palliative care: The patient, the family, and the process and outcome of care. Journal of Pain and Symptom Management, 10, 42150.Google Scholar
Jacobsen, P.B. & Breitbart, W. (1996). Psychosocial aspects of palliative care. Cancer Control, 3, 214222.Google Scholar
National Council for Hospice and Specialist Palliative Care Services. (2003). Guidance for Managing Cancer Pain in Adults, 3rd edition. Available at: www.hospice-spc-council.org.uk.
National Institute for Clinical Excellence. (2004). Improving Supportive and Palliative Care for Adults with Cancer: The Manual. London: Author.
Paice, J.A., Toy, C., & Shott, S. (1998). Barriers to cancer pain relief: Fear of tolerance and addiction. Journal of Pain and Symptom Management, 16, 19.Google Scholar
Pargeon, K.L. & Hailey, B.J. (1999). Barriers to effective cancer pain management: A review of the literature. Journal of Pain and Symptom Management, 18, 358368.Google Scholar
Patrick, L.E., Altmaier, E.M., & Found, E.M. (2004). Long-term outcomes in multidisciplinary treatment of chronic low back pain: Results of a 13-year follow-up. Spine, 29, 850855.Google Scholar
Perron, V. & Schonwetter, R.S. (2001). Assessment and management of pain in palliative care patients. Cancer Control, 8, 1524.Google Scholar
Potter, V.T., Wiseman, C.E., Dunn, S.M., et al. (2003). Patient barriers to optimal cancer pain control. Psychooncology, 12, 153160.Google Scholar
Treasure, T., Waller, D., Swift, S., et al. (2003). Radical surgery for mesothelioma: The epidemic is still to peak and we need more research to manage it. British Medical Journal, 328, 237238.Google Scholar
Ward, S., Donovan, H.S., Owen, B., et al. (2000). An individualized intervention to overcome patient-related barriers to pain management in women with gynecologic cancers. Research in Nursing and Health, 23, 393405.Google Scholar