Effect of Hospice Nonprofessional Caregiver Barriers to Pain Management on Adherence to Analgesic Administration Recommendations and Patient Outcomes

Mayahara, Masako; Foreman, Marquis D.; Wilbur, Jo Ellen; Paice, Judith A.; Fogg, Louis

doi:10.1016/j.pmn.2014.07.001

Cited by 23 publications

(17 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings support the need also to include caregivers in the educational process, especially since another researcher found that misunderstandings about pain management affected their caregiving activities related to medication adherence. 9 Optimally, this education should occur early after the cancer diagnosis as part of cancer survivorship programs 32 so that pain control is an expectation across the cancer trajectory, and the focus of end-of-life care does not need to include this type of education unless patients are diagnosed with advanced cancer and have a rapid decline toward death.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13] In a recent study of 46 hospice lay caregivers, investigators combined item scores in unique subscales, but those similar to prior scales had scores also similar to the dyad studies. 9 From the publications we identified, caregivers generally report BQ scores that are higher for concerns about addiction, medication tolerance, disease progression, and side effects of pain medications than the other areas of concern. However, the evidence about patient-caregiver dyads is from research conducted 1.5 to 2 decades ago and may or may not represent current beliefs about pain management or their relationships with pain intensity experienced by hospice patients with cancer.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pain Intensity and Misconceptions Among Hospice Patients With Cancer and Their Caregivers: Status After 2 Decades

Wilkie

Ezenwa

Yao

et al. 2016

Am J Hosp Palliat Care

View full text Add to dashboard Cite

There is little evidence about barriers to pain management or their relationships with pain outcomes of hospice patients with cancer. The purpose of the study was to determine the barriers reported by hospice patients with cancer and their caregivers and the relationships with demographic characteristics and the patients' pain. In this cross-sectional study, we used selected baseline data from an ongoing randomized clinical trial of patient and lay caregiver dyads receiving home-level hospice care. Participants used an Internet-enabled tablet to complete the valid, reliable measures of pain intensity, pain management barriers (Barriers Questionnaire 13 items [BQ-13]), and demographic characteristics. The responses indicate that the 2 areas of highest concern (mean scores >3) to both patients and caregivers were "pain means disease progression" and "constipation." Additionally, 3 other areas of highest concern (mean scores >3) to caregivers were "addiction" pain medicine causing "one to do embarrassing things" and "confusion." The mean BQ-13 scores ranged from 0.2 to 4.9 and averaged 2.6 ± 0.9 for the patients and ranged from 0.5 to 4.7 and averaged 2.7 ± 0.9 for the caregivers. Mean barrier scores remain high and were not different between patients and their caregivers or significantly related to the patients' pain intensity. However, there were differences in race, ethnic, and hospice setting in the barrier scores. Patients with Hispanic heritage reported higher barrier scores than non-Hispanic patients. Together, these findings not only support prior research findings but also contribute new insights about pain intensity and pain barriers that are relevant to hospices serving minorities with cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pain Intensity and Misconceptions Among Hospice Patients With Cancer and Their Caregivers: Status After 2 Decades

Wilkie

Ezenwa

Yao

et al. 2016

Am J Hosp Palliat Care

View full text Add to dashboard Cite

show abstract

“…A large study of 4707 cancer survivors revealed that two‐thirds reported at least 1 barrier to cancer pain management, with the most vulnerable groups—those who were nonwhite, less educated, older, or having more comorbidities—being most adversely affected . Numerous studies have examined specific barriers expressed by patients and family/caregivers regarding pain and pain management, with fears of addiction consistently being cited as a substantial concern . Physician barriers to cancer pain management include inadequate assessments and a reluctance to administer and prescribe opioids .…”

Section: Introductionmentioning

confidence: 99%

Cancer pain management and the opioid crisis in America: How to preserve hard‐earned gains in improving the quality of cancer pain management

Paice

2018

Cancer

Self Cite

View full text Add to dashboard Cite

Cancer pain remains a feared consequence of the disease and its treatment. Although prevalent, cancer pain can usually be managed through the skillful application of pharmacologic and nonpharmacologic interventions. Unfortunately, access to these therapies has been hampered by interventions designed to contain another serious public health problem: the opioid misuse epidemic. This epidemic and the unintended consequences of efforts to control this outbreak are leading to significant barriers to the provision of cancer pain relief. Oncologists and other professionals treating those with cancer pain will require new knowledge and tools to provide safe and effective pain control while preventing additional cases of substance use disorders (SUDs), helping patients in recovery to maintain sobriety, and guiding those not yet in recovery to seek treatment. How do these 2 serious epidemics intersect and affect oncology practice? First, oncology professionals will need to adopt practices to prevent SUDs by assessing risk and providing safe pain care. Second, oncology practices are likely to see an increased number of patients with a current or past SUD, including opioid misuse. Few guidelines exist for the direct management of pain when opioids may be indicated in these individuals. Third, modified prescribing practices along with the education of patients and families are warranted to prevent the exposure of these medications to unintended persons. Finally, advocacy on behalf of those with cancer pain is imperative to avoid losing access to essential therapies, including opioids, for those who might benefit. Cancer 2018;124:2491-7. © 2018 American Cancer Society.

show abstract

“…1 Analgesic medication errors are more likely when understanding is limited, 3 and family caregivers less effectively make decisions about analgesic regimens. 4 In our prior work we found that the majority of medical words used during care planning discussions are medication names, most of which are never explained. 5 Communication between team members and caregivers averaged fourth-grade level and reading ease was associated with caregiver understanding of and comfort with symptom management; 6 however, as grade level talk between caregivers and team members increased so did caregiver anxiety, and higher anxiety was associated with greater difficulty in understanding medication and symptom management.…”

Section: Introductionmentioning

confidence: 99%

Enhancing Communication Related to Symptom Management Through Plain Language

Wittenberg

Goldsmith

Ferrell

et al. 2015

Journal of Pain and Symptom Management

View full text Add to dashboard Cite

show abstract

Effect of Hospice Nonprofessional Caregiver Barriers to Pain Management on Adherence to Analgesic Administration Recommendations and Patient Outcomes

Cited by 23 publications

References 30 publications

Pain Intensity and Misconceptions Among Hospice Patients With Cancer and Their Caregivers: Status After 2 Decades

Pain Intensity and Misconceptions Among Hospice Patients With Cancer and Their Caregivers: Status After 2 Decades

Cancer pain management and the opioid crisis in America: How to preserve hard‐earned gains in improving the quality of cancer pain management

Enhancing Communication Related to Symptom Management Through Plain Language

Contact Info

Product

Resources

About