The Epidemiology of Cancer Pain

Goudas, Leonidas C.; Bloch, Rina; Gialeli-Goudas, Maria; Lau, Joseph; Carr, Daniel B.

doi:10.1081/cnv-50482

Cited by 220 publications

(64 citation statements)

References 36 publications

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“…In addition, the term "consultation service" is not used homogeneously in the context of the palliative care [2,16,17,22,23]. The distribution of diagnosed cancer entities and the high relevance of cancer pain we found is similar to what was reported in other studies [8,23,24], as were the recommendations that were made. However, we are unable to specify from our data whether and how the recommendations were implemented [25].…”

Section: Discussionsupporting

confidence: 75%

Characteristics of a palliative care consultation service with a focus on pain in a German university hospital

et al. 2014

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BackgroundA minority of patients with incurable and advanced disease receive specialised palliative care. Specialised palliative care services that complement the care of difficult and complex cases ought to be integrated with services that deliver general care for most patients. A typical setting in which this integrative concept takes place is the hospital setting, where patients suffering from incurable and advanced disease are treated in many different departments.The aim of the study is to investigate the profile and spectrum of a palliative care consultation service (PCCS) at a German university hospital with special reference to pain therapy.MethodsWe retrospectively analysed the PCCS documentation of three years.ResultsMost patients were referred from non-surgical departments, 72% were inpatients, and 28% were outpatients. 98% of the patients suffered from cancer. Counselling in pain therapy was one of the key aspects of the consultation: For 76% of all consulted patients, modifications of the analgesic regimen were recommended, which involved opioids in 96%. Recommendations on breakthrough-pain medication were made for 70% of the patients; this was an opioid in most cases (68%). The most commonly used opioid was morphine. For 17% of the patients, additional diagnostic procedures were recommended. Besides pain management palliative care consultation implied a wide range of recommendations and services: In addition to organising home care infrastructure, palliative care services supported patients and their families in understanding the life-limiting diseases. They also coordinated physical therapy and social and legal advice.ConclusionThis survey clearly shows that for a consultation service to support patients with incurable or advanced disease, a multi-disciplinary approach is necessary to meet the complex requirements of a needs-adapted palliative care in inpatient or outpatient settings. Timely integration of palliative expertise may support symptom control and may give the required advice to patients, their carers, and their families.

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Section: Discussionsupporting

confidence: 75%

Characteristics of a palliative care consultation service with a focus on pain in a German university hospital

et al. 2014

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“…Interventions at the end of life can also be helpful for both patients and their partners. We know that caregivers of patients in hospice experience high levels of distress (Haley, LaMonde, Han, Narramoer, & Schonwetter, 2001) and that patients sometimes experience uncontrolled pain (Goudas, Bloch, Gialeli‐Goudas, Lau, & Carr, 2005). A three‐session, in‐home intervention plus hospice care compared with hospice alone resulted in significant improvements in caregivers’ self‐efficacy for managing patient pain and other symptoms; however, patients did not report improvements in pain control or quality of life (Keefe et al., 2005).…”

Section: Cancermentioning

confidence: 99%

Couple and Family Interventions in Health Problems

Shields

Finley

Chawla

2012

J Marital Family Therapy

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Intervention research for couples and families managing chronic health problems is in an early developmental stage. We reviewed randomized clinical trials of family interventions for common neurological diseases, cardiovascular diseases, cancer, and diabetes, which is similar to the content of previous reviews discussed later. One overriding theme of these studies is that patients with chronic illnesses and their families face a variety of challenges to which researchers have responded with an array of treatment modalities. Very few of the interventions reviewed, with the exception of treatment for adolescents with diabetes, tested family psychotherapy models. Most interventions were time-limited therapeutic interventions that trained families to improve their communication and problem-solving skills, individual and family coping skills, and medical management. Researchers more clearly described mechanisms of change in intervention studies with cancer and diabetes than with other diseases, and not surprisingly, they found greater empirical support for their interventions. Family interventions show promise to help patients and family members manage chronic illnesses. To develop an empirical base for family approaches to managing chronic illnesses, interventions must be based on theories that delineate mechanisms of change in family processes and skills in medical management necessary to maintain patients' and family members' health.

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“…(2005) reported a moderate level of agreement for pain rated by patients with advanced cancer and by physicians during the last week of life. Pain is recognised as a substantial burden for patients with cancer (Goudas et al. 2005), and the definition of palliative care addresses the need for pain control at the end of life (EAPC 1998).…”

Section: Discussionmentioning

confidence: 99%