251. BARRIERS TO PAIN ASSESSMENT AND MANAGEMENT.
- Author
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Sun, Virginia, Borneman, Tami, Ferrell, Betty, Piper, Barbara, Koczywas, Marianna, and Uman, Gwen
- Subjects
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CANCER pain treatment , *CANCER patients , *CANCER complications , *EVALUATION of medical care - Abstract
Major deficiencies in the management of cancer-related pain have been documented over the past two decades. These deficiencies to optimum pain relief are related to patient, professional, and system barriers as identified by the NIH Symptom Management Consensus Conference. This NCI supported study is a prospective, longitudinal design including Usual Care/Phase I followed by two cohorts in experimental phases (Phase II and III). The overall purpose is to assess the efficacy and feasibility of the "Passport to Comfort" intervention to improve cancer pain management. The framework for the "Passport" is based on patient, professional and system barriers as identified by the AHCPR Clinical Practice Guidelines for Cancer Pain. This intervention also demonstrates innovation by translating the evidence-based guidelines for pain as developed by the National Comprehensive Cancer Network (NCCN) into practice. Patient-related outcomes and barriers were obtained using the COH QOL tool, Barriers to Pain Questionnaire (BQII), and Patient Knowledge Tool for Pain. A chart audit was conducted to capture professional and system barriers. Data was analyzed using SPSS derived through a descriptive design to explore the impact of the barriers through comparisons of data at baseline and 1 and 3 month follow-ups. Subjects' mean age (n=80) was 61, and included 33% ethnic minorities and 61% females. Subjects included 64% Stage III and IV disease of which 81% were currently on treatment. Findings revealed that highest patient-related barriers include fear of addiction (70%), tolerance to pain medications (59%), and belief that pain medications weakened the immune system (37%). The overall mean score for pain knowledge was high (75%), with worst scores related to addiction and around-the-clock dosing. Chart audits revealed a lack of referrals to supportive services and documentation of pain assessment and management on a professional and system level. Based on Phase I findings, a nursing intervention is being tested in Phase II to evaluate the efficacy and feasibility of the "Passport to Comfort" intervention. This project incorporates evidence-based guidelines to test an innovative yet realistic model of nursing practice using an interdisciplinary model for application to cancer care. Funding Sources: National Cancer Institute [ABSTRACT FROM AUTHOR]
- Published
- 2007