Claire J Han1, Nai-Ching Chi2, Soojeong Han3, George Demiris4, Debra Parker-Oliver5, Karla Washington5, Margaret F Clayton6, Maija Reblin7, Lee Ellington6. 1. Biobehavioral Cancer Prevention and Control Training Program, University of Washington, School of Public Health, Seattle, Washington, USA. Electronic address: jyh0908@uw.edu. 2. University of Iowa, College of Nursing, Iowa City, Iowa, USA. 3. University of Washington, School of Nursing, Seattle, Washington, USA. 4. University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania, USA. 5. University of Missouri, School of Medicine, Family and Community Medicine, Columbia, Missouri, USA. 6. University of Utah, College of Nursing, Salt Lake City, Utah, USA. 7. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA.
Abstract
CONTEXT: Family caregivers (FCGs) of hospice cancer patients face significant challenges related to pain management. Addressing many of these challenges requires effective communication between FCGs and hospice nurses, yet little empirical evidence exists on the nature of communication about pain management between hospice nurses and FCGs. OBJECTIVES: We identified ways in which FCGs of hospice cancer patients communicated their pain management challenges to nurses during home visits and explored nurses' responses when pain management concerns were raised. METHODS: Using secondary data from audio recordings of hospice nurses' home visits, a deductive content analysis was conducted. We coded caregivers' pain management challenges and immediate nurses' responses to these challenges. RESULTS: From 63 hospice nurse visits, 101 statements describing caregivers' pain management challenges were identified. Thirty percent of these statements pertained to communication and teamwork issues. Twenty-seven percent concerned caregivers' medication skills and knowledge. In 52% of the cases, nurses responded to caregivers' pain management challenges with a validating statement. They provided information in 42% of the cases. Nurses did not address 14% of the statements made by caregivers reflecting pain management challenges. CONCLUSION: To optimize hospice patients' comfort and reduce caregivers' anxiety and burden related to pain management, hospice nurses need to assess and address caregivers' pain management challenges during home visits. Communication and educational tools designed to reduce caregivers' barriers to pain management would likely improve clinical practice and both patient- and caregiver-related outcomes.
CONTEXT: Family caregivers (FCGs) of hospice cancerpatients face significant challenges related to pain management. Addressing many of these challenges requires effective communication between FCGs and hospice nurses, yet little empirical evidence exists on the nature of communication about pain management between hospice nurses and FCGs. OBJECTIVES: We identified ways in which FCGs of hospice cancerpatients communicated their pain management challenges to nurses during home visits and explored nurses' responses when pain management concerns were raised. METHODS: Using secondary data from audio recordings of hospice nurses' home visits, a deductive content analysis was conducted. We coded caregivers' pain management challenges and immediate nurses' responses to these challenges. RESULTS: From 63 hospice nurse visits, 101 statements describing caregivers' pain management challenges were identified. Thirty percent of these statements pertained to communication and teamwork issues. Twenty-seven percent concerned caregivers' medication skills and knowledge. In 52% of the cases, nurses responded to caregivers' pain management challenges with a validating statement. They provided information in 42% of the cases. Nurses did not address 14% of the statements made by caregivers reflecting pain management challenges. CONCLUSION: To optimize hospice patients' comfort and reduce caregivers' anxiety and burden related to pain management, hospice nurses need to assess and address caregivers' pain management challenges during home visits. Communication and educational tools designed to reduce caregivers' barriers to pain management would likely improve clinical practice and both patient- and caregiver-related outcomes.
Authors: Catherine E Dingley; Margaret Clayton; Djin Lai; Katherine Doyon; Maija Reblin; Lee Ellington Journal: Cancer Nurs Date: 2017 Sep/Oct Impact factor: 2.592
Authors: Ronald M Epstein; Cleveland G Shields; Peter Franks; Sean C Meldrum; Mitchell Feldman; Richard L Kravitz Journal: Ann Fam Med Date: 2007 Jan-Feb Impact factor: 5.166
Authors: Kathryn A Martinez; Rebecca A Aslakson; Renee F Wilson; Colleen C Apostol; Oluwakemi A Fawole; Brandyn D Lau; Daniela Vollenweider; Eric B Bass; Sydney M Dy Journal: Am J Hosp Palliat Care Date: 2013-02-12 Impact factor: 2.500
Authors: Karla T Washington; George Demiris; Debra Parker Oliver; Gemille Purnell; Paul Tatum Journal: J Am Med Dir Assoc Date: 2017-09-30 Impact factor: 4.669
Authors: Virginia LeBaron; Rachel Bennett; Ridwan Alam; Leslie Blackhall; Kate Gordon; James Hayes; Nutta Homdee; Randy Jones; Yudel Martinez; Emmanuel Ogunjirin; Tanya Thomas; John Lach Journal: JMIR Form Res Date: 2020-08-26