Joanna Veazey Brooks1, Claire Poague2, Taynara Formagini2, Andrew W Roberts3, Christian T Sinclair4, Carla C Keirns5. 1. Department of Population Health, University of Kansas School of Medicine, Kansas City, Kansas, USA; University of Kansas Cancer Center, Kansas City, Kansas, USA. Electronic address: jbrooks6@kumc.edu. 2. Department of Population Health, University of Kansas School of Medicine, Kansas City, Kansas, USA. 3. Department of Population Health, University of Kansas School of Medicine, Kansas City, Kansas, USA; University of Kansas Cancer Center, Kansas City, Kansas, USA; Department of Anesthesiology, University of Kansas School of Medicine, Kansas City, Kansas, USA. 4. Department of Anesthesiology, University of Kansas School of Medicine, Kansas City, Kansas, USA; Division of Palliative Medicine, Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, Kansas, USA. 5. Division of Palliative Medicine, Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, Kansas, USA; Department of History and Philosophy of Medicine, University of Kansas School of Medicine, Kansas City, Kansas, USA.
Abstract
CONTEXT: Patients with cancer face symptoms because of disease and treatment, and pain is common and complex. The opioid crisis may complicate patients' and clinicians' experiences of managing pain in cancer care. OBJECTIVES: In our study of perceptions and experiences with palliative care (PC) at an outpatient cancer center, we examined communication around symptom management throughout cancer care, and pain and its management emerged as particularly salient. The objective of this article is to describe, from the perspectives of patients, caregivers, and oncology health care professionals, the role of PC in navigating the complicated dynamics of pain management amidst the opioid crisis. METHODS: A qualitative descriptive study with grounded theory components was designed to investigate experiences with and perceptions of specialist PC and symptom management, including pain. Interviews were audiorecorded and transcribed, and focused coding identified themes related to pain and pain management from all three perspectives. RESULTS: About 44 patients, caregivers, and non-PC health care professionals completed interviews. Patients with cancer and their caregivers had many concerns about pain management and were specifically concerned about opioid use and stigma. For patients, PC improved pain management and helped to destigmatize appropriate pain management. Oncology clinicians reported that partnering with PC facilitated complex pain management and also provided moral support around difficult opioid recommendations for patients. CONCLUSION: PC offers the potential to uniquely support both patients and other oncology professionals in optimally navigating the complexity around pain management for cancer care in the midst of the opioid crisis.
CONTEXT: Patients with cancer face symptoms because of disease and treatment, and pain is common and complex. The opioid crisis may complicate patients' and clinicians' experiences of managing pain in cancer care. OBJECTIVES: In our study of perceptions and experiences with palliative care (PC) at an outpatientcancer center, we examined communication around symptom management throughout cancer care, and pain and its management emerged as particularly salient. The objective of this article is to describe, from the perspectives of patients, caregivers, and oncology health care professionals, the role of PC in navigating the complicated dynamics of pain management amidst the opioid crisis. METHODS: A qualitative descriptive study with grounded theory components was designed to investigate experiences with and perceptions of specialist PC and symptom management, including pain. Interviews were audiorecorded and transcribed, and focused coding identified themes related to pain and pain management from all three perspectives. RESULTS: About 44 patients, caregivers, and non-PC health care professionals completed interviews. Patients with cancer and their caregivers had many concerns about pain management and were specifically concerned about opioid use and stigma. For patients, PC improved pain management and helped to destigmatize appropriate pain management. Oncology clinicians reported that partnering with PC facilitated complex pain management and also provided moral support around difficult opioid recommendations for patients. CONCLUSION: PC offers the potential to uniquely support both patients and other oncology professionals in optimally navigating the complexity around pain management for cancer care in the midst of the opioid crisis.
Authors: Christine J McPherson; Thomas Hadjistavropoulos; Michelle M Lobchuk; Kelly N Kilgour Journal: Pain Res Manag Date: 2013-08-16 Impact factor: 3.037
Authors: Betty R Ferrell; Jennifer S Temel; Sarah Temin; Erin R Alesi; Tracy A Balboni; Ethan M Basch; Janice I Firn; Judith A Paice; Jeffrey M Peppercorn; Tanyanika Phillips; Ellen L Stovall; Camilla Zimmermann; Thomas J Smith Journal: J Clin Oncol Date: 2016-10-28 Impact factor: 44.544
Authors: Jessica S Merlin; Sarah R Young; Robert Arnold; Hailey W Bulls; Julie Childers; Lynn Gauthier; Karleen F Giannitrapani; Dio Kavalieratos; Yael Schenker; J Deanna Wilson; Jane M Liebschutz Journal: Am J Hosp Palliat Care Date: 2019-11-25 Impact factor: 2.500