Nursing Essay: Pain Management.

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Introduction

This essay will aim to look at the main principles of cancer pain management on an acute medical ward in a hospital setting. My rational for choosing to look at this is to expend my knowledge of the chosen area. Within this pieces of work I will look to include physiological, psychological and sociological aspects of pain management.

Pain, which is defined in its widest sense as an emotion which is the opposite of pleasure (White, 2004, p.455), is one of the major symptoms of cancer, affecting a majority of sufferers at some point during their condition (De Conno & Caraceni, 1996, p.8). The World Health Organization (WHO, 2009, online) suggests that relief from pain may be achieved in more than 90 percent of patients; however, Fitzgibbon and Loeser (2010, p.190) stress that pain may often be undertreated, even in the UK. Foley and Abernathy (2008, p.2759) identify numerous barriers to effective pain management, among which are professional barriers such as inadequate knowledge of pain mechanisms, assessment and management strategies.

Physiology of Cancer Pain

There are different types of pain which may be suffered by an individual with cancer, with some patients suffering only one type of pain, but others experiencing a range of all three types. Identifying the type of pain suffered is the first major step in ensuring effective treatment, as not all respond to different treatments in the same way (De Conno & Caraceni, 1996, p.9).

Somatic pain is that in which nociceptors in the cutaneous or deep tissues are activated by noxious stimuli. This is usually characterized by dull, aching pain which is well localized. This type of pain may be commonly experienced by individuals with metastatic bone pain or those who h...

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...newicht and Dunford (2004), physiotherapists, occupational therapists, Doctors, nurses, specialist pain teams and dieticians all care for the patient at once.

Effective treatment of cancer pain is essential for ensuring the best outcomes for cancer patients, in terms of physical, psychological and social aspects. Although there are no NICE guidelines for management of cancer pain, WHO guidance should be used to inform clinical practice. Careful assessment is a critical element of the process to ensure that patients are offered the treatment which is likely to offer the best outcomes, yet without providing a greater than necessary risk of complications such as tolerance and addiction to opioids. The main outcome that this paper highlights is that “Pain is what the patient says it is and exists when he says it does” (McCaffery 1983

cited in Sofaer 1992 pp14).

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