Cancer Pain in End-of-Life Cancer Patients - Essay Example

? Cancer Pain in End of Life Cancer Patients 13th, January, Cancer Pain in End of Life Cancer Patients Introduction Pain management in end-of-life care harbors unique opportunities to both patients and caregivers. There are millions of articles and other literature materials available for a particular topic. Therefore, identifying an article that best responds to a certain research question or topic is an uphill task, and hence the need for sophisticated literature identification criteria. This paper analyzes the articles identified in the module 1 literature review. In particular, the paper analyzes the problem or issue identified in the articles, strengths and weakness of the articles and proposed recommendations/solutions. Lastly, the paper gives a rationale to support the choice of the literature and its significance to the project. The articles propose pain prevention theories other than use of therapies. The first search strategy applied in the study is the use of well-built clinical questions. In this context, well-built research questions are those deduced from the research topic so that they respond to key issues that form the topic. 1. Ferrel, B., Levy, M. H., & Paice, J. (2008). Managing pain from advanced cancer in the palliative care setting. Clinical Journal of Oncology Nursing, 12 (4), 575-81. The author proposes a gate control theory of pain among cancer patients in palliative care. In particular, the article recommends integration of physical, physiological, social, and spiritual therapies for the well-being of patients. This approach is of key interest to patients and caregivers/nurses. The study utilizes a standardized scale to assess pain, using four basic approaches to pain relief that includes “modify the source(s) of pain(s) (,) alter the central perception of pain (,) modulate transmission of pain to the central nervous system (,) (and) block transmission of pain to the central nervous system” (Ferrel, Levy, & Paice, 2008, p. 577). The choice for this particle was based on its clarity on cancer pain among cancer patients. The article indentifies pain as a multivariate factor that affects the clinical, physical, social, and the spiritual well-being of a person. The article would be useful in determining the dimensions of pain among cancer patients at end of life. 2. Kumar, S. P. (2011). Reporting characteristics of cancer pain: A systematic review and quantitative analysis of research publications in palliative care journals. Indian Journal of Palliative Care, 17 (1), 57-66. This article identifies cancer as a “global health burden” and has reviewed existing scientific literature on palliative to establish whether there exists “adequate scientific research base on cancer pain” (Kumar, 2011, p. 57). The article proposes that adequate scientific research would be instrumental in pain management among cancer patients. In particular, effective research practices would enable researchers to identify chief causes of pain among cancer patients. Moreover, adequate research will make recommendations concerning the problem. The article uses sociological theories of self-awareness to solve cancer pain among patients. The article complies with up-to-date research on pain management among cancer patients, and hence is significant in the study. 3. Fayers, P. M., Hjermstad, M. J., Klepstad, P., Loge, J. H., Caraceni, A., Hanks, G. W., & Kaasa, S. (2011). The dimensionality of pain: Palliative care and chronic pain patients differ in their reports of pain intensity and pain interference. Pain, 152 (7), 1608-20. The article draws attention to the significance of accuracy in assessment of pain in palliative care. There are different levels of pain among terminally ill patients, and hence the need for different pain management practices. The article proposes the specificity theory as the best pain management theory among cancer patients. The article uses quantitative research techniques to categorize cancer pain. The article identifies intensity and interference as the main dimensions of pain. Unlike other related articles, this article provides strategies to quantify pain among cancer patients. The paper proposes psychological theories of pain management. However, the article fails to provide information on mortality and incapacitation based on these two dimensions. The literature provides effective strategies for measurement of pain among chronic patients. 4. Fine, P., Herr, K., Titler, M., Sanders, S., Cavanaugh, J., Swegle, J., & Reyes, J. (2010). The cancer pain practice index: A measure of evidence-based practice adherence for cancer pain management in older adults in hospice care. Journal of Pain and Symptom Management, 39 (5), 791-802. The study maintains that Medicare-certified hospice programs lack systematic studies or adherence to approved pain management practices. Lack of pain management guidelines for cancer patients is a significant deficit in the practice. The article notes an increase in the number of cancer patients currently enrolling in hospice programs. According to the authors, enrollment in hospice care has increased by 10% during the last ten years. Moreover, the authors argue that pain and other related distress are the leading cause of deaths among cancer patients. The article addresses care giving as a fundamental theory in pain management among cancer patients. The article provides a descriptive argument on causes of death among cancer patient. Thus, the article provides introductory theories required for the study. 5. Syrjala, K. L., Abrams, J. R., Polissar, N. L., Hansberry, J., Robinson, J., DuPen, S., & DuPen, A. (2008). Patient training in cancer pain management using integrated print and video materials: A multisite randomized controlled trial. Pain, 135 (1-2), 175-186. The authors analyze strategies for improving pain management among cancer patients. In particular, the article maintains that sustainable management practices will reduce professional-time while maintaining quality of care provided. Using a qualitative randomized methodology, the article proposes the significance of patient training. Trained patient would reduce professional hours by more than 14% and improve recovery rates. Selection of this article was based on its ability to propose an alternative pain management practice. Moreover, the article provides an innovative pain management strategy that utilizes modern video technologies. Theory provided in the article will be useful in demonstrating the range of alternative pain management practices for cancer patients. 6. Yennurajalingam, S., Kang, J. H., Hui, D., Kang, D. H., Kim, S. H. & Bruera, E. (2012). Clinical response to an outpatient palliative care consultation in patients with advanced cancer and cancer pain. Journal of Pain and Symptom Management, 44 (3), 340-50. The article points out inadequacies and inconsistencies in pain management among cancer patients. The paper utilizes quantitative techniques to analyze secondary sources. The study identifies deficiencies in pain relief support for cancer patients. Moreover, the article provides guideline for validating other related articles. Guidelines set out in the study will provide effective criteria for evaluating other related research articles. Theoretical concepts provided in the article will also be used as a measure to evaluate the research hypothesis. 7. King, S., Forbes, K., Hanks, G. W., Ferro, C. J., & Chambers, E. J. (2011). A systematic review of the use of opioid medication for those with moderate to severe cancer pain and renal impairment: A European Palliative Care Research Collaborative opioid guidelines project. Palliative Medicine, 25 (5), 525-552. The article analyzes use of opioids in cancer pain management. The study utilizes a qualitative and systematic review to generate relevant data and conclusions. Recommendations provided by the article are based on comparative analysis of negative effects of specified opioids. This article was essential to module 1 study since it analyzes the significance of assumptions and hypothesis in a research study. The author maintains that relevance of a research study is based on key assumptions made prior to the start of the study. Theoretical concepts provided in the article will offer useful guidelines while formulating a hypothesis for the project. 8. Capewell, C. M. R., Gregory, W., Clos, S. J., & Bennett, M. I. (2010). Brief DVD-based educational intervention for patients with cancer pain: Feasibility study. Palliative Medicine. Retrieved from http://pmj.sagepub.com/content/early/2010/06/17/0269216310371704. This article focuses on effective use of video technology in patient training. The article identifies attitudes, knowledge regarding cancer pain and strong opioid analgesia as an obstacle towards effective management of cancer pain. However, the article does not provide statistical evidence on the effectiveness of video training. This study is relevant to the proposed study in the sense that it deals with the training aspect, which will be part of the intervention strategies included in the proposed study. 9. Bhatnagar, S. (2011). Individualized interventional pain management technique in early stage of cancer pain: A desirable protocol for improving quality of life. Indian Journal of Palliative Care, 17 (2), 91. The article elaborates pain management among cancer patients. Key concepts in the study provide background information for the proposed study. Although the article is not based on scientific principles, it provides logical analysis and conclusions. Information provided in this article will be utilized in formulating intervention strategies for cancer patients. The article does not support clinical theories of pain management. The article was identified due to its relevance and applicability in modern-day palliative and clinical practices. 10. Dulko, D., Hertz, E., Julien, J., Beck, S., & Mooney, K. (2010). Implementation of cancer pain guidelines by acute care nurse practitioners using an audit and feedback strategy. Journal of the American Academy of Nurse Practitioners, 22 (1), 45-55. The article analyzes deficiencies in cancer pain management in the current clinical practices. In particular, the article measures deviations in modern clinical practices in relation to professional Clinical Practice Guidelines (CPGs). The article utilizes qualitative research methodology to determine effectiveness in different management practices utilized in modern healthcare. Findings from the study show a reduction in pain interference and increased satisfaction among patients. This article provides crucial information regarding intervention strategies from a nursing profession perspective. The article was indentified due to its adherence to professional ethics and practice. Information provided in the article would be required in formulating standards for literature identification. 11. Rustoen, T., Gaardsrud, T., Leegaard, M., & Wahl, A. K. (2009). Nursing pain management – a qualitative interview study of patients with pain, hospitalized for cancer treatment. Pain Management Nursing, 10 (1), 48-55. This article explores pain management in an evidence-based nursing practice (Rustoen, Gaardsrud, Leegaard, & Wahl, 2009, p. 48). The article combines qualitative and quantitative research to analyze the quality of pain management among patients. Data for the study was collected through in-depth interviews and qualitative descriptive techniques. The article provides crucial facts that will be utilized in the proposed study. In particular, identification of this article was based on its attitude towards application of research findings through evidence-based practice. Information specified in this article would provide effective criteria for formulating recommendations for the proposed study. 12. Miaskowski, C. (2010). Outcome measures to evaluate the effectiveness of pain management in older adults with cancer. Oncology Nursing Forum, 37 Suppl., 27-32. The author explores effectiveness of pain management strategies among older adults. Unlike other related articles, Miaskowski identifies demography as a critical factor in determination of pain management practices. Prevalence of cancer pain among older adults is a critical issue in cancer management. Theoretical concepts provided in the article will be utilized in the proposed study as guidelines and recommendations for best practices. 13. Coleman, E. A., Coon, S. K., Lockhart, K., Kennedy, R. L., Montgomery, R., Copeland, N., & Stewart, C. (2009). Effect of certification in oncology nursing on nursing-sensitive outcomes. Clinical Journal of Oncology Nursing, 13 (2), 165-72. This article presents results of a quantitative survey research carried out to assess the differences in quality of care provided for cancer pain patients. The article hypothesizes variations in provision of care between oncology certified nurses and non-certified nurses (Coleman et al., 2009, p. 165). According to the study, certified nurses follow National Comprehensive Cancer Network guidelines for chemotherapy-induced nausea and vomiting (CINV) management more often than noncertified nurses do. The essay highlights existence of alternative pain management practices that can be used to improve the lives of cancer patients. Selection of this article was based on its preference towards application of research findings through evidence-based practice. 14. Mair, J. (2009). Caring for people with chronic cancer pain. Journal of Community Nursing, 23 (5). Retrieved from http://www.cabdirect.org/abstracts/20103191291.html;jsessionid=068AB866513E2085DAA99062B77F7607?gitCommit=4.13.11-15-g9672536 The article explores pain experiences among cancer patients through case studies. Although the article is not based on a scientific study, it summarizes available information on pain management among cancer patients. The article provides elementary information that can be used in the proposed study as background information. 15. Ajello-Laws, L., Reynolds, J., Deyzer, N., Peterson, M., Ameringer, S., & Bakitas, M. (2009). Putting evidence into practice: What are the pharmacologic interventions for nociceptive and neuropathic cancer pain in adults? Clinical Journal of Oncology Nursing, 13 (6), 649-55. This article explores the effectiveness of the current hospice practices. The author maintains that current pain management practices do not address the issue effectively. The study has made a crucial observation that “pain is a nursing-sensitive patient outcome” implying that there are several interpersonal and spiritual aspects to pain management (Ajello-Laws et al., 2009, p. 649). The article provides variable data on effectiveness of pain relieving strategies, required in the proposed study. References Ajello-Laws, L., Reynolds, J., Deyzer, N., Peterson, M., Ameringer, S., & Bakitas, M. (2009). Putting evidence into practice: What are the pharmacologic interventions for nociceptive and neuropathic cancer pain in adults? Clinical Journal of Oncology Nursing, 13 (6), 649-55. Coleman, E. A., Coon, S. K., Lockhart, K., Kennedy, R. L., Montgomery, R., Copeland, N., & Stewart, C. (2009). Effect of certification in oncology nursing on nursing-sensitive outcomes. Clinical Journal of Oncology Nursing, 13 (2), 165-72. Ferrel, B., Levy, M. H., & Paice, J. (2008). Managing pain from advanced cancer in the palliative care setting, Clinical Journal of Oncology Nursing, 12 (4), 575-81. Kumar, S. P. (2011). Reporting characteristics of cancer pain: A systematic review and quantitative analysis of research publications in palliative care journals. 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