Pain management as a quality of care outcome.
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Humans↗
Biomedical subjects
M Rhiner
Publications and source records attributed to M Rhiner.
Assessment of quality of life with a single instrument.
A number of single measures of quality of life have been developed over the last few years. Some of these instruments have been used more frequently than others. Psychometric properties are reported in many of these instruments, and continued psychometric development is needed. Instruments differ in the content tested, and users are encouraged to have specific objectives in mind when selecting an instrument. The continued research interest and activity in the field of single measures has provided beginning tools for both research and clinical evaluations. Quality of life measures add to the depth of evaluation of the impact on cancer and cancer treatment, and provide a measurement dimension that augments that of the historic evaluation via morbidity and mortality statistics. Continued work on single measures for quality of life will provide both researchers and clinicians with valuable tools.
Humans↗
Defining the content domain of quality of life for cancer patients with pain.
This study identified attributes that define the content domain of quality of life in a sample of 41 cancer patients with chronic pain. Patients were asked four open-ended questions about the meaning of quality of life, what contributes to a good or poor quality of life, and how pain influences quality of life. Content analysis of responses revealed three categories of attributes that embrace the quality-of-life content domain. The first category is physical well-being. It includes general functioning and disease/treatment-specific attributes. The second is psychological well-being. It includes affective-cognitive attributes, coping ability, meaning of pain and cancer, and accomplishment attributes of quality of life. The third is interpersonal well-being. It incorporates social support and social/role functioning attributes. Replications of the current study in other groups of patients may yield data to support a two-part, multidimensional quality-of-life instrument. A norm-referenced measure can be used to evaluate quality of life in terms of attributes that are salient regardless of the disease or treatment. A domain-referenced measure may be used to evaluate attributes whose salience is dependent on specific disease, treatment, or life events.
Adaptation, Psychological↗
Nutritional management in the head and neck cancer patient.
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Enteral Nutrition↗
Pain as a metaphor for illness. Part I: Impact of cancer pain on family caregivers.
While previous research has focused on patients' or professional caregivers' perspective of pain, this study describes cancer pain from the family caregivers' perspective. Chronic pain, which is associated with malignant disease, produces an intense burden on the patient as well as on the entire family. This qualitative study included 85 family caregivers of patients with cancer pain. Data were collected using an interview guide, and verbatim responses were analyzed for themes. The results identified four themes surrounding family descriptions of pain (anatomic descriptions, hidden pain, family fear and suffering, and overwhelming/unendurable pain) and three themes surrounding family experience of pain (helplessness, coping by denying feelings, and a wish for death). This study documents the important role that family members play in cancer treatment. If the number of patients receiving care in the home from family members continues to grow, this role will become even more important. Part I of this two-part paper focuses on the impact that cancer pain has on family caregivers and concludes that pain does have a tremendous impact on the family because it is perceived as a metaphor of progressive illness and death.
Adaptation, Psychological↗
Pain as a metaphor for illness. Part II: Family caregivers' management of pain.
Changes in the healthcare system have made the patient's home the primary site of cancer care. Family members, already burdened with the psychological impact of having a loved one with cancer, take on caregiving roles to meet the multiple and complex needs of the patient. Part I of this two-part article focused on family caregivers' descriptions of the patients' pain and the impact of this pain on caregivers. A model of the Caregiver Experience of Pain is provided along with implications for future inquiry and clinical practice. Themes identified in caregiver roles in medication administration included deciding what to give, deciding when to give, night duty, reminding/encouraging, keeping records, fear of addiction, and doing everything. Caregiver roles in nondrug interventions included positioning/mobility, massage, use of ointments/lotions, cold, heat, being there through touch, avoiding touch, and talk and other distractions. Caregiver perceptions of what doctors or nurses could do better included themes of being there, explain, be honest/listen, addiction concern, and giving medication. Caregiver questions included areas of future, understanding why, death, concern about medications, and fear about what to do at home. The study results offer important suggestions for oncology nurses in supporting family caregivers in the management of the patient in pain.
Analgesics↗
Bridging the gap between research and practice.
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Clinical Nursing Research↗
The family experience of cancer pain management in children.
This study describes the family perspective of cancer pain management in pediatric patients. Family caregiver knowledge and attitudes regarding pain, caregiver burden associated with pain, and caregiver moods were identified. This study was conducted in a children's hospital (n = 31) and a community hospice (n = 8) with family caregivers of pediatric cancer patients as the participants. Pain intensity was rated by children and family caregivers using pain assessment scales applicable to children with cancer. Differences in pain ratings were reported. The Family Pain Questionnaire was used to identify parents' knowledge and attitudes about pain and its management. Areas for family teaching were identified with the questionnaire. Understanding the pain experience from the perspective of family caregivers and their role in pain management can assist healthcare providers in relieving pain in children with cancer.
Adolescent↗
A structured nondrug intervention program for cancer pain.
The management of cancer pain has been a primary focus in the authors' program of oncology nursing research. A study currently in progress entitled, "Assessment and Management of Pain for Elderly Cancer Patients at Home," applies knowledge of the authors' earlier work in an educational nursing intervention for patients with cancer and their family care-givers in the home. The program consists of three parts: (1) an overview of pain, (2) pharmacologic management of pain, and (3) nondrug interventions for pain. The nondrug component of this program is particularly unique in providing structured implementation of nonpharmacologic techniques, which are often neglected in pain management. Five categories of nondrug intervention are used including heat, cold, massage/vibration, distraction, and relaxation. The purpose of this article is to report on the development and initial results of the nondrug portion of a pain education program.
Analgesia↗