Putting Evidence Into Practice: Improving Oncology Patient Outcomes—Pharmacologic and Nonpharmacologic Interventions for Pain by Margaret Irwin, PhD, RN, MN, Jeanine Brant, PhD, APRN, AOCN®, and Linda Eaton, MN, RN, AOCN®
This ONS PEP resource was packed full of pertinent information, offering a brief but helpful review of types of pain and examples of clinical pain measurement tools. The introduction section featured several important sections before it really got into the meat of the book: problem, incidence, prevention, palliative care, survivorship issues, and assessment. The survivorship considerations were of particular interest and surprise to me. Probably to no one's surprise, most chronic pain in cancer survivors is a result of the cancer treatment, not the actual cancer. The authors point out that managing chronic pain in cancer survivors is different than that of other populations in two major ways.
- The therapeutic focus is on management and adaptive coping rather than finding a cure for the pain
- The possibility of significant pain exacerbation related to a recurrence of cancer is a problem unique to this population. Both of these points emphasize the importance of including the patient’s emotional and psychological wellness into their plan of care.
Reading the resource inspires me to continue reading about pain management. A word I was not familiar with, opiophobia, is a symptom I have certainly seen in both my personal and professional life. I’d love to learn more about that fear so that I can better educate my patients (and family), allowing pain to be relieved as effectively as possible.
The most disheartening piece of evidence was that the education of healthcare providers and/or patients does not affect pain scores; it affects only knowledge and care processes. I thought this was important because we do so much to educate ourselves, often taking continuing nursing education courses to maintain our licensure. However, our knowledge does not necessarily translate to better patient outcomes.
On the other hand, the authors discussed studies that demonstrated that, “Teamwork among the caregiver, patient, and healthcare professionals was crucial to pain control and that physical and cognitive strategies involving caregivers was a positive benefit to both the caregiver and the patient.” These psychoeducational interventions, as they are referred to, are recommended for practice as nonpharmaceutical interventions in the management of chronic pain.
I highly recommend ONS's Putting Evidence Into Practice: Improving Oncology Patient Outcomes—Pharmacologic and Nonphamacologic Interventions for Pain. As oncology nurses, treating pain comes with the territory. If I were a patient having a procedure or undergoing radiation or another potentially pain-causing therapy, I would want my nurse to have read this resource.