Pain Management in Palliative Care

Chapter 8: Pain Management

Description:

Nurses have a primary responsibility to recognise pain, to provide a comprehensive pain assessment and to participate in the overall pain management plan. Nurses should also act as advocates for patients and families and reassure them that most pain can be adequately relieved. This chapter provides an overview of the assessment and management of pain at the end of life. Definitions of pain and barriers to adequate pain management are also addressed. Pain guidelines, developed internationally as a basis for evidence-based practice, are also discussed.

Topics:

• Introduction
• What is pain?
• Barriers to pain relief
• Assessment of pain
  • General approach to pain assessment
  • Measuring pain intensity
  • Assessing the quality of pain
  • Temporal aspects of pain
  • Behavioural assessment of pain
  • Psychosocial and spiritual assessment of pain
• A model for pain management
• Analgesics at the end of life
  • Non-opiod analgesics
  • Choice of analgesics
    • Choice of opiods
    • Dosage regimens
    • Side-effects of opiods
  • Adjuvant analgesics
• Routes of administration
• Dosing and titration considerations
• Invasive procedures
• Non-pharmacological pain management
• Conclusion

Author / Speaker:

Jeannine Brant
Jeannine is the oncology clinical nurse specialist and pain consultant at St Vincent Healthcare in Billings (Montana, USA). She is also an assistant adjunct professor at Montana State University College of Nursing. Jeannine is well recognised for her work in pain management and end-of-life care. She has presented more than 200 lectures and published more than 40 manuscripts, book chapters and newsletters on pain management, palliative care and cancer care issues. She was also the 1998 recipient of the ONS/ Schering Clinical Lectureship Award and presented a lecture entitled ‘The Art of Palliative Care: Living with Hope, Dying with Dignity’.

Professional Reviews: