Summary
Background
Cancer pain remains a major public health concern. Despite effective treatments being
available to manage the majority of cancer pain, this debilitating symptom is frequently
under treated. As cancer has becomes a chronic disease a range of health professionals,
including community nurses in Australia are increasingly caring for people living
with cancer related pain. Yet, little is known about community nurses capacity to
assess and manage cancer pain in accordance with best available evidence.
Objectives
This study aimed to: identify the barriers and facilitators to adult cancer pain assessment
and management as perceived by Australian health professionals; identify if cancer
pain guidelines are currently used; identify barriers and facilitators to guideline
use; and establish the need for Australian cancer pain guidelines. This article reports
on community nurses’ perceptions of managing cancer pain in the community setting.
Methods
A cross-sectional survey was administered online. Invitations were circulated via
peak bodies and clinical leaders seeking the views and experiences of health professionals
involved in caring for people living with cancer pain. Descriptive statistics were
used to summarise the quantitative data, and thematic content analysis were used to
describe the qualitative data.
Results
Sixty-two community nurses responded to the survey, representing 29% of the total
sample. These participants reported high levels of adherence to accepted cancer pain
management practices in their workplace, with 71% nominating the Palliative Care Therapeutic
Guideline V.3 as being most frequently used to manage community patients’ cancer related
pain. Key barriers to effective cancer pain management in the community were: difficulties
accessing non-pharmacological interventions (89%), lack of coordination by multiple
providers (89%), and impact of distance on ability to access pain-related services
for patients (86%).
Conclusion
A range of system, health professional and consumer barriers limit access to best
available treatment in the community setting for people with cancer pain. A clinical
pathway that gives step-by-step guidance on evidence-based practice along with an
evaluation framework may be the best way of enabling community nurses to ensure their
patients with cancer related pain have access to best available care.
Keywords
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Article info
Publication history
Published online: December 23, 2013
Accepted:
November 5,
2013
Received in revised form:
September 17,
2013
Received:
May 7,
2013
Identification
Copyright
© 2013 Australian College of Nursing Ltd. Published by Elsevier Inc. All rights reserved.
