Holistic Total Pain Management in Palliative Care: Cultural and Global Considerations

Brant, Jeannine M.

doi:10.17140/pmhcoj-se-1-108

Cited by 14 publications

(11 citation statements)

References 29 publications

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“…As such, the findings suggest that apart from self-reports from children with ASD (e.g., by using WBFPS, VAS, or a numeric rating scale) included in pain assessment, observations of nonverbal responses 38,39 as well as proxy reports by familiar observers such as parents and caregivers should also be considered to ensure a holistic pain assessment. 49 Findings from this review, support that caregivers' proxy report on their children's pain cues and behaviors could also be considered as they are more familiar with the children. 5 influence their interpretation of the children's pain.…”

Section: Discussionmentioning

confidence: 55%

Pain communication in children with autism spectrum disorder: A scoping review

Johnson,

van Zijl,

Kuyler

2023

Paediatric and Neonatal Pain

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Children with autism spectrum disorder (ASD) experience social interaction and communication challenges and often display repetitive, restricted patterns of behavior, activities, and interests. The concept of pain is regarded as one of the most complex human stressors due to its subjective and personal nature and the influences of multiple internal and external factors. Due to the complexity of this disorder, it remains concerning how children with ASD communicate their pain and how observers (i.e., parents, carers, and health care practitioners) respond to these children's pain communication. This scoping review aimed to identify how children with ASD communicate or express their pain. Ten studies met the inclusion criteria for further data extraction. Through reflexive thematic analysis, two main themes were identified: verbal and nonverbal responses used by children with ASD to communicate their pain that could influence pain assessment and management strategies. This review highlighted that children with ASD utilized various verbal and nonverbal methods to communicate their pain experiences and that these methods differed compared to children without disabilities. Furthermore, this review emphasizes the importance of holistic pain assessment strategies as well as additional pictorial support for children with ASD. This review recommends that future research should focus on understanding how the inclusion of different stakeholders in pain assessment for children with ASD, can contribute to holistic pain assessment.

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Section: Discussionmentioning

confidence: 55%

Pain communication in children with autism spectrum disorder: A scoping review

Johnson,

van Zijl,

Kuyler

2023

Paediatric and Neonatal Pain

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“…For example, at this second stage, we noted that excerpts coded as mental health most commonly captured expressions of emotional discomfort (e.g., 'resident complained to writer that she was having anxiety during the night couple days prior'; Sharon, 74). We felt that these aspects of emotional pain aligned with the notion of 'total pain' described in palliative care literature (Brant, 2017), and hence developed the category pain and discomfort. This initial coding process allowed us to provide an overview of the types of charted care preferences and interactions typically documented in LTC (informing Research Question 1).…”

Section: Discussionmentioning

confidence: 75%

Chart based data as a resource for tracking and improving a person‐centred palliative approach in long‐term care

Sussman

Lawrence

Earn

et al. 2022

Journal of Clinical Nursing

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Aims and Objectives To enhance the practice of a person‐centred palliative approach in long‐term care. Background Implementing a person‐centred palliative approach in long‐term care entails placing residents at the centre of care planning that attends to the ‘whole’ person, rather than prioritising biomedical needs. Design We conducted a four‐stage directed content analysis of long‐term care progress notes to meet our study aims and applied the EQUATOR guidelines for qualitative research publication (COREQ). Methods We qualitatively analysed 78 resident charts across three long‐term care homes in southern Ontario to capture the extent to which person‐centred care was absent, initiated or implemented in different types of documented care interactions. Results Most residents had interactions related to daily care activities (65/78, 83%), social concerns (65/78, 83%) and treatment decisions (53/78, 68%). By contrast, interactions around pain and discomfort (34/78, 44%) and spirituality (27/78, 35%) were documented for less than half of the residents. Almost all (92%) residents had at least one progress note where staff initiated person‐centred care by documenting their preference for a certain type of care, but only a third had at least one progress note that suggested their preference was implemented (35%). Conclusions While person‐centred care is often initiated by nurses and other allied health professionals, changes to care plans to address resident preferences are implemented less often. Nurses and other allied health professionals should be encouraged to elicit care preferences crucial for holistic care planning and equipped with the skills and support to enact collaborative care planning. Relevance to Clinical Practice Collaborative care planning appears relatively absent in charted progress notes, constraining the full implementation of a person‐centred palliative approach to care. Patient or Public Contribution An advisory group consisting of long‐term care resident and staff representatives informed the overall study design and dissemination of the results.

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“…Cancer patients experience multiple symptoms, including pain that involves neurophysiological and affective components (Wood, 2021). Pain can be exacerbated, amplified and contributed to loss of body functions, grief, a sense of doom and other feelings, including anxiety, fear and uncertainty within this population (Brant, 2017).…”

Section: Discussionmentioning

confidence: 99%

Topical therapy for pain management in malignant fungating wounds: A scoping review

Ferreira¹,

González

Thum

et al. 2022

Journal of Clinical Nursing

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Aims and objectives: To map and synthesise the existing literature on topical therapies for malignant fungating wounds pain management and the gaps involved.Background: Most cancer patients with malignant fungating wounds suffer from wound-related pain, affecting their quality of life. Unfortunately, even though pain is a relevant symptom in cancer and palliative care, little is currently known about topical treatments' availability and impact on pain management. Design: A scoping review following JBI® methodologyMethods: Searches were performed in CINAHL, LILACS, Embase, Web of Science, PubMed, Cochrane, NICE, Scopus, JBISRIR and grey literature, in English, Portuguese and Spanish, with no time limit. Two authors independently reviewed all citations and a third was called in case of divergence, and studies in adults with malignant fungal wounds reporting topical pain interventions were included. In addition, a data extraction tool for synthesis and thematic analysis was developed. This study followed the PRISMA-ScR Checklist.Results: Seventy publications were selected from 796 records retrieved from databases. The studies mainly included non-systematic reviews and case studies with only six clinical trials. According to the narrative synthesis, twenty therapies were identified, including the use of wound dressings (58.6%), analgesic drugs (55.7%), topical antimicrobials (25.7%), skin barriers (15.7%), cryotherapy (5.7%) and negative pressure wound therapy (4.3%). Therapies were recommended to be applied to the wound bed or the periwound skin. In 68.5% of the studies, a standardised assessment for pain was not described.Conclusions: Topical therapies applied to malignant fungating wounds or periwound areas had been examined for pain management. However, their effectiveness was analysed in a few interventional studies, indicating the need for further primary studies to inform evidence-based practice.

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Holistic Total Pain Management in Palliative Care: Cultural and Global Considerations

Cited by 14 publications

References 29 publications

Pain communication in children with autism spectrum disorder: A scoping review

Pain communication in children with autism spectrum disorder: A scoping review

Chart based data as a resource for tracking and improving a person‐centred palliative approach in long‐term care

Topical therapy for pain management in malignant fungating wounds: A scoping review

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