Hospice home care pain management; Four critical variables

Austin, C W; Cody, Christine P.; Eyres, P J; Hefferin, Elizabeth A.; krasnow, Robert W.

doi:10.1097/00002820-198604000-00002

Cited by 20 publications

(9 citation statements)

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“…It is difficult to compare the adherence data in the literature because investigators used various methods to measure adherence (Table ). In general, 3 methods to measure adherence can be distinguished: (1) a questionnaire or statement that reflects patients' intention to be adherent (eg, Morisky Medication Adherence Scale); (2) interviews or statements aimed to distinguish patients who were adherent to the prescribed analgesics from those who were not; and (3) measurements of the ratio of analgesic doses taken by patients with respect to the analgesic doses prescribed (analgesic use ratio) . These described adherence rates should be interpreted differently.…”

Section: Discussionmentioning

confidence: 99%

“…More specifically, patients took their analgesics, but ingested them, especially WHO step 1 analgesics, at the wrong time intervals. Other studies only described to what extent patients took their analgesics (taking adherence) and found nonsignificant differences in adherence between WHO step 1 analgesics and opioids . Two other studies described that patients were more adherent to opioids than WHO step 1 analgesics .…”

Section: Discussionmentioning

confidence: 99%

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Adherence to Analgesics in Oncology Outpatients: Focus on Taking Analgesics on Time

2016

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adherence to Analgesics in Oncology Outpatients: Focus on Taking Analgesics on Time

2016

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“…An Institute of Medicine report (1) suggests that 40% of those at the end of life have severe, unrelieved pain. Patients say barriers to effective pain management include communication problems with providers, structural problems in the health care system (difficulty obtaining medications), fears related to addiction, and personal attitudes, beliefs, and values (2–4). Similarly, health care providers find patient adherence with pain medication regimens to be problematic (5, 6).…”

Section: Introductionmentioning

confidence: 99%

Hospice Caregivers' Experiences With Pain Management: “I'm Not a Doctor, and I Don't Know if I Helped Her Go Faster or Slower”

Oliver

Wittenberg-Lyles

Washington

et al. 2013

Journal of Pain and Symptom Management

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Context Those caring for their loved ones in hospice experience tremendous stress, being faced with numerous decisions as they work to manage the pain experienced by their loved one. Although hospice care teams create pain management strategies, it is the role of the caregiver to implement these plans. Objectives The purpose of this study was to further understand the hospice caregiver experience relating to pain management. Methods Semi-structured interviews with 146 caregivers provided data for the study. Responses to seven questions asking for a ranking of end-of-life pain management indicated a less than ideal experience. Available narratives from 38 caregivers were analyzed for themes related to further understanding the concerns. Results Five themes were identified in the data including difficulty with administration of pain medicines, concerns about side effects of medications, insecurity with pain assessment, frustrations with communication among health care team members, and memories of unrelieved pain. Conclusion These findings should raise concern among hospice professionals, whose commitment is to the management of pain, including emotional pain, with a focus on both the patient and the family as a unit of care. These data clearly suggest hospice providers have an opportunity to be sensitive to perceptions held by caregivers regarding pain management. Effective planning for pain control must incorporate the values and beliefs not only of each patient, but also of the family caregiver.

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“…Hospice patients have identified communication problems with providers, structural problems in the health care system (difficulty obtaining medications), fears related to addiction, and personal attitudes, beliefs and values as barriers to effective pain management (Austin et al 1986). Likewise, health care providers have indicated that patient adherence with pain medications is problematic (Abbas & Abbas 2003).…”

Section: Introductionmentioning

confidence: 99%

The use of videophones for patient and family participation in hospice interdisciplinary team meetings: a promising approach

Oliver

Demiris

Wittenberg-Lyles

et al. 2009

European Journal of Cancer Care

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Inclusion of patients and caregivers in decisions related to the delivery of care is inherent in the hospice philosophy. Telemedicine technologies offer a potential solution to the challenges presented by the geographic distance between team meetings and the home environment. While inclusion requires additional coordination by the hospice team, it also offers an important opportunity to improve communication between the team and the patient and family. A modified conceptual model based on two previous frameworks is outlined to support patient and family involvement in hospice team meetings. Further research is suggested to determine the structural feasibility of patient and family involvement via videophone as well as the structural and procedural changes resulting from this inclusion. Finally, clinical outcomes and family evaluation of the inclusion experience need to be thoroughly researched before final conclusions may be reached.

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Hospice home care pain management; Four critical variables

Cited by 20 publications

References 0 publications

Adherence to Analgesics in Oncology Outpatients: Focus on Taking Analgesics on Time

Adherence to Analgesics in Oncology Outpatients: Focus on Taking Analgesics on Time

Hospice Caregivers' Experiences With Pain Management: “I'm Not a Doctor, and I Don't Know if I Helped Her Go Faster or Slower”

The use of videophones for patient and family participation in hospice interdisciplinary team meetings: a promising approach

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