Why Study Pain? A Qualitative Analysis of Medical and Nursing Faculty and Students' Knowledge of and Attitudes to Cancer Pain Management

Abstract

Although effective means for pain management have long been available, cancer pain remains widely undertreated. Surveys of medical personnel have revealed knowledge deficits and attitudinal barriers to pain management, but have not determined why such attitudes persist and how they may be addressed in medical and nursing curricula. This paper presents findings from a qualitative study of the beliefs and attitudes toward pain and cancer pain management held by medical and nursing students and faculty who participated in the Cancer Education Module for the Management of Pain (CEMMP) project. Analysis centered on informants' prioritization and knowledge of pain and cancer pain management and on the meanings informants assigned to pain in a clinical context. Themes in prioritization included the importance of learning about pain versus cancer pain and the responsibility of primary care providers versus specialists for pain and cancer pain management. Themes in informants' knowledge of pain included knowledge deficits about medications and adjunct therapies and the presence of pain management in the curriculum, and the role of knowledgeable faculty members and mentors in the dissemination of information about pain management. Themes in the meanings informants' assigned to pain included opioidphobia, and the (inter-)subjectivity of pain. The discussion focuses in particular on tensions within the prioritization, knowledge and meanings of pain that must be resolved before students can be appropriately educated for optimal pain management.

Barriers to cancer pain management: home-health and hospice nurses and patients

“…The strengths of this study include our investigation of homehealth and hospice nurses perceptions, our use of focus group methodology, and the simultaneous investigation of patients and providers in order to compare and contrast the types of barriers identified. Themes identified in this study that parallel those conducted in other studies of nurses include the need to improve nurses' knowledge base about pain management, [7,5,6] and the need for improved teaching in nursing school on issues in pain management [8,9]. Although we did not ask specifically about the use of tools to rate pain, the need for improved communication about pain that we identified is supported in the literature by studies that show only mild correlation between patients' and providers' (including nurses') ratings of pain.…”

An Interprofessional Consensus of Core Competencies for Prelicensure Education in Pain Management: Curriculum Application for Nursing

“…Lack of faculty expertise and confidence in teaching about pain, including integrating this knowledge into practice, has been documented for more than 20 years (Duke, Haas, Yarbrough, & Northam, 2013; Goodrich, 2006; Graffam, 1990; Lasch et al, 2002; Voshall, Dunn, & Shelestak, 2013). Not only do these factors influence the need for new core competencies, but faculty and clinical educators who have not updated their knowledge of pain may be passing on outdated management strategies and related misbeliefs to the next generation of clinicians.…”

Appraisal of the Graduate End-of-Life Nursing Education Consortium Training Program

“…5 Other documents detailed the reasons for inadequate EOL care, including inadequate knowledge and education of health care professionals in symptom management and other palliative care skills. [6][7][8][9] These reports emphasize the need for well-trained professionals to overcome the crisis in care of the dying that exists today. One specific strategy noted in these documents is the expansion of educational materials and curriculum development in palliative care.…”