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You are caring for Jane Smith a 42-year old accountant who is receiving chemotherapy for malignant breast cancer with bony metastases. She is graduating with a law degree next week and wants the pain in her ribcage ‘sorted’ because ‘it’s bothering her’. She is currently prescribed 12-hour release morphine sulphate tablets 30mg twice daily but, when you ask her about this, she tells you that she only takes them when she needs to because she’s worried about becoming addicted. She also wonders whether ‘there’s anything else she can do’?
Outline how you respond in Jane’s situation, giving arguments for your key points which are supported by evidence from the literature.
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Pain can be described as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (Loeser & Treede, 2008). It has been the most common reason for people seeking integrated and complementary treatment approaches (National Center for Complementary and Integrative Health, 2016). In cancer, pain can be both acute as well as chronic. Chronic pain in cancer affects the overall quality of life in patients. Opioids have been the main line of treatment for relieving pain in cancer. However, due to rising concern about long-term harmful effects, recent advances have recommended the use of multimodal strategies that incorporate non-pharmacological interventions for pain management in cancer survivors (Glare, et al., 2014). This essay is based on the case study of Jane Smith, who is suffering from cancer-related pain. The essay highlights the major intervention strategies for pain management in cancer, description of non-pharmacological interventions that provide pain relief, the role of nursing care in non-pharmacological intervention, reasons behind recent interests in non-pharmacological interventions and future implications in nursing practice.
Pain management is a significant component of nursing practice. Unrelieved pain has a detrimental influence on individuals, especially with advancing age (Brant, 2010). Chronic pain not only poses physical and emotional liabilities but also cost a huge financial burden to society. (Hecke, Torrance, & Smith, 2013). Cancer pain has been described as complex and multidimensional in nature that reproduces both the harm in the body and the response of the body to harm. As nurses are in immediate contact with the patient majority of the times, they play a key role in effective pain assessment, providing pharmacological and non-pharmacological care to patients, providing education to patient and family members and evaluation of overall pain care management. (Elumelu, Adenipekun, Eriba, & Akinlade, 2014). Cancer pain is often difficult to treat due to its multifactorial nature. In recent times, the use of non-pharmacological interventions has been recommended for increasing the effectiveness of overall pain management in cancer. For providing pain care, the multidimensional approach needs to be adopted. For this, the nurses can play a major role to effectively manage the pain by adopting non-pharmacological therapies along with standard pharmacological protocol (Mori, Elsayem, Reddy, Bruera, & Fadul, 2012).
