Chronic cancer pain management by the nursing team

Oliveira, Anara da Luz; Palma Sobrinho, Natália da; Cunha, Beatriz Aparecida Silva

doi:10.5935/1806-0013.20160075

ABSTRACT

BACKGROUND AND OBJECTIVES:

Cancer patients' pain is related to the tumor, to diagnostic and therapeutic procedures and to the terminality of the disease; however health professionals, especially nursing teams, still have difficulties in evaluating and managing pain. As from experience in hospitals, it was noticed that nursing teams face barriers, which is intensified in case of cancer patients, marked by the "incurable" cancer pain stigma. This study aimed at identifying in the literature, how nursing teams manage chronic cancer pain.

We have found 710 articles being 194 in LI-LACS and 516 in Scielo, being included 14 articles by means of the descriptors "Nursing Care", "Nursing", Chronic pain", "Pain management", "Oncology". In the category "Cancer pain management by the nursing team", studies have reinforced the importance of pain evaluation by the nursing team and present resources and strategies to make it effective. In the category "Pharmacological methods for pain management", drugs appear as the first method of choice with the three steps stair of the World Health Organization and opiophobia is discussed. In the category "Non-pharmacological methods for pain management", there are interventions such as therapeutic massage, spiritual support and comfort measures, such as changing position.

CONCLUSION:

Assisting painful cancer patients goes beyond performing procedures; it is necessary to think about scientific knowledge acquisition and professional-patient link for a safe assistance when managing cancer pain.

Keywords:
Chronic pain; Nurse-patient relationships; Nursing; Nursing care; Oncology; Pain management

[1] Correspondence to: Praça Cruz Vermelha, nº 23, Centro 20230-130 Rio de Janeiro, RJ, Brasil. E-mail: anaraluzoli@yahoo.com.br

Category 1. Cancer pain management by the nursing team
Article	Year	Type of study	Objective	Conclusion
Palliative care: pain evaluation according to nurses	2015	Integrative literature review	Identify in Brazilian scientific production the status of nursing team assistance and knowledge of cancer pain.	Results have contributed for the scientific armamenta-rium of the nursing team, giving it support for better pain management with regard to its adequate measurement, major intervention aspects and predominant stumbling blocks for fighting against pain.
Postoperative management of cancer pain patients by nurses	2010	Convergent assistential qualitative research	Reveal concepts and contributions of nurses acting in palliative care about cancer patients’ pain evaluation	Implementation of systematized pain management entailed in nursing assistance systematization enables redirecting actions and this way a more complete and effective pain management.
Nurses and cancer pain	2013	Descriptive qualitative study	Describe the management of immediate postoperative pain of cancer patients by the nursing team	Nursing team should be prepared to manage postoperative pain of cancer patients, with the use of available tools and identification of pharmacological and complementary interventions needed for each patient.
Spiritual dimension in pain and suffering control of advanced cancer patients.	2015	Case report	Show the integration of spiritual aspects in pain sensation manifestation and their influence on pain and suffering control of advanced cancer patient.	Importance of recognizing the spiritual dimension in adequate total pain evaluation
Dialogues with nurses about oncologic pain assessment of patients under palliative care	2010	Experience re-port	Report the experience of developing a labor education process focused on the awareness of nurses about pain evaluation of patients under palliative care	Nurses stress the need to build pain evaluation systematization so that nurses may reinforce the importance of its control, and justify practice and ongoing education.
Category 2. Pharmacological methods for the management of cancer pain by the nursing team
Irruptive pain in advanced cancer	2011	Literature review	Systematize pain concepts and definitions as-sociated to cancer, understand onset mechanisms of irruptive pain and know the best ways to relieve it.	Severe non-relieved pain brings adverse physical, psychological and social consequences. Patients have the right to adequate treatment.
Avaliação da dor em pacientes oncológicos inter-nados em um hospital es-cola do Nordeste do Brasil.	2013	Prospective, crossover study	Describe cancer patients’ pain evaluation and treatment in Clinical Oncology Ward.	Non-treatment of pain by “fear of adverse reactions” or by negligence leads to serious violation of bioethical principles. Most common pain was nociceptive visceral pain, and neuropathic pain was the most difficult to control. There has been adequate pain control in patients admit-ted to the cancer ward.
Pain evaluation in cancer patients admitted to a teaching hospital of Northeastern Brazil Pain in cancer patients under chemotherapeutic treatment	2012	Quantitative, de script ive, crossover study	Evaluate cancer patients pain by means of standardized scales validated to the Portuguese language	Moderate and sensory pain is present in most cancer patients leading to loss of energy to perform daily activities.
Category 3. Non-pharmacological methods to manage cancer pain
Massage in children with cancer: effectiveness of a protocol	2013	Prospective, longitudinal, randomized, controlled study	Evaluate the efficacy of the implementation of a massage protocol to relieve pain of hospitalized children with cancer.	Massage seems to be a useful intervention to relieve pain in children with cancer, in spite of questions about the efficacy of this protocol. Authors recommend its use due to its contribution to children’s wellbeing and quality of life.
Effect of therapeutic massage on mental health of cancer patients	2015	Systematic literature review	Evaluate the effect of therapeutic massage on mental health of cancer patients	Therapeutic massage has short-term beneficial effects in terms of emotional wellbeing, physical and emotional discomfort, depressed mood, sleep pattern, relaxation and stress of cancer patients.
Complementary techniques to control cancer symptoms	2014	Literature review	Identify evidences in the scientific literature for the use of complementary techniques to control signs and symptoms of cancer patients.	Scientific evidences show the benefit of nonpharmacological treatment to control signs and symptoms such as pain in oncology.
Non-pharmacological methods to control pediatric cancer pain: view of the nursing team	2015	Descriptive, exloratory qualiquantitative study	Identify non-pharmacological methods to control pain used by nurses in hospitalized children, check most widely used pain scales and evaluate nursing team view about pain management with nonpharmacological methods.	The need for training on pain measurement scales according to age, possible non-pharmacological methods used by nurses and their association with the nursing process has been identified.
Pain in cancer patients under palliative care	2014	Crossover study	Evaluate pain and quality of life of cancer patients under palliative care.	Results have shown the presence of pain affecting quality of life and impairing daily life activities.
Interventionist procedures for cancer pain management.	2012	Quantitative, de script ive, crossover study	Describe the number and types of procedures performed by the Pain Interventionist Medicine Center of a private hospital of São Paulo.	Results are in line with the literature and confirm the efficacy of interventionist procedures for different types of cancer pain.

Brasil

Brasil

Chronic cancer pain management by the nursing team

ABSTRACT

BACKGROUND AND OBJECTIVES:

CONTENTS:

CONCLUSION: