Pain Management Concerns From the Hospice Family Caregivers' Perspective.
Nai-Ching Chi, George Demiris, Kenneth C Pike and 2 others
PMID 28875732WHAT IT FOUND
Hospice family caregivers described pain management as exhausting and morally difficult, especially when patients could not report pain.
They needed timely hospice team advice, simple pain assessment tools, and clear medication and disposal guidance.
Key findings
01Caregivers reported that exhaustion and beliefs about pain medication interfered with pain management.
02Pain assessment was difficult when patients could not express pain, and one caregiver said a 10-point scale was still hard.
03Caregivers described delayed help from hospice providers and needed medication guidance for breakthrough pain.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 15 of 514 parent study caregivers were analysed, and they were selected because pain management was their chosen priority issue. The sample was mostly white, highly educated, and from Washington, so the findings may not represent caregivers from other backgrounds or regions. The study used secondary interview data, so the researchers could not ask follow-up questions about participants’ concerns. Patients’ own perspectives were not included, so the findings reflect caregivers’ views of patient pain and communication. Some framework subthemes were absent, partly because caregivers with severe cognitive impairment or who did not speak English were excluded.
Declared interests
The authors declared no potential conflicts of interest. The parent trial was funded by NINR grants.
The easy way to misread this
Do not treat the framework as validated for all hospice caregivers. Only 15 mostly white, highly educated Washington caregivers were analysed, and some subthemes were absent.