
Contents
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Pain prevalence and impact Pain prevalence and impact
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Barriers to optimal pain control Barriers to optimal pain control
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Interventions to reduce barriers directed at patients Interventions to reduce barriers directed at patients
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Interventions to improve pain control directed at healthcare professionals (HCPs) Interventions to improve pain control directed at healthcare professionals (HCPs)
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Measuring and describing pain Measuring and describing pain
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Consensus from this evidence about the goal of each clinical encounter and guidelines to complete it, including strategies that form key steps in achieving this goal Consensus from this evidence about the goal of each clinical encounter and guidelines to complete it, including strategies that form key steps in achieving this goal
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Key communication skills and process tasks Key communication skills and process tasks
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Screening for pain Screening for pain
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Identifying presence of pain(s) and likely aetiology and underlying mechanism Identifying presence of pain(s) and likely aetiology and underlying mechanism
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Site Site
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Temporal factors Temporal factors
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Exacerbating and relieving factors Exacerbating and relieving factors
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Response to treatment Response to treatment
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To determine if pain is neuropathic To determine if pain is neuropathic
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Breakthrough pain Breakthrough pain
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Documenting the pain in a daily diary Documenting the pain in a daily diary
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Determining the impact of pain Determining the impact of pain
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Determining the meaning of pain Determining the meaning of pain
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Identifying beliefs that may act as barriers to pain control Identifying beliefs that may act as barriers to pain control
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Addiction Addiction
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Tolerance: Tolerance:
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Side-effects Side-effects
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Fear that morphine will hasten death Fear that morphine will hasten death
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Fear of masking the pain Fear of masking the pain
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Identifying cultural issues affecting pain communication Identifying cultural issues affecting pain communication
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Spiritual issues affecting communication Spiritual issues affecting communication
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Dealing with difficult pain communication situations Dealing with difficult pain communication situations
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History of substance abuse History of substance abuse
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Paediatric patients Paediatric patients
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Older persons Older persons
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Cognitively impaired Cognitively impaired
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Instructing patients in pain control Instructing patients in pain control
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Exemplary clinical scenarios across the range of common cancers to guide role-plays Exemplary clinical scenarios across the range of common cancers to guide role-plays
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Breast cancer and bone metastases Breast cancer and bone metastases
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Bowel cancer and pre-sacral mass Bowel cancer and pre-sacral mass
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Bone marrow transplant patient with mucositis pain Bone marrow transplant patient with mucositis pain
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Possibility of substance abuse Possibility of substance abuse
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In summary In summary
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References References
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27 Communication strategies and skills for optimal pain control
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Published:March 2010
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Abstract
Pain is a significant cause of suffering for cancer patients. The onset of pain can herald a host of fears of death, disability, disfigurement, dependence, and distress. The role of healthcare professionals is to offer competent pain management with compassion and commitment to excellence, central to which is facilitating communication with the patient. Pain is not an event in isolation. It occurs in a personal and physical environment influenced by the social, cultural, spiritual, and biological inheritance of the patient. Thus, the experience of pain has a unique impact on, and meaning for, each individual. At the time of assessment, factors such as associated fatigue, depression, and anxiety may result in the pain becoming overwhelming. Assessing the pain involves not only measuring the level of pain and determining the nature of the pain, so as to diagnose the aetiology and mechanism of pain, but also exploring the ‘deeper level of pain experience’. Failure to do so can result in poor pain control and a lost opportunity for transformation of the experience and healing of the individual.
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