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Poster Numbers 95 to 110 – Pain and symptom management: Poster No: 99
‘We all talk about it as though the authors are thinking about the same thing’: healthcare professionals' goals in the management of pain due to advanced cancer – a qualitative study
  1. Rebecca Bhatia,
  2. Colette Reid,
  3. Karen Forbes and
  4. Jane Gibbins
  1. University Hospitals Bristol, Bristol, UK

Abstract

Background and aims Cancer pain remains a significant problem worldwide. As well as challenges relating to the assessment and measurement of pain, barriers still exist which impede the successful treatment and there is no consensus as to what constitutes good pain control. Despite the plethora of research tools available to assess pain, little is known about what patients and healthcare professionals (HCPs) feel is important in pain management. This study aimed to explore what goals HCPs hold when managing pain.

Methods HCPs involved in the management of cancer pain were purposively sampled and interviewed using a semistructured technique. Data were analysed using the constant comparison technique, based on the principles of grounded theory.

Results Analysis of the interviews revealed four main themes: assessing pain, managing pain, managing expectations and building relationships. Managing pain included helping patients to maintain function and sleep, but also involved finding the meaning of the pain, being with, educating and empowering, and maintaining hope and a sense of self for the patients. HCPs used different terms when managing pain, such as ‘pain control’, but found it difficult to define these terms. Managing patients' expectations was seen as an important goal for HCPs in managing pain but it wasn't always clear how these expectations had been elicited. The HCPs discussed the importance of building therapeutic relationships but alluded to the tension between being patient-centred and controlling pain, particularly when patients were reluctant to increase opioids.

Conclusion The interview findings suggest that the use of goal setting, a technique used commonly in the management of chronic pain, would allow explicit joint identification of goals and expectations and a negotiated patient-centred outcome measure. The setting of realistic targets may also protect HCPs from burnout by preventing a sense of failure.

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