Barriers to Effective Cancer Pain Management in Home Setting: A Qualitative Study

Abstract

Background: Pain is one of the most disturbing and distressing symptoms experienced by cancer patients, and it is the most stressful factor affecting all aspects of patients and their families' lives. Understanding the barriers to effective cancer pain management in home setting is essential for designing programs to improve the quality of the patients and their families' lives. Aim: Exploring family caregivers' and cancer patients' experiences of barriers to pain management at home. Design: Qualitative exploratory descriptive study. Setting/Participants: Twenty patients and 32 family caregivers were recruited from oncology wards and palliative medicine clinics in hospitals affiliated to Iran University of Medical Sciences. Method: In-depth interviews were conducted with each participant, and audio-recorded and transcribed interviews were analyzed using thematic analysis. Results: Ten major themes emerged regarding barriers to cancer pain management in home setting: "Drug dependence and addiction," "Malingering," "Negative attitudes towards opioid analgesia," "Concealing pain," "Painful comorbidities," "Conflict in family members' perspectives," "Inaccessibility of pain relief facilities," "Poor skill and knowledge," "Patients' feelings of depression and hopelessness," and "Caregiver burden." Conclusion: The study documented the need for supportive and educational programs for cancer patients and their family caregivers in an attempt to improve the effectiveness of pain managment and cancer patients' quality of life. (C) 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.