• Anita Mehta, S Robin Cohen, Franco A Carnevale, Hélène Ezer, and Francine Ducharme.
• McGill University Health Center, Psychosocial Oncology, Montreal General Hospital, 1650 Cedar Ave., Montreal, Quebec, Canada. anita.mehta@muhc.mcgill.ca
• Cancer Nurs. 2010 Nov 1; 33 (6): 461-9.

BackgroundWhen cancer patients at the end of life stay at home, family caregivers are often directly implicated in the care. One challenge is pain management. They are often unprepared and unsupported as they attempt to meet this responsibility. There are few studies that examine what this responsibility entails.ObjectiveThe purpose of this article was to present one important process extracted from the results of a grounded theory study of family caregiver management of the pain of palliative cancer patients at home. Specifically, it will look at how family caregivers strategize to plan for pain management.MethodsTwenty-four family caregivers participated. They were recruited using purposeful and then theoretical sampling. The data sources were taped, transcribed, semistructured interviews and field notes. Data analysis used Strauss and Corbin's open, axial, and selective coding.ResultsThe process "strategizing a game plan," which includes the subprocesses of "accepting responsibility," "seeking information," and "establishing a pain management relationship" will be presented in this article. These processes were integral to pain management at home.ConclusionsThese results highlight that, even when family caregivers accept responsibility for pain management, they are not always well prepared and require appropriate support to ensure optimal pain control.Implications For PracticeUnderstanding that family caregivers are continuously engaging in specific processes as they prepare for and implement pain management strategies can help health care providers tailor their interventions to specific parts of the complex process of family caregiver management of palliative care cancer patients' pain.

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