Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2007
Preference for analgesic treatment for cancer pain among African Americans.
Over the past decade, there has been a surge of literature related to disparities in pain treatment between minority and non-minority patients. Conspicuously lacking from this body of literature is an effort to investigate the patient-level factors that might account for undertreatment of pain among minorities. The present qualitative descriptive study was designed to gain a preliminary understanding of the preference for analgesic treatment for cancer pain among African Americans and the factors shaping these preferences. ⋯ Qualitative findings revealed that despite having overt access to pain medications, considerable intra-ethnic heterogeneity existed in the preference for analgesia among this group of African Americans. The subjective preference for analgesics for cancer pain was tied to a number of covert factors such as meaning of cancer pain treatment, past experience with pain relief and analgesic side effects, fears of dependency and tolerance, and past experience with providers and the health system. These factors should be the focus of future inquiry.
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J Pain Symptom Manage · Aug 2007
Randomized Controlled TrialGabapentin and an opioid combination versus opioid alone for the management of neuropathic cancer pain: a randomized open trial.
Neuropathic cancer pain represents a major challenge. Treatment often requires adjuvant analgesics, including gabapentin, to complement the effects of opioids. This study aimed to compare the effectiveness and safety of gabapentin combined with an opioid versus opioid monotherapy for the management of neuropathic cancer pain. ⋯ An earlier significant decrease (at Day 4, P=0.002) was observed for allodynia in the GO group compared to the OO group. The rate of side effects in the GO group was significantly lower than that in the OO group (P=0.015). These data suggest that gabapentin added to an opioid provides better relief of neuropathic pain in cancer patients than opioid monotherapy; this combination of gabapentin and an opioid may represent a potential first-line regimen for the management of pain in these patients.
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J Pain Symptom Manage · Aug 2007
Meaninglessness in terminally ill cancer patients: a validation study and nurse education intervention trial.
Recent empirical studies revealed that fostering patients' perception of meaning in their life is an essential task for palliative care clinicians. However, few studies have reported the effects of training programs for nurses specifically aimed at improving skills to relieve the meaninglessness of terminally ill cancer patients, and we have had no specific measurement instruments. The primary aims of this study were 1) to validate measurement tools to quantify nurses' self-reported practice and attitudes toward caring for terminally ill cancer patients feeling meaninglessness and 2) to explore the effects of the five-hour educational workshop focusing on meaninglessness on nurses' self-reported practice, attitudes toward caring for such patients, confidence, burnout, death anxiety, and meaning of life. ⋯ The Self-Reported Practice scale and the Attitudes Toward Caring for Patients Feeling Meaninglessness scale are reliable and valid tools to specifically quantify nurses' self-reported practice and attitudes toward caring for terminally ill cancer patients feeling meaninglessness of life. The five-hour workshop appeared to have a modest but significant beneficial effect on nurse-reported practice, attitudes, and confidence in providing care for terminally ill cancer patients feeling meaninglessness. Further educational intervention trials with control groups are promising.