Pain medication management processes used by oncology outpatients and family caregivers part II: Home and lifestyle contexts

Karen L. Schumacher, Vicki L. Plano Clark, Claudia M. West, Marylin J. Dodd, Michael W. Rabow, Christine Miaskowski

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Context. Despite the increasing complexity of medication regimens for persistent cancer pain, little is known about how oncology outpatients and their family caregivers manage pain medications at home.

Objectives. To describe the day-to-day management of pain medications from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial of a psychoeducational intervention called the Pro-Self© Plus Pain Control Program. In this article, we focus on pain medication management in the context of highly individualized home environments and lifestyles.

Methods. This qualitative study was conducted as part of a randomized clinical trial, in which an embedded mixed methods research design was used. Audio-recorded dialogue among patients, family caregivers, and intervention nurses was analyzed using qualitative research methods.

Results. Home and lifestyle contexts for managing pain medications included highly individualized home environments, work and recreational activities, personal routines, and family characteristics. Pain medication management processes particularly relevant in these contexts included understanding, organizing, storing, scheduling, remembering, and taking the medications. With the exception of their interactions with the intervention nurses, most study participants had little involvement with clinicians as they worked through these processes.

Conclusion. Pain medication management is an ongoing multidimensional process, each step of which has to be mastered by patients and their family caregivers when cancer treatment and supportive care are provided on an outpatient basis. Realistic patient- and family-centered skill-building interventions are needed to achieve effective and safe pain medication management in the contexts of individual home environments and lifestyles.

Original languageEnglish (US)
Pages (from-to)784-796
Number of pages13
JournalJournal of Pain and Symptom Management
Volume48
Issue number5
DOIs
StatePublished - Nov 1 2014

Fingerprint

Pain Management
Caregivers
Life Style
Outpatients
Pain
Randomized Controlled Trials
Nurses
Qualitative Research
Research Design
Neoplasms

Keywords

  • Cancer pain management
  • analgesics
  • family caregivers
  • home
  • lifestyle
  • medication management
  • medications
  • qualitative research
  • randomized clinical trial
  • self-care
  • self-management

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Pain medication management processes used by oncology outpatients and family caregivers part II : Home and lifestyle contexts. / Schumacher, Karen L.; Plano Clark, Vicki L.; West, Claudia M.; Dodd, Marylin J.; Rabow, Michael W.; Miaskowski, Christine.

In: Journal of Pain and Symptom Management, Vol. 48, No. 5, 01.11.2014, p. 784-796.

Research output: Contribution to journalArticle

Schumacher, Karen L. ; Plano Clark, Vicki L. ; West, Claudia M. ; Dodd, Marylin J. ; Rabow, Michael W. ; Miaskowski, Christine. / Pain medication management processes used by oncology outpatients and family caregivers part II : Home and lifestyle contexts. In: Journal of Pain and Symptom Management. 2014 ; Vol. 48, No. 5. pp. 784-796.
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abstract = "Context. Despite the increasing complexity of medication regimens for persistent cancer pain, little is known about how oncology outpatients and their family caregivers manage pain medications at home.Objectives. To describe the day-to-day management of pain medications from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial of a psychoeducational intervention called the Pro-Self{\circledC} Plus Pain Control Program. In this article, we focus on pain medication management in the context of highly individualized home environments and lifestyles.Methods. This qualitative study was conducted as part of a randomized clinical trial, in which an embedded mixed methods research design was used. Audio-recorded dialogue among patients, family caregivers, and intervention nurses was analyzed using qualitative research methods.Results. Home and lifestyle contexts for managing pain medications included highly individualized home environments, work and recreational activities, personal routines, and family characteristics. Pain medication management processes particularly relevant in these contexts included understanding, organizing, storing, scheduling, remembering, and taking the medications. With the exception of their interactions with the intervention nurses, most study participants had little involvement with clinicians as they worked through these processes.Conclusion. Pain medication management is an ongoing multidimensional process, each step of which has to be mastered by patients and their family caregivers when cancer treatment and supportive care are provided on an outpatient basis. Realistic patient- and family-centered skill-building interventions are needed to achieve effective and safe pain medication management in the contexts of individual home environments and lifestyles.",
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