Knowledge of and barriers to pain management in caregivers of cancer patients receiving homecare.

Cancer treatment is increasingly being provided in outpatient settings, requiring many of the responsibilities for patient care to be undertaken by family caregivers. Pain is one of the most frequent and distressing symptoms experienced by cancer patients and is a primary concern for the family caregiver. Caregivers struggle with many issues that lead to inadequate management of cancer pain. The purpose of this study was to determine pain management knowledge and examine concerns about reporting pain and using analgesics in a sample of primary family caregivers of cancer patients receiving homecare. The Barriers Questionnaire and the Family Pain Questionnaire were administered to 46 primary caregivers. Between 46% and 94% of the caregivers reported having at least some agreement with the various concerns that are barriers to reporting pain and using analgesics, and up to 15% reported having strong agreement. The areas of greatest concern were about opioid-related side effects, fears of addiction, and the belief that pain meant disease progression. Results showed that caregivers with higher pain management knowledge had significantly fewer barriers to cancer pain management, supporting the importance of increasing caregiver's knowledge of management of cancer pain.

Disparities between black and white patients with cancer pain: the effect of perception of control over pain.

CONTEXT: Pain continues to be a problem in ambulatory patients with cancer. Disparities in minority patients with pain have been previously identified. OBJECTIVE: To examine the effect of perception of control over pain on disparities in pain, symptom distress, and functional status in white and black patients with cancer. DESIGN: Cross-sectional, descriptive. SETTING: Outpatient clinic in a large urban cancer center. PATIENTS: A total of 281 patients who reported having pain within the last month and were receiving treatment in the cancer center. OUTCOME MEASURES: Pain intensity, pain-related distress, functional status, perception of control over pain. RESULTS: Black patients had significantly higher pain intensity, more pain-related distress, and reported more pain-related interference with function than white patients. Disparities in pain-related distress and functional status were significantly reduced and only disparities in pain intensity remained when perception of control over pain was held constant. CONCLUSIONS: Perception of control over pain is an important factor in understanding responses to pain. Increasing a patient's perception of control over pain may decrease disparities and increase functional status.