title: Cancer pain in palliative care: why is management so difficult?
abstract: Pain is the major source of anxiety and distress at the end of life, particularly in cases of end-stage cancer. However, pain management is not always effective or effectively implemented. This article identifies several barriers to effective pain relief in terminal cancer--the complexity of pain; difficulties in physical, emotional and spiritual assessment; difficulties in the delivery of medication--that challenge the skills of all professionals involved in palliative care. There are no simple answers, but awareness of the breadth of the issues may help focus nurses' minds on the patient in every encounter.
authors.affiliation: Department of Nursing and Midwifery, University of Hertfordshire. l.hemming@herts.ac.uk
authors.forename: Laureen
authors.initials: L
authors.lastname: Hemming
authors.forename: David
authors.initials: D
authors.lastname: Maher
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D024802:Nurse's Role; D009730:Nursing Assessment; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods / Q000451:nursing / Q000523:psychology; D010166:Palliative Care / Q000379:methods* / Q000523:psychology; D011788:Quality of Life; D029181:Spirituality; D013315:Stress, Psychological / Q000209:etiology
chemical_list: D000700:Analgesics