title: Barriers to venipuncture-induced pain prevention in cancer patients: a qualitative study.
abstract: BACKGROUND
  Procedural pain reduces the quality of life of cancer patients. Although there are recommendations for its prevention, there are some obstacles for its management. The purpose of this study was to analyze the barriers to procedural pain prophylaxis in cancer patients reflecting the views of the nurses.
  
  
  METHODS
  We used qualitative methodology based on semi-structured interviews conducted with nurses, focusing on practices of venipuncture-induced and needle change for implantable central venous access port (ICVAP) pain management in cancer patients. A thematic analysis approach informed the data analysis.
  
  
  RESULTS
  Interviews were conducted with 17 nurses. The study highlighted 4 main themes; technical and relational obstacles, nurses' professional recognition, the role of the team, and organizational issues. Participants understood the painful nature of venipuncture. Despite being aware of the benefits of the anesthetic patch, they did not utilize it in a systematic way. We identified several barriers at different levels: technical, relational and previous experience of incident pain. Several organizational issues were also highlighted (e.g. lack of protocol, lack of time).
  
  
  CONCLUSIONS
  The prevention of venipuncture-induced cancer pain requires a structured training program, which should reflect the views of nurses in clinical practice.
authors.affiliation: Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310, Pierre-Bénite, France. marilene.filbet@chu-lyon.fr.
authors.forename: Marilène
authors.initials: M
authors.lastname: Filbet
authors.affiliation: UCD School of Nursing, Midwifery and Health Systems & Our Lady's Hospice and Care Services University College Dublin, Stillorgan Rd, Belfield, Co., Dublin, Ireland.
authors.forename: Philip
authors.initials: P
authors.lastname: Larkin
authors.affiliation: Coordination for the Evaluation of Professional Practices in Healthcare in the Rhône-Alpes Region, 162 Avenue Lacassagne Bâtiment A - 7ème étage, 69424, Lyon Cedex 03, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Chabloz
authors.affiliation: Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310, Pierre-Bénite, France.|Lyon 2 University, Psychology Institute, 5 Avenue Pierre Mendès France, 69500, Bron, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Chirac
authors.affiliation: Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310, Pierre-Bénite, France.
authors.forename: Léa
authors.initials: L
authors.lastname: Monsarrat
authors.affiliation: Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310, Pierre-Bénite, France.
authors.forename: Murielle
authors.initials: M
authors.lastname: Ruer
authors.affiliation: Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310, Pierre-Bénite, France.
authors.forename: Wadih
authors.initials: W
authors.lastname: Rhondali
authors.affiliation: Coordination for the Evaluation of Professional Practices in Healthcare in the Rhône-Alpes Region, 162 Avenue Lacassagne Bâtiment A - 7ème étage, 69424, Lyon Cedex 03, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Collin
mesh_terms: D000328:Adult; D000698:Analgesia / Q000451:nursing; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D009369:Neoplasms / Q000451:nursing*; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology / Q000592:standards; D010146:Pain / Q000451:nursing / Q000517:prevention & control*; D010465:Perception; D018962:Phlebotomy / Q000009:adverse effects*; D057968:Transdermal Patch; D062666:Vascular Access Devices / Q000009:adverse effects
keywords: Cancer; Incidental pain; Nursing; Procedural pain; Prophylaxis