Paper
Tuesday, November 6, 2007

693
This presentation is part of : Creative Strategies for Chronic Health Issues
The Current State of Pain Management Practices for Older Adults with Cancer in Hospices
Keela Herr, RN, PhD, FAAN1, Marita Titler, PhD, RN, FAAN2, Perry Fine, MD3, Chris Forcucci, RN, BSN, BA4, Patty McNichol, RN, BSN, CHPN4, Kimberly Bergen, RN, BSN4, Jimmy Reyes, RN, BSN4, Melissa Lehan Mackin, RN, BSN4, Xiangming Fang, MS4, Sara Sanders, PhD5, and John Swegle, DPh6. (1) College of Nursing, University of Iowa, Iowa City, IA, USA, (2) Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, Iowa City, IA, USA, (3) Pain Research Center, School of Medicine, University of Utah, Salt Lake City, UT, USA, (4) Cancer Pain in Elders Grant, The University of Iowa, Iowa City, IA, USA, (5) College of Social Work, The University of Iowa, Iowa City, IA, USA, (6) College of Pharmacy, The University of Iowa, Iowa City, IA, USA
Learning Objective #1: describe the current state of pain management practice in community-based hospices in the Midwest.
Learning Objective #2: discuss the implications of the current state of pain management practice in community-based hospices on future research and practice.
The purpose of this presentation is to describe the current state of pain management for older adults with cancer in hospice programs in the Midwest.  Despite existence of evidence-based guidelines to improve assessment and management of pain in this vulnerable population, adoption and use of recommendations based on best scientific evidence lags. Data from the National Hospice and Palliative Care Organization suggests that 50% of patients cared for in hospices are older adults with advanced cancer where one of the priorities is to assure a pain free death.  Studies evaluating pain-related outcomes in non-hospice settings show insufficient pain control in the last days to weeks prior to death.  While surveys (e.g. Family Evaluation of Hospice Care) show high degrees of satisfaction with pain control in the hospice setting, detailed studies regarding pain outcomes in home-based hospice settings are lacking. Data collected by the Cancer Pain in Elders: Promoting the use of Evidence Based Practices in Hospices Grant details health care provider treatment practices related to pain management for older adults with cancer who received services in a community-based hospice setting.  This large study, which is still in process, is a randomized control trial to test adoption and maintenance of practices recommended in three current EBP guidelines: the American Pain Society Cancer Pain Guideline, National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, and the University of Iowa Geriatric Nursing Interventions Research Center’s Acute Pain Management in Older Adults. Our sample is randomly selected and consists of 320 older adults   65 years of age or older with an active cancer diagnosis and enrolled in one of 16 community hospices in Iowa, Nebraska, and Missouri. 
In this presentation we will report our current findings, the current state of pain management practices, and implications for future research and practice.

 

See more of Creative Strategies for Chronic Health Issues
See more of The 39th Biennial Convention (November 3 -- 7, 2007)