Hospice Caregivers’ Negative Attitudes Toward Opioids May Hinder Patient Care
Hospice caregivers’ knowledge and attitudes toward opioids and their ability to administer pain medicines should be assessed by health care providers as these factors can significantly affect patient outcomes and quality of life, according to new findings.
Masako Mayahara, RN, PhD, of Rainbow Hospice, Park Ridge, Illinois, examined 59 patient-caregiver pairs, both of whom completed a questionnaire assessing barriers to pain management (Barrier Questionnaire II) and an open-ended questionnaire about pain management activities. While 64% of patients had severe pain in the past 24 hours, only 41% of the overall group had complete pain relief, and only 41% received 24-hour analgesia. Inappropriate use of psychotropic agents and acetaminophen was found, and more than 60% of patients did not know the names or doses of analgesia that they were given. A significant negative relationship was found between caregiver barrier scores and patients’ satisfaction with pain management (P<0.05). In addition, caregivers’ degree of fatalism was negatively correlated with patients’ satisfaction with pain management and quality of life and was positively associated with depression among patients.1
Another hospice-based study showed a relatively high level of adherence to pain medications among 65 elderly patients with cancer. Overall mean adherence scores were 2.65-2.89 on a 3-point scale with 3 indicating maximal adherence. The lowest rate of adherence (2.65) was found for opioids, according to research led by Keela Herr, PhD, RN, chair of the Adult and Gerontology Area of Study and Research Director, John A. Hartford Center of Geriatric Nursing Excellence, University of Iowa in Iowa City, Iowa.2
References
- Mayahara M. Pain medication management by hospice caregivers. Pain. 2011. doi:10.1016/j.jpain.2011.02.111.
- Herr K, Sanders S, Fiala C, Fine P, Forcucci C, Tang X. Patient adherence to the pain treatment plan for older adults with cancer pain in hospices. Pain. 2011. doi:10.1016/j.jpain.2011.02.064.
