The purpose of this study was to describe the
pain and
pain-related symptoms experienced by persons receiving treatment in a
cancer center or a hospice and to describe the nurses' responses to these problems. The sample consisted of 25 hospice and 19
cancer center patients who were being treated for
pain.
Pain was assessed three times in a 24-hour period using a visual analogue scale (VAS).
Constipation was assessed using the
Constipation Assessment Scale. Sedation was assessed on a 0 (fully alert) to 4 (
comatose) scale. The nurses' documentation was assessed using the Chart Audit for
Pain. Results showed that patients in the
cancer center and hospice continued to experience
pain (VAS M = 38.6 and 29.7 respectively) in spite of their
pain management regimens. The
cancer center patients were given an average of 38% of the maximum ordered dose of
analgesic while the hospice patients self-administered 93% of the ordered dose. The
cancer center nurses documented the efficacy of the
analgesics in only 26% of cases while hospice nurses recorded this information in 96% of the charts. Sedation was not found to be a problem.
Constipation was reported by 100% of
cancer center patients and 84% of hospice patients but was rarely documented by nurses in either setting. It appears that nurses need to do more thorough assessment of patient symptoms and more consistent follow-up evaluation and documentation.