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Pain Management in Palliative Care




Nurses have a primary responsibility to recognise pain, to provide a comprehensive pain assessment and to participate in the overall pain management plan. Nurses should also act as advocates for patients and families and reassure them that most pain can be adequately relieved. This chapter provides an overview of the assessment and management of pain at the end of life. Definitions of pain and barriers to adequate pain management are also addressed. Pain guidelines, developed internationally as a basis for evidence-based practice, are also discussed.


Contents include

  • Introduction
  • What is pain?
  • Barriers to pain relief
  • Assessment of pain
    • General approach to pain assessment
    • Measuring pain intensity
    • Assessing the quality of pain
    • Temporal aspects of pain
    • Behavioural assessment of pain
    • Psychosocial and spiritual assessment of pain
  • A model for pain management
  • Analgesics at the end of life
    • Non-opiod analgesics
    • Choice of analgesics
      • Choice of opiods
      • Dosage regimens
      • Side-effects of opiods
    • Adjuvant analgesics
  • Routes of administration
  • Dosing and titration considerations
  • Invasive procedures
  • Non-pharmacological pain management
  • Conclusion
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Author / Editor Biographies

PhD, APRN and AOCN.
Jeannine M Brant is an Oncology Clinical Nurse Specialist, Pain Consultant, and Nurse Scientist at Billings Clinic Cancer Center and an Assistant Affiliate Professor at Montana State University College of Nursing. Jeannine's work focuses on symptom management, and she is recognised for her work as an author and lecturer in the field of oncology nursing, palliative care, and pain management. She has lectured extensively and is a prolific writer with over 50 contributions to nur

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