BARRIERS TO CANCER PAIN RELIEF - FEAR OF TOLERANCE AND ADDICTION

The purposes of this study were to (a) test the feasibility of the Can cer Total Quality Pain Managemen(TM) (TQPM(TM)) Patient Assessment Too l in a, population of oncology inpatient and outpatients; and (b) iden tify factors associated with poor pain relief The Cancer TQPM Tool was adapted from the American Pain Society's Quality Assurance Standards on Acute Pain and Cancer Pain and was tested in a convenience sample o f 200 patients. The majority of patients reported that the TQPM Tool w as easy to understand and to use, providing evidence for the feasibili ty of the tool. Factors associated with higher pain intensity included the inpatient setting the presence of metastatic disease, hesitancy i n bothering the nurse, and concerns regarding tolerance and addiction. Although there was a strong relationship between concern about addict ion and concern about tolerance, fear of tolerance appeared to have a greater effect on pain intensity scores than did fear of addiction. Th e findings from this study suggest that the Cancer TQPM Patient Assess ment Tool can be used effectively in both inpatients and outpatients t o determine outcomes and the quality of cancer pain management, as wel l identify factors associated with poor pain control. Clinical implica tions include more effective education of patients and caregivers, inc luding equivalent emphasis on tolerance and addiction. (C) U.S. Cancer Pain Relief Committee, 1998.