[Pain management in patients with cancer. Perspectives of various network participants]. / Schmerzmanagement bei Menschen mit Tumorerkrankung. Die Sicht einzelner Netzwerkakteure.

BACKGROUND: High healthcare needs are evident for pain caused by cancer. Those affected are not only looking for help in acute inpatient structures but also for a much larger part in outpatient care structures. To avoid mistreatment, undertreatment or overtreatment of pain in people with cancer, it is necessary to differentiate the tasks and roles of different providers while highlighting the specific aspects of pain management within the given network structures. MATERIALS AND METHODS: Aspects, such as pain assessment and the necessary scope of action in pain treatment are illustrated from the perspective of nurses from home care services, primary physicians as well as the general or special ambulatory palliative care (AAPV or SAPV) on the basis of initial survey results and a documentation analysis. RESULTS: Ambulatory care nurses (93 %) and primary caregivers (64 %) use pain assessment scales. The kind of scales used varies. The ability to provide adequate pain care for patients in the immediate care situation is reported as given by more than half of the nurses (56.6 %). CONCLUSIONS: In order to ensure an adequate pain therapy targeted interprofessional coordination is required between outpatient and primary physicians with respect to aspects of pain assessment, scope of action and accessibility.

[Non-pharmacologic measures in pain therapy. Application in 25 German hospitals]. / Nichtmedikamentöse Massnahmen in der Schmerztherapie. Anwendung in 25 deutschen Krankenhäusern.

BACKGROUND: The application of non-pharmacologic therapy (NPT) within pain therapy increases patient satisfaction and is, in addition to pharmacologic methods, recommended in the National Expert Standard on Pain Management in Nursing of the German Network of Quality Development in Nursing. If and to what extent non-pharmacologic methods are applied within pain therapy in German hospitals has as yet been unknown. MATERIALS AND METHODS: Within the project "Pain-Free Hospital" 2,840 nurses in 25 hospitals were interviewed via questionnaire forms and oral interviews about the use of NPT. RESULTS: Of the nurses 80% confirmed the use of NPT. The majority of the interviewed nurses applied superficial cold, bedding and heat for pain relief. We identified barriers to the implementation of NPT, such as the scarce knowledge of nurses about these therapeutic areas and the uncertainty whether NPT needs to be described by doctors or not. CONCLUSION: Some of the NPTs are well established in hospitals. For nationwide use of NPT their systematic training and implementation is necessary.