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The Association for the Study of pain provides also a comprehensive definition of pain as 'an unpleasant sensory and subjective experience associated with actual or potential tissue damage, or described in terms of such damage. This implies that pain is a more individual experience and a complex phenomenon influenced by biological, psychological and social factors. Wilson (2007) further explained that pain is a multidimensional phenomenon with physical, psychological, social and spiritual components. Suggesting that pain may arise from a number of situations and could be from injury which is a major cause, or may also arise from an illness. Pain has many causes. It may result from a chronic condition such as arthritis or fibromyalgia, it may occur during an intervention (procedural pain after surgery, in response to an injury or as a symptom of disease British pain Society (2007).2 pain Theories nair and peate (2009) found. The specificity theory hypothesises that pain is experienced when specific nerve endings are stimulated.

Gralow andTripathy (2007) further found that up to 70 of patients with cancer-related pain writing do not receive adequate pain relief and this affects physical and psychological well-being, leading to a lower quality of life for the cancer patients. A another report indicated that a about33.3 of cancer patient exprience pain. This perecentage rises to 75 in the advanced stages of the disease and further attempt to reduce pain and hence improve the ability to perform basic daily life activities and quality of life have been overshadowed in the attempts to cure the underlying disease, scottish. Chapman (2012) affirm that cancer pain has many dimensions including psychological, physical, social and spiritual which must be addressed in order to improve their quality of life. According to a systematic study by kessels et al (2007) indicated that pain prevalence ranges from 33 in patients after curative treatment to 59 in patients on anticancer treatment and to 64 in patients with metastatic, advanced or terminal phase. Sun, borneman and Piper (2008) explained the factors that influence the development of chronic pain in cancer survivors who have completed treatment as peripheral neuropathy due language to chemotherapy, radiation-induced brachial plexopathy, chronic pelvic pain secondary to radiation and postsurgical pain. Moreover, another systematic review of literature showed that nearly half of cancer patients were under-treated, with a high variability across study designs and clinical settings. Finally recent studies conducted both in Italy and pan European by Breivik, cherny and Collett (2009) confirmed and makes it clearly evident that different types of pain or pain syndromes are prevalent in all phases of cancer and are not adequately treated or managed. 2.1 Definition of pain pain is difficult to define due to the complexity of its anatomical and physiological foundations, and the experience and the perceptions of each individual person and the social and cultural meanings of pain Pas and seymour (2008). In contrast, McCaffery (1972) defined pain as 'whatever the experiencing patient says it is, and exists whenever he says it does 'This old but useful definition of pain is well known and still relevant to practitioners. However, the British pain society (2006) also described pain in a more functional way as an unpleasant sensation that is conveyed to the brain by sensory neurons.

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In uk, it been found that two million people have cancer or have lived with cancer experiencing pain It has been shown by study that this number of pain with cancer continue to rise annually. Despite many aware and published guidelines and educational programs on the assessment and treatment of cancer-related pain, pain continues to be a substantial worldwide public health concern in patients with either solid or haematological malignancies British pain Society (2010). Patients with long-term cancer pain have been found to report poorer make health, functional or psychological disability as a result of their cancer pain. Macmillan Cancer Support (2008). Laird and Colvin (2008) added that cancer-related pain is a huge public health issue and represents a significant challenge to patients and healthcare professionals. Pain in cancer patients may be down to pre-existing pathologies, progression of the disease, tumour growth, bone metastases (cancer-intduced bone pain, cibp) or the treatment of cancer itself (Strong 2002; Twycross 2008; Urch 2008). These writers concluded that pain due to metastatic cancer is often severe, unrelieved and poorly controlled with patients often having to take high doses of drugs with undesirable side-effects.

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Many studies of cancer pain occurrence have demonstrated that about 30-50 of patients in receive of cancer treatment experience pain with advanced disease as indicated by Abernethy, samsa and Matchar (2003). The world health Organization (who reported that the gradual increased incidence of cancer in 2008 was and based on this figures, the incidence of cancer will be 15 million in 2020. Suggesting that the incidence of cancer pain will continue to rise if appropriate measures and interventions are not put in place by then. British pain Society (2010) reported that pain is a major indication of all stages in cancer conditions. This pain experience or symptom can be the first signal to patients with cancer and may be an indication of relapse after curative treatment which many patients with metastatic disease may present due to suboptimal pain treatment. Kassa (2010) indicated that many patients with cancer are continuously complaining that pain is the symptom they mostly fear and that they hypothetically think of seeking for euthanasia in a state of unbearable pain which makes life difficult for them. This report further indicating that pain associated with cancer continues to be a huge health problem for patients and may presents a major health issue to the society and the nation as a whole.

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Subsequently, further research was carried out through the Internet, accessing the wiley online library, world health Organization and The oncology nursing isociety, british pain Society website, and various Nursing journals online. In addition specialist journals available in the nursing library and discussions with specialist nurse practitioners and course tutors were used. The university library was used at length and assistance obtained from the librarians with expertise of doing searches some limitations of the electronic searches were encountered. The importance of using many approaches to identify appropriate literatures was emphasized by Greenhalgh and peacock (2005).This process was followed in aiding me to make look up for reference lists in journals which gave me useful insight into the topic. Hand searches were also sorted from related journals and publications from health institutions such as the national Institute for Clinical Excellence, department of health on the topic cancer pain, by going through the content pages for relevant articles. 1.3 Inclusion and Exclusion Criteria, i set an appropriate criterion to assists me in focusing on the project topic, as explained in aveyard (2010).

The exclusion and inclusion criterion sets the limits for my review and therefore helped guide me in staying focused within the select subject. In setting the inclusion criterion, secondary data research was used extensively and publications researched in English focussing on the cancer pain assessment essay and how the nurse can improve pain assessment for cancer patients. Literature review, the literature review aim to stress and identify areas of unending poor practices or gaps in care delivery to aid in discussing knowledge and evidence based practice in managing cancer pain. The nurses and Midwifery council (2002) also necessitate a registered nurses to keep up with their professional knowledge and competency on up to date evidence, best practice and if possible bases on applicable available validated research Valente (2003). This desired practice can be successful when nurses and midwifes build up attitude and an understanding of the need to carry out research process and demonstrate the ability to research and critically question research Ingham-Broomfield (2007).

There following inclusion criteria were deployed in assisting to get the most of up to date related literature. Secondary research articles, english Language. Literatures from, literatures relevant to the chosen topic. In setting these inclusion criteria under consideration the literature searching started from the ovid database, searching through cindhl (Cumulative index to the nursing and Allied health Literature medline and the bni (British Nursing Index). The literature searching commence with the electronic search on data bases such as psyinfo, medline and cinahl as these databases contain a rich and resourceful information on health and the social sciences as indicated by gerrish and Lacey (2006). Boolean Operators was used to give the search engine the key words to either include or exclude Ely and Scott (2007).


These are and, or and not. And or not which turn to narrow the search whiles or broadens. This boolean Operating system was employed in combining the appropriate keywords to aid in looking up for literature review. The key words are as follows: Cancer pain experience, pain management, terminal pain suffering in cancer. Terminal cancer care, chronic cancer care, nursing role and interventions in cancer pain. The results were then combined and narrowed down to meet the research subject. This search focused on the identification of qualitative literatures relevant to the experience of cancer pain. The research period is from in order to obtain an up- to -date literature to improve practice.

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My primary goal is to discuss and analyse the role of the nurse and other multidisciplinary team involved in delivery an evidenced based care in meeting the holistic assessment of pain for the adult cancer patients. I will also look at barriers that prevent effective pain assessment and finally research for literature reviews from World health Organisation and the national guidelines, policies and recommendation that underpins the assessment and management of oncology pain. To achieve these objectives, a literature search was conducted. 1.2 search Strategy, polit et al (2006) argued that the aim of carrying out a literature search differs from one researcher to the other. However the nursing paper Times (2007) identified another rationale for conducting a literature search by stating that literature search a well thought and organized search for all of the obtainable literatures available on a chosen topic. They further went on to say that a thought through literature search is the most valuable and well-organized way to search for sound evidence small on the topic in question. These evidence based literatures were researched in books, journals, government documents and the electronic data base. The purpose for conducting literature search for this project is to enable me to obtain articles needed for this piece of work and finally to draw together more information on the chosen subject in order to make an informed discussion in building up knowledge for.

nursing essay writers uk

The purpose of this dissertation is to explore recent literature reviews which focuses on nursing practice aimed at identifying gaps in cancer pain assessments and management. To be able to achieve this, i will be demonstrating personal competency in analysing and critiquing available literatures and evaluate their impact on healthcare practice. The chosen topic for this dissertation is cancer pain assessments and management. This is a very interesting topic as there is still more knowledge to be explored. The rationale for this selection is in twofold: first and foremost, this is a topic of personal interest. Having cared for a family member experienced pain during cancer ill health and again coming into contact with patients suffering from aggressive cancer pain as a student nurse in placements have further promoted my passion and interest around the topic. Lastly, by writing this thesis it is hoped to further enhance personal knowledge and skills in the nursing profession required to understand, manage and assess oncology pain effectively in preparation to becoming a qualified nurse.

or interventional procedures persist to have a large effect on cancer patients' survivors' quality of life. This makes it obvious that nurses are uniquely placed in healthcare and have a duty of care in pain assessment for cancer patients and to make sure that pain management strategies are initiated to improve patient's life, chapman (2011). The need to change clinical practice demands healthcare practitioners to regularly develop and enhance their knowledge and skills to make sure they are abreast with best practices. Nursing research consequently focuses on knowledge that is useful in the practice by creating knowledge that influence best clinical practice burns grove (2006). Nurses need to continually look for solutions, choices and outcomes for patients that represent the best available knowledge to constantly improve and validate nursing care, polit and Beck (2009).The emergence of evidence-based practice and the development of an evidence base for nursing, the pressure. They all reflect a desire to deliver the best nursing care as possible. Pearson, field and Jordan (2007).1 The rational for the topic.

Out of these 180 literatures, 79 were found to be duplication. The quality of these literatures were each critically analysed and evaluated using the framework for critical Appraisal research tool. Using these criteria, i identify 25 literatures search as not directly appropriately related to the topic cancer pain but rather authors writing about various issues on cancer diseases. 20 results were eliminated as they were also directly linked with children or the palliative care. Finally, 8 core articles were carefully selected as the core articles for this project as they provide recommendations through consensus to provide a useful cancer-related evidenced base pain guide for practice. Conclusion, further research and education need to be carried twist out in supporting clinicians particularly, the nurses who are in constant contact with cancer patients. These training and support will enhance the effectiveness of implementing cancer pain assessments and treatments to patients thereby increasing service quality and controls the output of front line workers.

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Essay writer is dedicated to offering a high quality and affordable custom essay and dissertation writing service tailored to your individual requirements. Our ethics is to provide the homework best possible customer service - your success is Essay writer's first priority. Print, reference this, published: 23rd March, 2015, the aim of this project is to a literature review to emphasize the occurrence of inadequate assessment of pain in cancer patients and to identify the significant role of the nurse in the modern multi-professional team in delivering. Pain is one of the most prevalent and distressing symptoms in patients with advanced cancer. Almost 70 of patients with cancer experiences pain at a point through the progression of their diseases. Even though most patients achieve adequate pain control, patients with more complex pain syndromes continues to fail to obtain adequate pain management, fainsinger et al (2010). Design, the literatures searches was carried out on a major data base through journal and researched publications relating to the subject the role of the nurse in effective cancer pain assessment. However, 5 main articles were critically analysed using the Critical Analysis Framework. Findings 176 of papers of potential interest were identified through database searching and 4 additional records identified from other books and publications.


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