Author Affiliations: Colleges of Nursing (Drs Marshall and Efre) and Public Health (Mss Chavez and Lake and Dr Tyson) and Department of Mental Health Law and Policy, College of Behavioral and Community Science (Dr Rigg), University of South Florida; and Moffitt Cancer Center (Drs Lubrano, Pabbathi, and Rajasekhara), Tampa, Florida.
Cancer Nurs. 2023;46(5):386-393. doi: 10.1097/NCC.0000000000001126. Epub 2022 Dec 11.
Cancer survivors can experience long-term negative effects from cancer and its treatment. Pain is one of the most common and distressing symptoms that cancer survivors experience. Opioids are often prescribed for pain; however, cancer survivors who have completed active treatment may have unique challenges with regard to pain management.
The aim of this study was to explore barriers to pain management and perceptions of opioid use among cancer survivors.
This research was an exploratory pilot study using in-depth qualitative interviews with adult cancer survivors who were recruited from community-based survivorship organizations. Data were analyzed using applied thematic analysis techniques.
Participants (n = 25) were mostly women (96%), diagnosed with breast cancer (88%) and stages I to III disease (84%), with a mean age of 56.2 years. Three themes on barriers to adequate pain control emerged: (1) taking just enough to take the edge off: self-medicating behaviors and nonadherence to prescribed regimen; (2) lack of insurance coverage and costly alternative pain treatment options; and (3) chronicity of cancer-related pain not adequately addressed and often mismanaged.
Discussions with cancer survivors unveiled personal accounts of unmanaged pain resulting from limited pain management/opioid education, fear of opioid addiction, negative perceptions/experiences with opioids, lack of insurance coverage for alternative pain therapies, and regulatory policies limiting access to opioids.
There is a clear need for improved access to multimodal pain management options and nonopioid alternatives for cancer survivors. Oncology nurses should endeavor to support policies and procedures aimed at opioid education, training, and legislation.
癌症幸存者可能会经历癌症及其治疗带来的长期负面影响。疼痛是癌症幸存者最常见和最痛苦的症状之一。阿片类药物通常用于治疗疼痛；然而，已完成积极治疗的癌症幸存者在疼痛管理方面可能会面临独特的挑战。
本研究旨在探讨癌症幸存者在疼痛管理方面的障碍和对阿片类药物使用的看法。
这是一项采用深入定性访谈的探索性试点研究，参与者为从社区生存组织招募的成年癌症幸存者。使用应用主题分析技术对数据进行分析。
参与者（n=25）主要为女性（96%），诊断为乳腺癌（88%）和 I 期至 III 期疾病（84%），平均年龄为 56.2 岁。有三个关于充分控制疼痛的障碍的主题：（1）适量服用以缓解疼痛：自我治疗行为和不遵守规定的治疗方案；（2）缺乏保险覆盖和昂贵的替代疼痛治疗选择；（3）癌症相关疼痛的慢性程度未得到充分解决且经常管理不当。
与癌症幸存者的讨论揭示了由于缺乏疼痛管理/阿片类药物教育、对阿片类药物成瘾的恐惧、对阿片类药物的负面看法/体验、缺乏替代疼痛疗法的保险覆盖以及限制获取阿片类药物的监管政策，导致疼痛管理不善的个人经历。
癌症幸存者显然需要更好地获得多模式疼痛管理选择和非阿片类替代方案。肿瘤护士应努力支持旨在提供阿片类药物教育、培训和立法的政策和程序。
