Pain management is a significant concern in many areas of nursing practice, including oncological care. Adequate pain management leads to improved quality of life by reducing cancer patients’ symptoms following chemotherapy treatment. Although opiates are used as the primary pain management strategy, cannabis-based treatment could also be effective. The chosen PICOT question is, “In cancer patients(P), how does Cannabidiol (CBD) (I) compared with opioids (C) affect pain(O) over chemotherapy treatment? (T)”.
Study Population
The selected population includes cancer patients undergoing chemotherapy treatment. This type of treatment is associated with several unwanted side effects, including peripheral neuropathic pain (Park, 2014). Cancer patients can also experience pain for other reasons, and the pathophysiology of cancer pain is often poorly understood (Fallon et al., 2018). The primary need of patients with cancer who are in chemotherapy is to maintain the highest possible quality of life.
Pain often prevents them from being socially active and interferes with coping, which may lead to poor mental health outcomes. Patients with cancer pain that cannot be managed using non-opioid analgesics usually receive prescriptions for opioids (Fallon et al., 2018). Nevertheless, opioids are highly addictive and pose threats related to overdosing. This can inhibit the beneficial effect of pain management on cancer patients’ quality of life. Hence, considering other options, such as cannabidiol, would be helpful.
The Theory
The key nursing theory that can be applied to cancer pain management is Katharine Kolcaba’s Theory of Comfort. This theory posits that nursing is the process of assessing patients’ need for comfort and meeting it using appropriate care plans (Puchi, Paravic-Klijn, & Salazar, 2018). There are three types of comfort described in Kolcaba’s theory: relief, ease, and transcendence. This theory is relevant because cancer patients experience the need for all of these types of comfort because they experience both physical and psychological challenges. Successful cancer pain management aims to provide lasting relief, thus meeting patients’ comfort needs. Practicing by Kolcaba’s theory also requires nurses to address patients’ mental health needs, for instance, by referring them to a qualified counselor or offering recommendations for achieving higher levels of social support.
Research Design
Evidence-based practice is the key to successful pain management because it enables nurses to use research to develop appropriate care plans (Melnyk & Fineout-Overholt, 2019). Evidence-based practice usually relies on results from quantitative studies because they provide statistically sound findings (Turner, Balmer, & Coverdale, 2013). Hence, determining the comparative effectiveness of cannabidiol and opioids for cancer pain management requires the use of a quantitative method. In particular, it would be useful to conduct a randomized controlled trial by measuring patients’ numerical pain rating and comparing the results between the intervention and the control group (Ingham-Broomfield, 2014). This design would allow collecting information required to support positive changes in evidence-based practice, thus helping to enhance cancer pain management.
Conclusion
Overall, cancer pain is an important problem because it reduces patients’ quality of life and affects their overall well-being. Patients with cancer need adequate pain management to participate in regular activities and cope with their diagnosis more effectively. Kolcaba’s Theory of Comfort is suitable for oncological nursing practice because it stipulates the nurse’s role in providing physical and psychological comfort to patients.
Based on this theory, appropriate pain management strategies offer comfort in the form of pain relief. To study cannabidiol as an alternative to opioid pain management, it would be useful to apply the randomized controlled trial methodology to measure the level of pain reported by patients using one or the other medication. The results of the trial will provide reliable results that could enhance evidence-based practice in cancer pain management.
References
Fallon, M., Giusti, R., Aielli, F., Hoskin, P., Rolke, R., Sharma, M.,… ESMO Guidelines Committee. (2018). Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines. Annals of Oncology, 29(4), iv166-iv191.
Ingham-Broomfield, R. (2014). A nurses’ guide to quantitative research. The Australian Journal of Advanced Nursing, 32(2), 32-38.
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Walters Kluwer.
Park, H. J. (2014). Chemotherapy-induced peripheral neuropathic pain. Korean Journal of Anesthesiology, 67(1), 4-7.
Puchi, C., Paravic-Klijn, T., & Salazar, A. (2018). The comfort theory as a theoretical framework applied to a clinical case of hospital at home. Holistic Nursing Practice, 32(5), 228-239.
Turner, T. L., Balmer, D. F., & Coverdale, J. H. (2013). Methodologies and study designs relevant to medical education research. International Review of Psychiatry, 25(3), 301-310.