Introduction
The effective assessment and management of pain in patients is a crucial undertaking in the care of patients (Anderson 2009, pp.23-24). The task becomes even more significant when the patients are suffering from a fatal condition such as cancer in general and lung cancer in particular. Pain can accelerate the degeneration of the patient and lead to early deaths (Ferrell 1995, pp.609-616). The focus of medical care is to enable people to live as long as possible and in a comfortable way (Cleeland 1991, pp.823-826). Comfort is not possible in the presence of pain. Proper handling of pain starts with the careful examination of the patient to tell whether there is pain or not (WHO 2006, pp.19-24). The outcome of this type of exercise is dependent on certain factors that can make the assessment smooth or problematic. Those that make it problematic are barriers to effective pain assessment while those that facilitate the smooth examination of pain are the ones referred to as enablers of effective pain assessment. The same enablers and barriers are found in pain management. The facilitators to the proper handling of pain in a patient by both patients and the caretakers are enablers while those that hinder the proper management of pain are called barriers to proper pain management. This essay will discuss both barriers and enablers to proper pain assessment and management in patients suffering from lung cancer, which is a fatal condition. The discussion will be capped by a brief conclusion.
Barriers to Effective Pain Assessment in Patients with Lung Cancer
The absence of adequate education to lung cancer patients on how to assess their pain is one of the major barriers to effective pain assessment (Grossman, Benedetti, Payne & Syrjala1999, pp.34-38). It is justifiable to state that when a patient has information on how he or she feels is likely to when suffering from lung cancer, this patient can estimate the extent to which the pain will rise and therefore seek medical attention in advance if it will be higher or bear it if it is manageable. But in most cases, people suffering from lung cancer are not given the required information to be in a position to assess pain before it is too late. It is from this perspective that the pain is viewed as unchecked given that no one knows how serious it can get. In most cases, the patients decide to seek medical attention when it is too much and too late. It is almost definite that remedial measures may fail to work in cases that have run out of control. The contrasting scenario to inadequate patient education as far as pain assessment is concerned is whereby the lung cancer patient is equipped with all the essential information and instructed to report certain signs to qualified medical personnel for appropriate action(Gunnarsdottir, Serlin & Ward 2005, pp. 273-280).
Secondly, communication is a serious barrier to pain assessment among lung cancer patients. Cases of lung cancer patients whose level of communication has seriously been impaired due to the damage to the lung are commonplace. The frequent coughing is a source of interruption that cuts words midway; a phenomenon that makes it very difficult for medical personnel to understand what the patients are trying to communicate to them. The same problem is encountered by all the other caretakers who stand a chance of carrying out a careful pain assessment on the patient, and this leads to improper pain assessment. The case would be different if the patients had unimpaired communication ability in that they would then be able to tell their caretakers how they are reacting to medication as well as other forms of care and this would help the caretakers to assess their pain (Jacox, Carr & Payne 1994, pp. 199-201).
Far from impaired communication among lung cancer patients, the shortage of required equipment is a big obstacle to the effective assessment of pain. In the examination of most medical conditions, special equipment is always needed (Zech, Grond, Lynch, Hertel & Lehmann1995, pp. 65-70).
Some special items or tools are needed by medical personnel as they try to examine the level of damage the lungs have undergone. This level of damage enables the doctors to predict the level of pain the patient may be experiencing as he or she lives with the disease. What happens in the absence of this equipment? The medical personnel will not be in a position to carry out this delicate procedure of examining the level of damage in the lungs. Thus the level of pain the patient may be experiencing will not be estimated or predicted. If it is high, the patient will suffer silently. This is particularly a risk in cases where the conditions have deteriorated and only a short period stands in between the examination period and the commencement of the immense pain. With proper tools, the doctors or the nurses will be able to know that in the next one or two days the patient will begin experiencing too much pain and therefore remedial actions can be taken. But as already mentioned when these tools are not available this prediction is not possible and when the extreme pain settles in, it is too late to help the patient.
Besides the above, poor monitoring is another key element that has hampered the effective assessment of pain among lung cancer patients. The changes that occur in the bodies of people suffering from lung cancer are many and they occur at great speeds at certain stages of the illness (Mazzone 2009, pp.67-68). This, therefore, means that if slight but vital changes are to be detected, there has to be continuous monitoring of the patients suffering from lung cancer. This kind of continuous monitoring is not sometimes adequate for both the patients themselves as well as the person taking care of them and this leads to a condition where these changes go undetected. The absence of detection of these changes means that the chance to make an effective assessment of the pain the patient is likely to experience at certain periods as dictated by the progression of the disease is lost. This is a big impediment to the effective assessment of pain in patients suffering from lung cancer.
Enablers to Effective Pain Assessment In patients with Lung Cancer
The top enabler to effective assessment of pain in patients with lung cancer is the education o the patients themselves. As already mentioned elsewhere in this essay, when the patients are given proper education as far as the facts regarding the disease are concerned, they will be in a position to take a careful look at their condition and know what some of the critical signs mean. For example, if a lung cancer patient is informed that too much coughing or difficulty in breathing will be accompanied by extreme pain in the diaphragm, they will keenly lookout for these signs and seek medical attention whenever they experience them. Thus they will be able to assess their pain and this has a bearing on pain management.
Besides proper education of patients regarding the behavior of lung cancer, the presence of the appropriate equipment in some cases is a huge facilitator towards the effective assessment of pain (Parles & Schiller 2009, pp.34-37). As also identified elsewhere in this essay, some special tools or items are required to make up to date measurements of body fluid temperature as we as the concentrations of other constants to be in a better position to tell how severe the pain will get or how much it will reduce within a certain amount of time. It is possible that in some places this equipment is accessible to both the patient as well as the rest of the caretaker team. This is a great contributor to the whole exercise of effective pain assessment. The parts of the world where lung cancer patients have to do without the said equipment have poor ability to assess the extent of the pain they are likely to experience and that outcome is not medically positive. The developing countries with limited financial resources to support health initiatives are particularly vulnerable to this situation.
The third enabler to effective pain assessment is the careful constant monitoring that is affordable in most developed countries such as the United States but absent in most developing countries. This monitoring is very important as an enabler as it avails the capable hands that examine every change in the patient and this monitoring helps in predicting moments of intense pain. The monitoring also becomes very important in cases where the patients are not educated on how to monitor their pain because the personnel who do the monitoring do the pain assessment.
Barriers To effective Pain Management
Pain management is made difficult by financial constraints within the healthcare systems. How does this happen? In the management of pain, there are special drugs that are very important in enabling medical personnel to control pain in their patients. These drugs are made available through the investment of huge financial resources by the government. What then happens if the financial resources are not sufficient? The definite effect of this I that the drugs will not be availed and therefore controlling pain among patients will not be possible. Is this the only dimension that brings finances into the pain management issue?
There is another dimension to the financial issue as it relates to pain management. The equipment that is vital in pain assessment is availed through the use of money. The same applies to the employment of personnel who monitor the progress of the patients suffering from lung cancer. In the absence of sufficient financial resources, these items will not be achieved and therefore it is not possible to carry out a proper assessment of pain. Pain that is not properly assessed is pain that is not properly managed.
In addition to the above, the increase in health complications has played a major role in the absence of effective pain assessment among lung cancer patients. In modern days, it is not surprising to get an individual with lung cancer who is also obese and has other health complications such as high blood pressure or high blood sugar levels. In such cases, an attempt to assess the level of pain in lung cancer patients whose systems are also be affected by these maladies will lead to erroneous assessment whereby the patient may be feeling false comfort which shifts to a different level in a short while. In the most conventional medical case of a lung cancer patient, it is possible to carefully analyze the level of pain the patient is experiencing if lung cancer is the sole condition that the patient is suffering from. But this is different when other issues come in.
Far from the above, there are rare cases where the medical personnel who are charged with the responsibility to measure pain or assess pain are not properly trained (Potter, Wiseman, Dunn & Boyle 2003, pp. 153-160). This is a sure way of making the wrong assessment of pain that the patient is going through and this leads to more problems for the patient. How often does this happen? The frequency of unqualified medical personnel making mistakes in pain assessment is higher in places where the resources to give medical personnel adequate training are lacking. But in areas or regions where the resources are available, the doctors and nurses are trained properly and therefore enabled to carry out effective pain assessments. This, therefore, makes inadequate training of medical personnel a contributing factor in ineffective pain assessment.
Enablers to effective pain management in Lung cancer patients
The top enabler to effective pain management among patients suffering from, lung cancer is the level of training that caretakers for cancer patients are given. People who are charged with the responsibility of taking care of patients with serious fatal conditions such as lung cancer are usually given adequate training and this enables them to know the actions to take to reduce the level of pain lung cancer patients are experiencing.
The high-level medical inventions and discoveries are also very crucial enablers to pain management in lung cancer patients (Foley 1985, p.8495). There are special machines that are now available whose ability to make up-to-date examinations on the lungs of lung cancer patients is unrivaled. This is important in the management of pain since the medical personnel can use the obtained data to predict the next stage of the condition and prepare adequately in terms of how they will be able to deal with it to ensure that the patient is not suffering. This would not be possible in the absence of these discoveries or inventions.
There is also the education that is given to patients suffering from lung cancer which is crucial in guiding them on how to handle themselves to reduce their pain (Lange 2009, pp.56-57). This education is not sufficient as mentioned elsewhere but the much that has been done is helpful and if it is done to maximum levels, patients who are suffering from lung cancer will be able to handle their pain in a better way. For example, the fact that most patients of lung cancer have been informed that exposure to smoke as well nicotine, and carcinogen worsens their pain has been instrumental in modeling the behavior of lung cancer patients along the right lines. Education is a source of empowerment that makes them do the right things to avoid worsening their pain. What will happen if this education is given to all lung cancer patients? The results are easy to predict. The patients will be able to know the right things to do to avoid worsening the lung cancer and therefore adding to their pain and suffering. This is clear evidence that the education of lung cancer patients on the best ways to handle themselves is a vital enabler in the management of pain among lung cancer patients.
Conclusion
From the above essay, it is evident that lung cancer patients can have their pain effectively assessed and managed or ineffectively assessed and managed. The hindrances to effective assessment of pain in lung cancer patients include the low levels of education among some lung cancer patients (Ward, Hughes, Donovan & Serlin 2001, pp.148-155), poor communication ability among some lung cancer patients, shortage of proper equipment for pain assessment purposes, and absence of monitoring. The enablers to effective assessment of pain in lung cancer patients include patient education, the advances that have been made in medical technology, and the presence of monitoring services especially in developed countries (Beck & Falkson 2001, pp. 75-81). Pain management is hampered by the absence of financial resources to secure the required medication for pain management or the hiring of the required personnel for monitoring purposes. It is also hampered by the absence of education of some lung cancer patients and the increase in the number of complications that afflict lung cancer patients whereby it is not uncommon to come across a lung cancer patient who has obesity and hypertension in addition to lung cancer. The fact that some cases of inadequate personnel training are present in the care of lung cancer patients means that managing the pain of lung cancer patients is difficult. The facilitators or enablers to effective pain management include patient education, technological advancement in medication, and high-quality medical care.
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