Moreover, fully three-quarters of the surveyed nurses reported that the lack of adequate assessment of cancer pain was a significant barrier to effective pain management, and almost as many (72%) reported a lack of clinician knowledge as representing yet another significant barrier to effective pain management (Vorthern and Ward 1992). Given the complexity of the pain experience, helping caregivers provide appropriate levels of pain management is particularly challenging. Many caregivers may be reluctant to provide adequate levels of opioids for pain management in the home based on fears of addiction, levels of tolerance, potential side effects of the drugs and whether increased opioid treatment reflecting disease progression (Aranda et al. 2003). Although the sample used in their study was relatively small (n=75), Aranda et al. (2003) conclude that, "The increasing role of the family in managing the patient's pain in the home environment and a recognition that family beliefs and attitudes will influence the success of their role adds to the growing call for intervention development that includes the family caregiver as a target of such work" (342). Taken together, these issues indicate that day-to-day dealings with pain patients and colleagues tasked with the provision of effective opioid-based pain management protocols must be based on factual realities rather than preconceptions that can result in unnecessary suffering and litigious outcomes. Conclusion

The research showed that although the experience of pain is virtually universal, the effective management of pain is complicated by a number of barriers, including psychological barriers among both pain patients and healthcare providers alike. These psychological barriers were shown to include misperceptions concerning the need for opioid analgesics from the outset, and extended across the board to include significant differences in how pain is experienced by different people at different times. Clinicians may be reluctant to provide adequate levels of pain management for fear of patients becoming addicted...

In the final analysis, each patient is unique and will experience pain differently. The task of the healthcare provider is to accurately assess the level of pain and provide clinical interventions that are founded on evidence-based practices rather than personal misperceptions that may cause unnecessary suffering.
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Ward S.E., Goldberg N., Miller-McCauley V.,…