Striving to respond to palliative care patients' pain at home: a puzzle for family caregivers.

PURPOSE/OBJECTIVES to describe the types of pain patients in palliative care at home experience and how family caregivers assess them and intervene. RESEARCH APPROACH qualitative using grounded theory. SETTING family caregivers' homes. PARTICIPANTS 24 family caregivers of patients with advanced cancer receiving palliative care at home. METHODOLOGIC APPROACH semistructured interviews and field notes. Data analysis used Strauss and Corbin's recommendations for open, axial, and selective coding. MAIN RESEARCH VARIABLES pain, pain management, family caregivers, palliative care, and home care. FINDINGS caregivers assessed different types of pain and, therefore, were experimenting with different types of interventions. Not all family caregivers were able to distinguish between the different pains afflicting patients, and, consequently, were not selecting the most appropriate interventions. This often led to poorly managed pain and frustrated family caregivers. CONCLUSIONS The accurate assessment of the types of pain the patient is experiencing, coupled with the most appropriate intervention for pain control, is critical for optimal pain relief as well as supporting the confidence and feelings of family caregivers who are undertaking the complex process of cancer pain management. INTERPRETATION nurses involved with patients receiving palliative care and their family caregivers should be aware of all types of pain experienced by the patient and how caregivers are managing the pain. Nurses should be knowledgeable about different pain relief interventions to help family caregivers obtain accurate information, understand their options, and administer these interventions safely and effectively.