The experience of caregivers in managing pain with morphine in advanced cancer patients receiving palliative care at home

Abstract

Advanced pain management in palliative care patients is complex and important in order to achieve a good quality of life and a dignified death. This qualitative study aimed to study the pain management experiences of caregivers of end-of-life cancer patients receiving palliative care at home. The samples were purposively selected of 11 caregivers of end-of-life cancer patients receiving palliative care at home for key informants until saturated data. Data were collected through in-depth interviews and observation during interviews, and audio recordings. The research was conducted in the area of Lomsak district, Lomsak hospital, Phetchabun province between November 2020 and March 2021. Qualitative data were analyzed using data triangulation and content analysis for theme finding.

The results revealed that the experiences of caregivers of end-of-life cancer patients receiving palliative care at home were divided into 3 themes including 1) perceived morphine as both an analgesic and narcotic, 2) morphine using methods of caregivers that included three-step approach: goal of morphine use; pre-administration assessment and morphine administration methods. The caregivers aimed to give the drug to avoid patients suffering and assess the pain before administering by managing the drug on time or according to the pain, and 3) the barrier to using morphine was the taste of morphine, the belief that morphine is an addicting drug, and fear of using a device to administer morphine. In conclusion, healthcare professionals need to communicate with patients and caregivers about morphine use in order for caregivers understand and conformable medication goals. In addition,
there should be advice on pain assessment, drug utilization, dosing devices, and contact methods for consultation from healthcare professionals. This will help caregivers to use morphine for appropriate and quality management of pain in end-of-life cancer patients receiving palliative care at home.