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Intrathecal infusions for intractable cancer pain: A qualitative study of the impact on a case series of patients and caregivers
Pain Research and Management, 10/28/09
Hawley P et al. – The present study is a qualitative exploration of the impact of intrathecal pump implantation on cancer patients, and also the impact of the intervention on the staff caring for those patients. Six patients participated, with up to three interviews each. Twenty–four staff interviews took place. Patients' hopes and expectations were not always fully met, but the infusions had a profound positive effect on quality of life. Patients expressed anxiety about dependence on the device, and also on a few highly skilled individuals. Staff interviews revealed a significant impact on the 'culture' of the palliative care unit. Clear communication of the rationale for infusion was very important, as was regular education about infusion management. Implanted intrathecal infusion devices are a necessary part of a tertiary level cancer pain management service for the unfortunate minority with intractable pain. Practical recommendations for care are made for palliative care programs contemplating offering intrathecal infusions.
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