Abstract
Pain debilitates over 75% of patients with advanced-stage cancers and its management is a primary palliative care objective1. This study aimed to assess the adequacy of cancer-related pain management and identify related patient-perceptions and nursing-experiences at Shantha-Sevana and Sathya-Sai Hospices, Sri Lanka. This was a descriptive study which used expert-developed questionnaires, Brief Pain Inventory, Focus Group Discussions to collect patient data and in-depth interviews to collect nursing data. Adequacy of analgesia was assessed using Pain Management Index [PMI]. Relevant ethical clearance was obtained. Twenty terminally-ill cancer patients and nine nurses took part in the study. Assessment of analgesic adequacy in patients revealed that negative, zero and positive PMI were 40%, 35% and 25% respectively. All patients with negative PMI had moderate-severe pain with none being treated with strong opioids. Adverse patient-perceptions emerged in cognitive and emotional aspects, with pain-related depression being dominant [n=14]. Key patient-perceptions on pain-management were decrease in pain after hospice admission [n=9] and satisfaction with the pain-management provided [n=10]. None of the nurses had received structured training on pain-management for palliative care at basic or recruitment stages. No grading of pain was performed during pain-management. Conclusively, cancerrelated pain is undertreated in hospices and room for improvement exists.