Barriers to Cancer Pain Management Among Nurses in Kenya: A Focused Ethnography

Abstract

BackgroundUp to 80% of cancer patients in Kenya suffer from untreated moderate to severe pain. AimThis study explored barriers to cancer pain management among nurses caring for oncology patients in Kenya. This was part of a larger study whose primary objective was to understand the role of nursing subculture on cancer pain management. DesignA focused ethnographic was used in this study. SettingsAn oncology private unit in large referral hospital in Kenya. ParticipantsTwenty-five (n = 25) nurses participated in this study. MethodsSemi- structured interviews and observations were used to collect data. Nurses were recruited through purposive, snowball sampling strategy. Content analysis led to identification of key barriers to optimal cancer pain management. ResultsOrganizational, cognitive, professional and patient/family related barriers to cancer pain management were noted. Specifically, barriers such as lack of accessibility to pain management guidelines and training, professional collaboration, restrictive dispensing guidelines, and opioid related fears were identified. ConclusionsInterventions should streamline palliative care training and implementation of pain management guidelines in both units. Interventions should consider the influence of different subcultures while implementing pain management policies and training.