B St Marie
Published by WB Saunders (2002)
ISBN: 0-7216-9089-0. 564 pages plus index.
Despite the availability of a number of effective pharmacological and non-pharmacologic pain therapies, pain continues to be a major problem for a significant proportion of people with cancer. Many organisational, patient and health care provider factors have been identified as contributing to this problem. Education of health care professionals is, therefore, an important strategy in efforts to improve pain management.
Core Curriculum for Pain Management Nursing has been developed to help nurses improve their knowledge about assessment and management of acute, chronic and cancer pain throughout the life span. The scope of the text is broad, covering pain management issues in various clinical and sociocultural contexts. Section one covers curriculum content relating to foundational concepts of pain management nursing, including philosophical, epidemiological, cultural, legal, ethical and theoretical perspectives of pain. Section two addresses various clinical issues in pain management, while section three includes chapters addressing nursing roles and models for delivering pain management services.
Each chapter presents a list of topics for inclusion in pain curricula, with a brief description of content areas to be addressed. Many of the chapters provide extensive references lists, as well as useful tools for clinical practice. For example, the chapter on cultural perspectives includes numeric pain rating scales translated into various languages. Similarly, the chapter on pharmacological agents provides a useful overview of adult drug doses including routes, average does ranges and intervals and other special considerations for drugs, including antidepressants, anxiolytics, hypnotics, NSAIDS, opioids and steroids. While the chapter does not elaborate on how such dosage guidelines may be applied or modified in more complex and rapidly changing pain management situations, such as in palliative care, the information presented does provide a concise overview of the many agents that have potential uses in pain management. The chapter on pain assessment also provides a useful framework for nursing practice, although it does not cover in any depth the importance of assessment data obtained from clinical investigations that may help to determine various pain mechanisms and appropriately tailored management strategies.
The strength of the text is its broad perspective and its clear definitions and descriptions of complex pain management concepts. Attention to the specific needs of special populations, such as older persons, children and chemically- dependent persons is also a useful addition. The text is targeted primarily to the US audience, and as such epidemiological data, legal and regulatory references and some drugs are not applicable to the Australian setting.
Moreover, as a core curriculum, the text focuses solely on content and areas of knowledge, rather than on practice or competency outcomes, or on teaching and learning processes that will help to achieve desired learning outcomes. Nonetheless, the text does provide a valuable resource not only for those involved in designing educational programs for nurses, but also for nurses in practice who are looking for a guide to assist their own learning in this field.
Faculty of Health
Queensland University of Technology
Centre for Palliative Care Research and Education
Kelvin Grove, QLD