Moreover, fully three-quarters of the surveyed nurses reported that the lack of adequate assessment of cancer pain was a significant barrier to effective pain management, and almost as many (72%) reported a lack of clinician knowledge as representing yet another significant barrier to effective pain management (Vorthern and Ward 1992). Given the complexity of the pain experience, helping caregivers provide appropriate levels of pain management is particularly challenging. Many caregivers may be reluctant to provide adequate levels of opioids for pain management in the home based on fears of addiction, levels of tolerance, potential side effects of the drugs and whether increased opioid treatment reflecting disease progression (Aranda et al. 2003). Although the sample used in their study was relatively small (n=75), Aranda et al. (2003) conclude that, "The increasing role of the family in managing the patient's pain in the home environment and a recognition that family beliefs and...
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