| Children with cancer experience a variety of pains such as cancer-related, procedural-related, and treatment related pain. Cancer-related pain is chronic and attributed to tumor growth in various organs and tissues; procedure-related pain is acute and may be a result of lumbar puncture, bone marrow aspiration, and postoperative pain; and treatment-related pain is recurrent and associated with the side effects of chemotherapy and radiation therapy. Several studies have been conducted on the management of procedure-related pain and an increasing number of studies have examined cancer-related pain, but the literature on managing treatment-related pain is scarce (Blount, Davis, Powers, & Roberts, 1989; Katz, Kellerman, & Siegel, 1990; Smith, Ackerson, Blotcky, & Berkow, 1990; McAlpine & McGrath, 1999; Weekes & Savedra, 1988). This dissertation reviews the existing pain assessment and management literature, and the pain-related variables that influence children's self-reports of pain and their ability to effectively utilize pain management techniques.; Secondly, it addresses the gap between cancer-related, procedure-related, and treatment-related research in the pain management literature by using a cognitive-developmental approach to develop a nonpharmacological pain management model protocol for treatment-related neuropathic pain. This protocol serves as a conceptual bridge by applying concepts from the existing literature on the nonpharmacological management of cancer-related and procedure-related pain to treatment-related pain. A detailed description of the structure, administration, scoring, interpretation, and implementation of this protocol; along with a hypothetical case study that demonstrates how this protocol can be applied to children presenting with neuropathic pain is discussed. Finally, the dissertation concludes with a discussion of significant findings, protocol limitations, and recommendations for future protocols and research in this area. |
