Communication and Palliative Care: E-Health Interventions and Pain Management

  • Gary L. Kreps


Pain is both a biological and symbolic phenomenon. Every physical manifestation of pain is embedded in symbolic interpretations of pain. Effective pain management treats both the physiological and symbolic aspects of pain. Typical medical interventions for pain management, such as medication and surgery, are best suited for treating the physiological aspects of pain and are less effective for influencing the symbolic aspects of pain. Strategic health communication interventions, however, can have powerful therapeutic influences on symbolic interpretations of pain. Communication has been shown to help consumers cope with pain by helping them increase their understanding about the causes of pain, their unique patterns of pain incidence, and the best strategies for pain management. Yet, access to therapeutic communication, particularly at the points in time when it is most needed, is often limited for many pain sufferers. This chapter describes the potential to use new electronic health (e-health) communication interventions to increase access to therapeutic health communication and to promote effective long-term pain management.


Palliative Care Pain Management Health Information Technology Pain Incidence Healthcare Consumer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Adler, B., Yarchoan, M., & Adler, J. R. (2011). Neurosurgical interventions for the control of chronic pain conditions. In R. J. Moore (Ed.), Handbook of pain and palliative care. New York, NY: Springer.Google Scholar
  2. Ahles, T., Blanchard, E., & Ruckdeschel, J. (1983). The multidimensional nature of cancer-related pain. Pain, 17, 277–288.PubMedCrossRefGoogle Scholar
  3. Appel, P. R., Bleiberg, J., & Noiseux, J. (2002). Self-regulation training for chronic pain: Can it be done effectively by telemedicine? Telemedicine Journal and E-Health, 8, 361–368.PubMedCrossRefGoogle Scholar
  4. Arora, N. K. (2003). Interacting with cancer patients: The significance of physicians’ communication behavior. Social Science and Medicine, 57, 791–806.PubMedCrossRefGoogle Scholar
  5. Berry, D. L., Wilkie, D. J., Thomas, C. R., Jr., & Fortner, P. (2003). Clinicians communicating with patients experiencing cancer pain. Cancer Investigation, 21(3), 374–381.PubMedCrossRefGoogle Scholar
  6. Bostrom, B., Sandh, M., Lundberg, D., & Fridlund, B. (2004). Cancer-related pain in palliative care: Patients’ perceptions of pain management. Journal of Advanced Nursing, 45(4), 410–419.PubMedCrossRefGoogle Scholar
  7. Carr, E., Brockbank, K., & Barrett, R. (2003). Improving pain management through interprofessional education: Evaluation of a pilot project. Learning in Health and Social Care, 2(1), 6–17.CrossRefGoogle Scholar
  8. Chumbler, N. R., Mkanta, W. N., Richardson, L. C., Harris, L., Darkins, A., Kobb, R., & Ryan, P. (2007). Remote patient–provider communication and quality of life: Empirical test of a dialogic model of cancer care. Journal of Telemedicine and Telecare, 13, 20–25.PubMedCrossRefGoogle Scholar
  9. Cook, A. J., Roberts, D. A., Henderson, M. D., Van Winkle, L. C., Chastain, D. C., & Hamill-Ruth, R. J. (2004). Electronic pain questionnaires: A randomized crossover comparison with paper questionnaires for chronic pain assessment. Pain, 110, 310–317.PubMedCrossRefGoogle Scholar
  10. Cowan, P. (2011). Support groups for chronic pain. In R. J. Moore (Ed.), Handbook of pain and palliative care. New York, NY: Springer.Google Scholar
  11. Detmar, S. B., Aaronson, N. K., Wever, L. D., Muller, M., & Schornagel, J. H. (2000). How are you feeling? Who wants to know? Patients’ and oncologists’ preferences for discussing health-related quality-of-life issues. Journal of Clinical Oncology, 18, 3295–3301.PubMedGoogle Scholar
  12. Detmar, S. B., Muller, M. J., Wever, L. D., Schornagel, J. H., & Aaronson, N. K. (2001). Health-related quality-of-life assessments and patient-physician communication: A randomized controlled trial. Journal of the American Medical Association, 285(10), 1351–1357.PubMedCrossRefGoogle Scholar
  13. Dobratz, M. C., Wade, R., Herbst, L., & Ryndes, T. (1991). Pain efficacy in home hospice patients: A longitudinal study. Cancer Nursing, 14(1), 20–26.PubMedCrossRefGoogle Scholar
  14. Egbert, N., Sparks, L., Kreps, G. L., & Du Pré, A. (2008). Finding meaning in the journey: Methods of spiritual coping for aging cancer patients. In L. Sparks, D. O’Hair, & G. L. Kreps (Eds.), Cancer communication and aging (pp. 277–291). Cresskill, NJ: Hampton Press.Google Scholar
  15. Eng, T. R. (2001). The e-health landscape: A terrain map of emerging information and communication technologies in health and health care. Princeton, NJ: The Robert Wood Johnson Foundation.Google Scholar
  16. Ferguson, T. (1996). Health online: How to find health information, support groups, and self help communities in cyberspace. Reading, MA: Addison-Wesley.Google Scholar
  17. Fitzmartin, G. M., Blum, D., & Swanton, R. (1995). Psychosocial barriers to cancer pain relief. Cancer Practice, 3(2), 71.Google Scholar
  18. Hallenbeck, J. (2011). Pain and intercultural communication. In R. J. Moore (Ed.), Handbook of pain and palliative care. New York, NY: Springer.Google Scholar
  19. Harris, L. M., Kreps, G. L., & Dresser, C. (2007). Health communication technology and quality of cancer care. In D. O’Hair, G. L. Kreps, & L. Sparks (Eds.), Handbook of communication and cancer care (pp. 59–71). Cresskill, NJ: Hampton Press.Google Scholar
  20. Hesse, B. W., Nelson, D. E., Kreps, G. L., Croyle, R. T., Arora, N. K., Rimer, B. K., & Viswanath, K. (2005). Trust and sources of health information. The impact of the Internet and its implications for health care providers: Findings from the first Health Information National Trends Survey. Archives of Internal Medicine, 165(22), 2618–2624.PubMedCrossRefGoogle Scholar
  21. Holland, J. C. (2003). Psychological care of patients: Psycho-oncology’s contribution. Journal of Clinical Oncology, 21(23s), 253s–265s.PubMedCrossRefGoogle Scholar
  22. Huang, H.-Y., Wilkie, D., Faan, Z. S., Berry, D., Hairabedian, D., Judge, M. K., Farber, S., & Chabal, C. (2003). Developing a computerized data collection and decision support system for cancer pain management. CIN: Computers, Informatics, Nursing, 21, 206–217.PubMedCrossRefGoogle Scholar
  23. Jamison, R. N., Fanciullo, G., & Baird, J. C. (2002). Introduction: Computer and information technology in the assessment and management of patients with pain. Pain Medicine, S3, 83–84.Google Scholar
  24. Jamison, R. N., Raymond, S. A., Levine, J. G., Slawsby, E. A., Nedeljkovic, S. S., & Katz, N. P. (2001). Electronic diaries for monitoring chronic pain: 1-year validation study. Pain, 91, 277–285.PubMedCrossRefGoogle Scholar
  25. Jamison, R. N., Raymond, S. A., Slawsby, E. A., McHugo, G. J., & Baird, J. C. (2006). Pain assessment in patients with low back pain: Comparison of weekly recall and momentary electronic data. The Journal of Pain, 7, 192–199.PubMedCrossRefGoogle Scholar
  26. Junker, U., Freyhagen, R., Längler, K., Gockel, U., Schmidt, U., Tölle, T. R., Baron, R., & Kohlmann, T. (2008). Paper versus electronic rating scales for pain assessment: A prospective, randomised, cross-over validation study with 200 chronic pain patients. Current Medical Research and Opinion, 24, 1797–1806.PubMedCrossRefGoogle Scholar
  27. Kimberlin, C., Brushwood, D., Allen, W., Radson, A., & Wilson, E. (2004). Cancer patient and caregiver experiences: Communication and pain management issues. Journal of Pain and Symptom Management, 26, 566–578.CrossRefGoogle Scholar
  28. Kreps, G. L. (1996). The interface between health communication and health psychology. Journal of Health Psychology, 1(3), 259–260.PubMedCrossRefGoogle Scholar
  29. Kreps, G. L. (2001). The evolution and advancement of health communication inquiry. In W. B. Gudykunst (Ed.), Communication yearbook 24 (pp. 232–254). Newbury Park, CA: Sage.Google Scholar
  30. Kreps, G. L. (2004). The role of communication in cancer pain and symptom management. Psycho-Oncology, 13(1 Suppl), 35.Google Scholar
  31. Kreps, G. L., & Chapelsky Massimilla, D. (2002). Cancer communications research and health outcomes: Review and challenge. Communication Studies, 53(4), 318–336.CrossRefGoogle Scholar
  32. Kreps, G. L., Gustafson, D., Salovey, P., Perocchia, R. S., Wilbright, W., Bright, M. A., & Muha, C. (2007). The NCI Digital Divide Pilot Projects: Implications for cancer education. Journal of Cancer Education, 22(Suppl 1), S56–S60.PubMedCrossRefGoogle Scholar
  33. Kreps, G. L., & Neuhauser, L. (2010). New directions in e-health communication: Opportunities and challenges. Patient Education and Counseling, 78, 329–336.PubMedCrossRefGoogle Scholar
  34. Kreps, G. L., & O’Hair, D. (Eds.). (1995). Communication and health outcomes. Cresskill, NJ: Hampton Press.Google Scholar
  35. Lindsay, S., Smith, S., Bellaby, P., & Baker, R. (2009). The health impact of an online heart disease support group: A comparison of moderated versus unmoderated support. Health Education Research, 24, 646–654.PubMedCrossRefGoogle Scholar
  36. Manzanec, P., Buras, D., Hudson, J., & Montana, B. (2002). Transdisciplinary pain management. Journal of Hospice and Palliative Nursing, 4(4), 228–234.CrossRefGoogle Scholar
  37. Marceau, L. D., Link, C., Jamison, R. N., & Carolan, S. (2007). Electronic diaries as a tool to improve pain management: Is there any evidence? Pain Medicine, S3, S101–S109.CrossRefGoogle Scholar
  38. Mendenhall, M. (2003). Psychosocial aspects of pain management: A conceptual framework for social workers on pain management teams. Social Work in Health Care, 36(4), 35–51.PubMedCrossRefGoogle Scholar
  39. Morrison, L., & Morrison, R. S. (2006). Palliative care and pain management. Medical Clinics of North America, 90, 983–1004.PubMedCrossRefGoogle Scholar
  40. Nelson, W., & Weir, R. (2001). Biopsychosocial approaches to the treatment of chronic pain. The Clinical Journal of Pain, 17(4), 114–127.CrossRefGoogle Scholar
  41. Neuhauser, L., & Kreps, G. L. (2010). E-health communication and behavior change: Promise and performance. Social Semiotics, 20(1), 7–24.CrossRefGoogle Scholar
  42. Newman, M. G., Consoli, A. J., & Taylor, C. B. (1999). A palmtop computer program for the treatment of generalized anxiety disorder. Behavior Modification, 23, 597–619.PubMedCrossRefGoogle Scholar
  43. Novy, D. (2004). Psychological approaches for managing chronic pain. Journal of Psychopathology and Behavioral Assessment, 26(4), 279–288.CrossRefGoogle Scholar
  44. Palermo, Y. (2011). The art of pain: The patient’s perspective of chronic pain. In R. J. Moore (Ed.), Handbook of pain and palliative care. New York, NY: Springer.Google Scholar
  45. Pargeon, K. L., & Hailey, B. J. (1999). Barriers to effective cancer pain management. Journal of Pain and Symptom Management, 18, 358–368.PubMedCrossRefGoogle Scholar
  46. Peng, P. W., Stafford, M. A., Wong, D. T., & Salenieks, M. E. (2006). Use of telemedicine in chronic pain consultation: A pilot study. The Clinical Journal of Pain, 22, 350–352.PubMedCrossRefGoogle Scholar
  47. Peters, M. L., Sorbi, M. J., Kruise, D. A., Kerssens, J. J., & Bensing, J. M. (2000). Electronic diary assessment of pain, disability and psychological adaptation in patients differing in duration of pain. Pain, 84, 181–192.PubMedCrossRefGoogle Scholar
  48. Pollo, A., & Benedetti, F. (2011). Pain and the placebo/nocebo effect. In R. J. Moore (Ed.), Handbook of pain and palliative care. New York, NY: Springer.Google Scholar
  49. Pronovost, A., Peng, P., & Kern, R. (2009). Telemedicine in the management of chronic pain: A cost analysis study. Canadian Journal of Anesthesia, 56, 590–596.PubMedCrossRefGoogle Scholar
  50. Rogers, M. S., & Todd, C. J. (2000). The ‘right kind’ of pain: Talking about symptoms in outpatient oncology consultations. Palliative Medicine, 14(4), 299–307.PubMedCrossRefGoogle Scholar
  51. Sehgal, N., Falco, F., Benjamin, A., Henry, J., Josephson, Y., & Manchikanti, L. (2011). Rehabilitation treatments for chronic musculoskeletal pain. In R. J. Moore (Ed.), Handbook of pain and palliative care. New York, NY: Springer.Google Scholar
  52. Short, R., & Vetter, T. R. (2011). Acute to chronic pain: Transitions in the post surgical patient. In R. J. Moore (Ed.), Handbook of pain and palliative care. New York, NY: Springer.Google Scholar
  53. Stone, A. A., Broderick, J. E., Schwartz, J. E., Shiffman, S. S., Litcher-Kelly, L., & Calvanese, P. (2003). Intensive momentary reporting of pain with an electronic diary: Reactivity, compliance, and patient satisfaction. Pain, 104, 343–351.PubMedCrossRefGoogle Scholar
  54. VanDenKerkhof, E. G., Goldstein, D. H., Lane, J., Rimmer, M. J., & Van Dijk, J. P. (2003). Using a personal digital assistant enhances gathering of patient data on an acute pain management service: A pilot study. Canadian Journal of Anaesthesia, 50, 368–375.PubMedCrossRefGoogle Scholar
  55. Wilkie, D. J., Judge, M. K. M., Berry, D. L., Dell, J., Zong, S., & Gilespie, R. (2003). Usability of a Computerized PAIN Report It in the general public with pain and people with cancer pain. Journal of Pain and Symptom Management, 25, 213–224.PubMedCrossRefGoogle Scholar
  56. Zhao, Z., & Cope, D. K. (2011). Nerve blocks, trigger points, and intrathecal therapy for chronic pain. In R. J. Moore (Ed.), Handbook of pain and palliative care. New York, NY: Springer.Google Scholar

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© Springer Science+Business Media, LLC 2013

Authors and Affiliations

  1. 1.Department of CommunicationGeorge Mason UniversityFairfaxUSA

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