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Module 2: Relieving Pain and Other Symptoms

ACTIVITY 6: LECTURE
Addressing Parents' Fears about Opioid Analgesia

Description

 Facilitator's Guide Download PDF  Order the video 

This seminar is comprised of two parts, "Part One: Common Fears and Concerns Regarding the Use of Opioids in Children," and "Part Two: Communicating with Parents About Opioid Medications." The videotape, There's Gotta Be Another Way: Addressing Parents' Fears about Opioid Analgesia, is used as a trigger for discussion in both Part One and Part Two. The videotape is a dramatization of a conference among three clinicians and the parents of an eight-year-old neuroblastoma patient, Miguel, for whom morphine has been prescribed to treat pain.

We encourage the facilitator to review both parts of the videotape and both parts of the Facilitator Guide. Then consider the knowledge, experience, and beliefs of the participants you expect to attend. You may choose to use Part One, Part Two, or a combination of discussion questions from each part to form a 45-minute seminar. Another option is to schedule 90 minutes in one or two sessions to present both parts in their entirety. A description and learning objectives for each part appear below.

Description of Part One

Part One, "Common Fears and Concerns Regarding the Use of Opioids in Children," begins with a 3-minute videotape segment in which Miguel's parents, Elena and Robert raise a number of concerns about giving Miguel IV morphine for his pain. The facilitator uses the questions in Part One of the Facilitator's Guide to lead a discussion about the basis for each concern, the degree to which some healthcare providers may share the parents' concern, and the medical information that could be used to mitigate parents' and healthcare providers' fears.

Learning Objectives for Part One

Participants will be able to:

  • Recognize common fears and concerns of parents and some healthcare professionals regarding opioid use and the truths and misconceptions surrounding them
  • Anticipate and respond to parents' concerns about:
    - opioid addiction
    - adverse side effects of opioids
    - accidental overdose
    - morphine's association with death
    - drug theft

Description of Part Two

In Part Two, "Communicating With Parents About Opioid Medications" the facilitator plays the 3-minute video segment shown in Part One and a second segment in which the conference continues and the three members of the healthcare team respond to Elena and Robert's concerns. This video segment is not intended as a model of excellent communication. Instead it is a trigger for a discussion about the ways in which the clinicians were effective and how they might have handled the conference better. The facilitator leads a discussion about effective communication and collaboration among parents and members of a multi-disciplinary care team on a difficult issue.

Learning Objectives for Part Two

Participants will be able to:

  • Recognize and anticipate that opioid fears are common among parents and that if not addressed, they can lead to anxiety, distrust, and a breakdown in the collaborative relationships that are needed to provide quality, family-centered care.
  • Recognize the importance of questioning and listening to parents to find out the basis of their concerns.
  • Develop a style or strategy for communicating with parents about opioid medications that:
    - Acknowledges and legitimizes parents' concerns
    - Distinguishes the facts vs. the myths regarding opioid medications and how the facts
      relate to their child's current situation
    - Explains why an opioid is necessary
    - Clarifies the choices that are available now
    - Clarifies the choices that might be available later if the situation changes
    - Be honest and forthcoming
    - Provides a role for the parents (e.g., pain assessment, monitoring of side effects)

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