NURSING STRATEGIES FOR CANCER PAIN MANAGEMENT: INTEGRATING PHARMACOLOGICAL AND NON-PHARMACOLOGICAL APPROACHES

N. Misceo¹, G. Fedelfranco² | ¹Ministry of Health, SASN Bari, Italy; ²Social Health Local District, Asl Bari, U.O. PUA/UVM, University of Bari “Aldo Moro”, Italy

Introduction. Pain remains one of the most prevalent and distressing symptoms experienced by cancer patients, affecting a large proportion of individuals during active treatment and advanced disease stages. Despite advances in analgesic therapies, cancer pain remains undertreated in many clinical settings due to assessment gaps, opioid-related concerns, and insufficient integration of complementary strategies. This scoping review maps the available evidence on nursing-led pain assessment, pharmacological monitoring, and non-pharmacological interventions in oncology settings.
Methods. A scoping review was conducted in accordance with the JBI methodology for scoping reviews and reported following PRISMA-ScR guidance. PubMed, CINAHL, Scopus, Cochrane Library, PsycINFO, and Web of Science were searched for sources published between 2008 and 2025, focusing on nursing-led pain assessment tools, opioid titration protocols, and the integration of non-pharmacological interventions such as relaxation techniques, education, and psychological support within oncology nursing practice. Data were charted regarding intervention characteristics, clinical setting, and reported impact on pain outcomes, with eligibility assessed according to JBI criteria.
Results. The included sources consistently described that systematic use of validated pain assessment scales by nursing staff improved early detection of breakthrough pain and treatment-related side effects. Nurse-led education on opioid use was reported to reduce patient fears regarding addiction and respiratory depression, improving adherence. Several sources also described the integration of non-pharmacological techniques, including mindfulness and guided relaxation, as contributing to reduced pain intensity scores and improved patient-reported quality of life, although the strength of evidence varied across study designs.
Conclusions. This scoping review indicates that comprehensive cancer pain management increasingly positions nurses as central coordinators, combining pharmacological monitoring with patient education and complementary therapies. The mapped literature reveals persistent variability in implementation models and outcome measures, highlighting the need for further primary studies and continuing education programs for oncology nurses to bridge gaps in cancer pain control.