Cancer pain is the most common symptom in malignancy patients. Approximately 60-90% of advanced cancer patients have experienced severe pain, which has seriously affected the life quality of these patients. There are still numerous barriers to effective pain management, some of which come from medical professionals and the medical system. There are some other reasons caused by the patients themselves, such as erroneous beliefs and misconceptions. So we conducted a series of questionnaires among patients receiving analgesics to investigate the patient-related barriers to pain management.
Patients hospitalized in Shanghai Tenth People's Hospital of Tongji University and the cooperative hospitals, receiving analgesia therapy, were enrolled in the study. Patients received questionnaires for assessment of mood, satisfaction with pain management, concerns about the agents and barriers in communication with doctors. The variables extracted were sex, cancer site and stage, education, smoking and drinking history, religion and marital status. We try to examine the correlation of the barriers and the variables above.
Of 125 patients evaluated, 41.6% of the patients had experienced moderate to severe depression, and 53.6% experienced moderate to severe anxiety. The mean BQ- II scores were 2.02 for physiologic effects, 1.78 for fatalism, 1.76 for communication, 2.23 for harmful effects and 1.97 in total. Patient characteristics including sex, smoking and drinking history, education, religion and marital status were not associated with high BQ scores. High scores for barriers to pain management were related to depression and anxiety.
Patients involved showed great fear of becoming addicted to pain medication, the belief that pain medications harm the immune system and becoming resistant to the medications. Scores on concerning physiologic effects of analgesics may be decreased by timely symptomatic treatment for the side effects. Patients had less barriers to communication and confidence of overcoming cancer pain. Depression and anxiety state may influence communication with doctors and faith in defeating cancer-related pain.
Clinical trial identification
Legal entity responsible for the study
Shanghai Tenth People's Hospital
Shanghai Health System
All authors have declared no conflicts of interest.