Significant differences exist in the QoL of patients with breast cancer based on the coping style they adopt. Patients with breast cancer should be helped to adopt coping styles that would enhance their QoL.
It is important to assess cancer patients for the kind of coping strategies they are adopting to use in coping with their cancer burden, thereby guiding against lower QoL due to negative coping strategies. Intervention programmes could be developed to help cancer patients adopt more positive and effective coping strategies to improve patients' QoL.
Oral morphine elixir in the immediate release form became available in Nigeria in the year 2006 after decades of use in the treatment of cancer pain in many other countries. In order to determine the effectiveness of oral morphine in Nigerian patients, 182 patients presenting with severe cancer pain at the Radiotherapy Clinic, University College Hospital (UCH), Ibadan, Nigeria, were recruited in a prospective descriptive observational study. Information on patient's demography, diagnosis, baseline intensity and character of pain, morphine dosages, and effects were collected using a semistructured questionnaire administered at recruitment and biweekly in the follow-up period. Mean (+ SD) age of the patients was 47 (+ 14.6) years and the most common types of cancer diagnosed in the study participants included cancer of the breast and uterine cervix. The pretreatment pain intensity score mean (+ SD) was 8.09 (+ 1.51). Of the 166 patients whose data were analyzed, 84.3% (95% confidence interval [CI] 77.8-89.5%) achieved a 3-point reduction in pain intensity using the 11-point Numerical Rating Scale at the end of the first week of treatment. Twenty-six patients (15.7%) required adjuvant therapy. The reduction in pain intensity was maintained throughout the 3 months follow-up period, with the mean 24-hour morphine consumption of 55.54 mg in the first month and 61.54 mg in the third month. Oral morphine significantly reduced cancer pain in Nigerian patients (P < .01). Increasing dose as required was found to enhance the effectiveness of oral morphine.
Background: Pain is a symptom of both physical and psychological disorder in patients. Pain may be acute or chronic. Chronic pain can also be the consequence of progressive diseases such as cancer. Cancer pain can be defined as a complex sensation that reflects both damage to the body and the body's response to the damage. Proper pain management is crucial in the overall care of patients. The doctor-patient ratio is still low in Nigeria according to World Health Organization (WHO). 2012, we have 1:3500 doctor-patient ratio as against the standard 1:600, but that of nurse-patient is better, 1:30 as against WHO standard of 1:6, however more nurses are needed to meet the need of the rising population of Nigeria. Incidence of cancer is rising worldwide and majority of the advanced cases occur in the developing countries like Nigeria. In order to uphold the standard of cancer pain management in our patients, active participation of the nurses is essential. More importantly all health professionals need to serve as advocates for adequate cancer pain control and should ensure that pain treatment is based on ethical principles and evidence-based standards. However nurses play a critical role in effective pain management because they have more contact time with patients in any healthcare setting. This vantage position gives the nurse a unique privilege to identify patients who have pain, assess the pain and its impact on the patients and their family members, thus initiate actions to manage the pain and evaluate the effectiveness of those actions.
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