Symptom management and its barriers among patients with terminal advanced cancer in Thailand

Abstract

Aims Effective symptom management is important part of end of life care. It is aimed at improving the quality of dying. The findings presented in this conference are taken from a larger project, the aim of which was to explore the experience of patients living with terminal cancer in southern, Thailand. This presentation reports on one of the main themes under this study's investigation; symptom management and its barriers. Method A longitudinal qualitative study was conducted. Fifteen patients who had been diagnosed with terminal cancer and 20 caregivers were recruited. Series interviews and observations were employed. Content analysis was applied. Findings The common symptoms perceived by patients as most burdensome and distressful were lack of energy, anorexia, pain and dry mouth. Family played a key role in managing symptoms for the dying patients. Symptom management strategies used by family caregivers focused not only on searching for cure by using complementary therapy, but also on managing everyday symptoms based on their beliefs and experiences. The barriers to manage symptoms consisted of attitude and concern about medication and its side effects, lack of knowledge about symptoms and symptom management, patients' wills to live, limited access due to the services system, and communication gaps among persons involved in care (doctor-care giver, care giver-care giver, patient-care giver). Conclusion The finding from this research will provide a picture of experiences of patients with terminal advanced cancer. Awareness of effects of perceived barriers to symptom management will guide healthcare providers to develop effective interventions to improve quality of life among these patients.

Symptoms experienced by cancer patients and barriers to symptom management

“…[ 5 ] Nilmana et al . [ 6 ] and Harding et al . [ 7 ] reported in their study that most of the cancer patients had pain (87.5%), lack of energy (77.7%), feeling sad (75.9%), feeling of drowsiness (72.3%) and worry (69.6%).…”

“…The present study showed that barriers to symptoms management were: Worry about side effect (71.4%), fear of addiction (23.1%) and pain medication harm the immune system (89.0%). Similar findings on barriers were observed by Nilmana et al .,[ 6 ] Edrington et al . [ 9 ] and Ward et al .…”

Physical problems and needs of patients in palliative care center

“…6 87.5% of cancer patients reported pain in another study by Nilmana et al 7 Pain results either from illness and its treatment or cooccurring illnesses. Increase in the intensity of pain is usually seen in the last four months before death and it is linked to nociceptive or neuropathic mechanisms or both pain types.…”