The relationship between pain management and psychospiritual distress in patients with advanced cancer following admission to a palliative care unit

Lee, Ya Ping; Wu, Chih Hsun; Chiu, Tai‐Yuan; Chen, Ching-Yu; Morita, Tatsuya; Hung, Shih‐Chang; Huang, Paul Sin-Bao; Kuo, Chia Sheng; Tsai, Jaw‐Shiun

doi:10.1186/s12904-015-0067-2

Cited by 26 publications

(21 citation statements)

References 44 publications

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“…Pain was significantly associated with the psychological distress even after controlling performance status, age, gender, and tumor site, pain would be the only predictor . A prospective observational study also found that poor pain management may be associated with intractable depression in advanced cancer patients . Our results showed after controlling the demographic variables, clinical variables, major problem resources including physical and emotional problems, pain degree and breakthrough pain were still the predictor of psychological distress among the advanced cancer patients, and the patients with breakthrough pain reported greater HADS distress.…”

Section: Discussionsupporting

confidence: 48%

“…A logistic regression suggested that advanced cancer inpatients with breakthrough pain, higher pain degree, poorer KPS, and emotional problems may be at high risk of psychological distress. Pain was significantly associated with the psychological distress even after controlling performance status, age, gender, and tumor site, pain would be the only predictor . A prospective observational study also found that poor pain management may be associated with intractable depression in advanced cancer patients .…”

Section: Discussionmentioning

confidence: 95%

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The use of distress thermometer in advanced cancer inpatients with pain

et al. 2019

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Objective: This study aimed to provide support for the extensive application of Distress Thermometer (DT) in advanced cancer inpatients with pain and explored factors associated with high DT scores among this population. Methods: Advanced cancer patients with pain were recruited from Department of Pain Relief in Tianjin Cancer Hospital and Institute, China. They completed the DT with problems list and HADS within 48 h after admission. The cutoff score of DT was evaluated against Hospital Anxiety and Depression Scale (HADS) for its sensitivity and specificity by using receiver operating characteristic (ROC) curves. Multiple logistic regression model analysis was performed to investigate correlates of DT scores.Results: Four hundred forty one inpatients with mixed diagnoses were recruited.Referring to the cutoff of 15 on HADS, DT cutoff score of 5 yielded AUC of 0.757, with an optimal sensitivity of 0.861 and specificity of 0.531. Using the cutoff scores of greater than or equal to 5, 70.5% of the patients were distressed. Logistic regression analysis of DT found that the breakthrough pain, poorer KPS, higher pain degree, and emotional problems were the predictive factor for current distress.Conclusion: DT is efficacious in screening for psychological distress in advanced cancer inpatients with pain. Psychological distress is prevalent with a cutoff score of greater than or equal to five. To better identify the distressed cancer patients with pain, pain degree, performance status, and emotional problems should be considered together.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 95%

The use of distress thermometer in advanced cancer inpatients with pain

et al. 2019

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“…A substantial proportion of patients with cancer experience pain [ 1 ], which sometimes interferes with their daily lives and affects their mental health [ 2 , 3 ]. As stated in the World Health Organization (WHO) guidelines on pain relief and palliative care, assessment of pain and providing appropriate treatment for it are important aspects of pain management [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Negative pain management index scores do not necessarily indicate inadequate pain management: a cross-sectional study

Sakakibara¹,

Higashi²,

Yamashita

et al. 2018

BMC Palliat Care

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BackgroundThe Pain Management Index (PMI) is widely used in the assessment of pain management, and negative scores are traditionally considered to indicate inadequate pain management. However, it is not known whether negative PMI scores are always problematic.MethodsIn this prospective observational study, we examined the data of 1156 patients with cancer and pain who were hospitalized in a cancer care hospital in Japan from July 2012 to January 2015 and compared the proportion of patients with PI across various PMI scores in this cohort. We further evaluated the predictive validity of PMI scores for PI using different cutoffs. This study aimed to examine the association between PMI scores and the proportion of patients whose pain interferes with their daily lives (i.e., pain interference [PI]).ResultsWe found that lower PMI scores were generally associated with a higher percentage of patients with PI. A smaller proportion of patients with PMI scores of − 1 (567/1550, 36.6%) reported PI compared with those with PMI scores of 0 (788/1505, 52.4%). The sensitivities of PMI scores < − 1 and < 0 for predicting PI were 0.16 and 0.37 and the corresponding specificities were 0.95 and 0.71, respectively.ConclusionsThese findings suggest that PMI scores are inversely associated with the proportion of patients with PI. However, PMI scores of − 1 do not always indicate inadequate pain management; pain management should therefore be evaluated from multiple perspectives.

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“…A meta-analysis has found a dose–response effect, indicating that higher levels of psychological distress are linked to a 41% increased risk of cancer death 4. Psycho-spiritual distress, such as anxiety, depression and hopelessness, is prevalent among patients with cancer undergoing chemotherapy 5. Approximately 32.5% to 75.7% of patients with cancer experience psycho-spiritual distress, which is higher than in the population as a whole, as well as higher than in patients with other diseases 6–8.…”

Section: Introductionmentioning

confidence: 99%

Development and evaluation of a WeChat-based life review programme for patients with cancer: protocol for a randomised controlled trial

Xiao

2018

BMJ Open

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IntroductionPatients with cancer often suffer from considerable distress. Life review is a process of recalling, evaluating and integrating life experiences to alleviate a sense of despair and achieve self-integrity. Empirical data have supported the fact that life review is an effective psychological intervention, but it is not always accessible to patients with cancer. There is little evidence of internet-based life review programmes tailored to patients with cancer. This study aims to develop a WeChat-based life review programme and evaluate its effectiveness on the psycho-spiritual well-being of patients with cancer undergoing chemotherapy.Methods and analysisA single-centre randomised parallel group superiority design will be used. Patients with cancer will be randomised, to either a control group, or to an experimental group receiving a 6-week WeChat-based life review programme. The programme, which was mainly developed based on Erikson’s psycho-social development theory and Reed’s self-transcendence theory, provides synchronous and asynchronous communication modes for patients to review their life. The former is real-time communication, providing an e-life review interview guided by a facilitator online. The latter is not simultaneously dialogic and is used to interact with patients before and after a life review interview through Memory Prompts, Review Extraction, Mind Space and E-legacy products. The primary outcomes include anxiety, depression and self-transcendence, and the secondary outcomes are meaning in life and hope. These will be measured at baseline, and immediately, at 3 months, and at 6 months after the programme’s conclusion.Ethics and disseminationEthics approval has been obtained from the Biological and Medical Research Ethics Committee of the corresponding author’s university (IRB Ref No: 2016/00020). The trial results will be published in a peer-reviewed journal and presented at national and international conferences.Trial registration numberChiCTR-IOR-17011998.

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The relationship between pain management and psychospiritual distress in patients with advanced cancer following admission to a palliative care unit

Cited by 26 publications

References 44 publications

The use of distress thermometer in advanced cancer inpatients with pain

The use of distress thermometer in advanced cancer inpatients with pain

Negative pain management index scores do not necessarily indicate inadequate pain management: a cross-sectional study

Development and evaluation of a WeChat-based life review programme for patients with cancer: protocol for a randomised controlled trial

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