End-Of-Life Cancer Patients’ Total Pain: The Necessity To Supplement Pharmacology With Psycho-Socio-Spiritual Treatments

Abstract

Aim: To analyze pain considering its different bio-psycho-social-spiritual manifestations and to assess the effectiveness of the analgesic treatments in end-of-life cancer patients. Materials & methods: The study was cross-sectional. A total of 376 end-of-life cancer inpatients participated in the research. Their socio-demographic and clinical data were collected and, during the first psychological consultancy, they filled in a set of validated rating scales assessing pain, anxiety, depression and quality of life. Results: The results show that physical pain was well managed for almost all patients. Nevertheless, the majority showed clinically significant levels of psychological distress. Conclusion: Treating pain means caring for all its possible manifestations including psychological symptoms and reduced wellbeing. Thus, integrating pharmacological treatment with psycho-socio-spiritual interventions, in other words, psychological, social and spiritual support, could be effective and desirable.

Plain language summary

The aim of this article was to analyze in patients with oncological disease at the end-of-life different types of pain from which they can suffer, for example, physical pain, psychological distress and their various types of wellbeing. Moreover, we would like to assess if the drugs they assumed for their physical pain were sufficient to remove the pain. A total of 376 patients participated in the research. Their personal and medical data were gathered and they were invited to fill in some questionnaires investigating the presence of pain, anxiety, depression and quality of life. The results showed that physical pain was contained and well treated for almost all patients. Nevertheless, most of the patients had high anxiety and depression and low quality of life. It is important to provide patients with adequate pharmacological treatment, but also to offer them other types of interventions such as psychological support, psychotherapy, social support and spiritual support. Combining the pharmacological treatment with these interventions could be desirable to care for all the possible types of pain.

Keywords::

• cancer
• end-of-life
• oncology
• pain
• palliative care
• psychological interventions
• spirituality

Financial & competing interests disclosures

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval from Comitato Etico Interaziendale A.O.U. ‘San Giovanni Battista di Torino A.O. C.T.O./Maria Adelaide di Torino’: protocol number 0073054, procedure number 255, date of approval: 14 April 2015 and the study followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.