Thesis (M.A.)--York University, 2007. Graduate Programme in Kinesiology and Health Sciences. / Typescript. Includes bibliographical references (leaves 63-89). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR38773

Thesis (Ph. D.)--University of Hong Kong, 1998. / Includes bibliographical references (leaves 272-287).

Thesis (M.S.)--Florida State University, 2005. / Advisor: Jeanne Flannery, Florida State University, School of Nursing. Title and description from dissertation home page (viewed Feb.1, 2006). Document formatted into pages; contains ix, 113 pages. Includes bibliographical references.

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published_or_final_version / Anaesthesiology / Doctoral / Doctor of Philosophy

Background: In the sub-Saharan African countries, cancer pain is a widespread and intractable problem that has a major impact on the quality of life of patients with cancer and their relatives. For many patients, cancer causes a series of symptoms, where pain is one of those that, according to research, affects the patient negatively in several ways. Purpose: The purpose of the literature review was to compile literature on pain in patients with cancer in sub-Saharan Africa. Method: A general literature study based on a systematic method of analyzing data (Popenoe et al., 2021). Searches have taken place in databases of scientific articles and 13 articles with a qualitative, quantitative and banded design have been included.   Results: A compilation of the results yielded four themes: Occurrence of pain, Pain assessment instruments, Medicines, CAM and alternative treatment methods and Impact on daily life. The studies show that patients with cancer report a lot of pain and that assessment tools are used very rarely. In addition to this, drugs for pain are difficult to obtain. Alternative treatment methods are common and pain is strongly associated with anxiety, depression and negative impact on quality of life.   Conclusion: Patients with cancer in sub-Saharan Africa report a lot of pain, which has a major impact on daily life. A number of obstacles to optimal pain relief have been identified and several studies have been conducted on these obstacles. Solutions exist, but the process is complicated by laws, financial priorities, the ignorance of the healthcare staff and availability of pain medication. Education of healthcare professionals, overview of laws and local regulations and increased availability of pain medication can improve the pain problem and increase the quality of life for patients with cancer in sub-Saharan Africa.

SUMMARY AIM OF THE STUDY. To evaluate the needs of medical care and the quality of care in cancer patients, experiencing pain. METHODS. One hundred cancer patients experiencing pain were interviewed in Kaunas Medical university Oncology hospital and Oncology department of Kaunas Medical university hospital (KMUH).. Age range- 27-68 years. Two questionnaires were used for the interview: “Pain anamnesis” and “McGill’s pain questionnaire”- specific questionnaire of pain-words. RESULTS. The results of questionnaires were analyzed. Men more often than women experienced chronic pain (17% and 48 %). There was statistically positive correlation between the strongest pain in 24 hours and weakest pain in 24 hours experience. While analyzing adverse reactions of various treatment methods in the respondents treated in KMUH Oncology department and KMU Oncology hospital the anorexia (p ≤ 0,05), constipation and insomnia were more common in KMUH (p ≤ 0,05). The quality of care according to 58% of Patients in KMUH and 34% in KMU OH was not sufficient (p ≤ 0,05). About 12% of KMUH patients and 46% in KMU OH declared that the quality of care is worse during the weekends. (p ≤ 0,05) CONCLUSIONS. A lot of adverse reactions appear while treating cancer patients with pain. One can decrease or even eliminate these reactions by purposeful care activities and providing information needed. Increasing the quality of care, the evaluation of received care by cancer pain patients will become better. ... [to full text]

Yes / We linked UK cancer registry data with the corresponding electronic primary care medical records of 6080 patients who died of cancer over a 7-year period in a large United Kingdom city. We extracted all prescriptions for analgesics issued to each patient in the linked cohort during the 12 months before death and analysed the extent and duration of strong opioid treatment with clinical and patient characteristics. Strong opioids were prescribed for 48% of patients in the last year of life. Median interval between first prescription of a strong opioid and death was 9 weeks (interquartile range 3-23). Strong opioid prescribing was not influenced by cancer type, duration of illness, or gender but was adversely influenced by older age. Compared with patients who died in a hospice, those who died in a hospital were 60% less likely to receive a strong opioid in primary care before admission (relative risk ratio 0.4, CI 0.3-0.5, P < 0.01). The study provides the first detailed analysis of the relatively late onset and short duration of strong opioid treatment in patients with cancer before death in a representative UK cohort. This pattern of prescribing does not match epidemiological data which point to earlier onset of pain. Although persistent undertreatment of cancer pain is well documented, this study suggests that strategies for earlier pain assessment and initiation of strong opioid treatment in community-based patients with cancer could help to improve pain outcomes. / National Institute for Health Research (NIHR) (RP-PG-0610-10114)

Cancer pain is a complex symptom that affects the quality of life of oncology patients, caregivers, and families. The limitations of pain management treatment for cancer patients can be attributed to the lack of knowledge and availability of nonpharmacological treatments. The purpose of this project was to identify and gather evidence on the effectiveness of nonpharmacological interventions in the treatment of cancer pain using the methodology of a systematic review. Watson's theory of human caring supported the project by incorporating the perception of treating the human being holistically during the illness process. The Johns Hopkins nursing evidence-based practice model provided a structured approach to address the practice problem and practice-focused question. The tools used to assess the quality and synthesize the findings of the studies were the Research and Evidence Appraisal Tool and the Synthesis Process and Recommendations Tool. The practice-focused question explored whether nonpharmacological interventions could be used to complement opioid treatments for cancer pain. A systematic review of the literature indicated 11 studies in which 2 interventions--music therapy and exercise--addressed the practice-focused question. Psychological distress, decreased physical function, and decreased involvement in social activities can all be attributed to the poor management of cancer pain. The study of alternatives to opioids could support social change by increasing the knowledge of healthcare professionals and the range of treatment options for pain management in cancer patients.