Susanne Hellerstedt-Börjesson1, Karin Nordin, Marie-Louise Fjällskog, Inger K Holmström, Cecilia Arving. 1. Author Affiliations: Department of Public Health and Caring Sciences, Uppsala University, Sweden (Mrs Hellerstedt-Börjesson and Drs Nordin, Holmström, and Arving); Department of Global Public Health and Primary Care, University of Bergen, Norway (Dr Nordin); School of Health, Care and Social Welfare, Mälardalen University, Sweden (Dr Holmström); and Department of Radiology, Oncology and Radiation Sciences, Uppsala University, Sweden (Dr Fjällskog).
Abstract
BACKGROUND: Chemotherapy treatment for cancer diseases can cause body pain during adjuvant therapy. OBJECTIVE: The aim was to describe the perceived impact of adjuvant chemotherapy-induced pain (CHIP) on the daily lives of women with newly diagnosed breast cancer, using triangulation. METHOD: Fifty-seven women scheduled for chemotherapy in doses of 75 mg/m or greater of epirubicin and/or docetaxel participated. Twenty-two of these women registered pain with values of 4 or more on the visual analog scale on day 10 following chemotherapy. Of these 22, 16 participated in an interview and colored a printed body image. A qualitative thematic stepwise analysis of the interviews was performed. RESULTS: Chemotherapy-induced pain had a profound impact on daily life. Ten women reported the worst possible pain, with visual analog scale scores of 8 to 10. Three different categories crystallized: perception (A) of manageable pain, which allowed the women to maintain their daily lives; perception (B) of pain beyond imagination, whereby the impact of pain had become more complex; and perception (C) of crippling pain, challenging the women's confidence in survival. CONCLUSIONS: The findings highlight the inability to capture CHIP with 1 method only; it is thus necessary to use complimentary methods to capture pain. We found that pain had a considerable impact on daily life, with surprisingly high scores of perceived pain, findings that to date have been poorly investigated qualitatively. IMPLICATIONS FOR PRACTICE: Nurses need to (1) better identify, understand and treat CHIP, using instruments and protocols; and (2) provide improved communication about pain and pain management.
BACKGROUND: Chemotherapy treatment for cancer diseases can cause body pain during adjuvant therapy. OBJECTIVE: The aim was to describe the perceived impact of adjuvant chemotherapy-induced pain (CHIP) on the daily lives of women with newly diagnosed breast cancer, using triangulation. METHOD: Fifty-seven women scheduled for chemotherapy in doses of 75 mg/m or greater of epirubicin and/or docetaxel participated. Twenty-two of these women registered pain with values of 4 or more on the visual analog scale on day 10 following chemotherapy. Of these 22, 16 participated in an interview and colored a printed body image. A qualitative thematic stepwise analysis of the interviews was performed. RESULTS: Chemotherapy-induced pain had a profound impact on daily life. Ten women reported the worst possible pain, with visual analog scale scores of 8 to 10. Three different categories crystallized: perception (A) of manageable pain, which allowed the women to maintain their daily lives; perception (B) of pain beyond imagination, whereby the impact of pain had become more complex; and perception (C) of crippling pain, challenging the women's confidence in survival. CONCLUSIONS: The findings highlight the inability to capture CHIP with 1 method only; it is thus necessary to use complimentary methods to capture pain. We found that pain had a considerable impact on daily life, with surprisingly high scores of perceived pain, findings that to date have been poorly investigated qualitatively. IMPLICATIONS FOR PRACTICE: Nurses need to (1) better identify, understand and treat CHIP, using instruments and protocols; and (2) provide improved communication about pain and pain management.
Authors: Rashi Asthana; Liying Zhang; Bo Angela Wan; Daniela Gallo-Hershberg; Angie Giotis; Mark Pasetka; Jenna van Draanen; Shannon Goodall; Patrick L Diaz; Leah Drost; Edward Chow; Carlo De Angelis Journal: Support Care Cancer Date: 2019-05-17 Impact factor: 3.603