Paper
Friday, July 23, 2004
Thai Cancer Pain Experience: Relationships Among Pain Beliefs, Spiritual Beliefs, Pain Appraisal, Pain Coping, and Pain Outcomes
Nada Lukkahatai, RN, PhD, Jo Ann Dalton, N/A, and Michael Belyea, N/A. School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| Learning Objective #1: Discuss multidimensional phenomena of pain experience and discuss major factors influencing pain intensity and interference reported in Thai cancer patients
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| Learning Objective #2: Discuss interventions that may help improve cancer pain management |
Objective: The study purpose is to gain a better understanding of the cancer pain experience in Thai cancer patient and to explore the relationships among pain beliefs, spiritual beliefs, pain appraisal, pain coping and pain-related outcomes. Design : An exploratory descriptive design is being used to describe the cancer pain experience of Thai patients. Population: 265 subjects were recruited from one university-affiliated hospital, one national cancer institution and one regional hospital in Thailand. Variables: Stage of cancer, number of pain sites, pain duration, age, gender, pain beliefs, spritual beliefs, pain appraisal, pain coping, pain intensity and interference. Methods: The structural equation modelling techniques were used to test the theoretical model. Findings: The results of the structural model revealed that patients with high pain belief score are more likely to appraised pain as more negative than patients with the low pain beliefs score. Patients who strongly believed in their spirituality appraised low ability to control pain. Coping strategies have a significant effect on the report of pain intensity but not on pain interference with activities reports. The frequent used of catastrophizing, however, was found to have an impact on increasing the report of pain interference but not of pain intensity. Conclusions: The multidimensionality of pain was addressed in this study. By including pain beliefs and spiritual beliefs in the study model provide a better understanding of the role of culturally related factors, and religious beliefs in the cancer pain experience. Implications: The finding of this study strongly suggested that the cancer pain assessment and management should consider cancer pain as the multidimensional phenomenon, which is surrounding with all possible related factors. The understanding of the influence of Thai culture on the cancer pain experience is one clinical challenge the health care professionals in Thailand have to face to improve pain management.
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