Chronic Pain Experiences Among Advanced Cancer Patients In The Accra Metropolis

Abstract

Chronic pain among advanced cancer patients (ACP) has several devastating effects on the patient’s quality of life and need to be understood for effective pain management. However, there is lack of literature on chronic pain experiences among ACP in Ghana. This study aimed to explore and describe chronic pain experiences among ACP in the Accra Metropolis. A qualitative approach with exploratory-descriptive design was used for this study. The Multidimensional Model of Cancer Pain was used as an organising framework for the study. A semi structured interview guide was used to collect data from 13 purposively sampled participants. The data were analysed using thematic content analysis. Findings indicated seven (7) major themes: sensory dimension, cognitive dimension, behavioural dimension, affective dimension, sociocultural dimension, pain coping strategies and pain management. Chronic pain was multi-sited, described in terms of known pain descriptors such as burning, shooting, sharp, piercing and tingling. The pain was of high intensity especially at night. Participants were knowledgeable about their pain and they interpreted their pain as: a progression of their cancer, emergence of death and ineffective medication. Furthermore, participants were preoccupied with death wishes, suicidal ideations/tendencies. They responded to pain behaviourally by communicating their pain using pain behaviours, verbally or being stoical. Chronic pain related symptoms such as disturbed sleep, fatigue and sexual difficulties were identified. Affectively, participants responded to their pain with negative emotions. Additionally, advanced cancer patients’ sociocultural characteristics influenced their perception of the pain, coping strategies, management of the pain and the overall pain experience. In conclusion, chronic pain has devastating effect on quality of life of patients with advanced cancer. It was recommended that, regular assessment of the pain and multidisciplinary approach is necessary for effective chronic pain management.