Factors Predicting the Difficulty of Pain Management in Patients Receiving First Palliative Care Consultation
DOI:
https://doi.org/10.60099/jtnmc.v39i03.267495Keywords:
physical factors, psychological factors, social factors, spiritual factors, pain, management, palliative care teamAbstract
Introduction Pain is a common symptom in palliative care patients. Those with complex pain suffer both physically and psychologically. Without holistic care, pain management becomes increasingly difficult, often resulting in chronic, and severe pain.
Objectives This study aimed to investigate the joint predictive ability of psychological, social, and spiritual factors in predicting the difficulty of pain management in patients with first-time palliative care consultation, using the World Health Organization’s bio-psycho-social model of chronic pain as the conceptual framework.
Design This research employed a retrospective matched-case control study.
Methodology This study included 85 patients with difficulty in pain management and 85 patients with effective pain management. Both groups had no significant differences in principal diagnosis, gender, and age. Data were collected using a demographic form and a modified distress thermometer assessment questionnaire divided into three parts: psychological, social, and spiritual. The content validity index was .90, and the reliability coefficient of the questionnaire, measured by Cronbach’s alpha, was .75. Descriptive and inferential statistics, including Chi-square tests and Multiple logistic regression, were used for data analysis.
Results Most participants were male (57.65%), with a median age of 59. Most of them were married (68.82%). After controlling for principal diagnosis, gender, and age, factors that jointly predicted difficulty in pain management were economic problems (OR 2.82, 95% CI= 1.0-7.67, p=.042), family anxiety (OR 11.45, 95% CI= 5.58-23.53, p<.001), lack of support (OR 4.94, 95% CI=1.35-18.01, p=.016), psychological problems (OR 4.72, 95% CI= 2.39-9.33, p<.001), spiritual problems (OR 15.61, 95% CI= 5.24-46.50, p <.001), and unmet needs (OR 7.43, 95% CI=3.06- 18.03, p<.001).
Recommendation The findings of this study suggest that nurses and healthcare teams should assess all dimensions of patients experiencing pain during their first consultation with palliative care and provide holistic pain management to reduce the difficulty in managing pain.
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