Pain assessment and treatment of patients in an oncology-palliative care unit

Loredana Antuanela Tuinea (a,d), Anda-Natalia Ciuhu (a,g), Nicoleta Clenciu (a,e), Roxana-Andreea Rahnea-Niță (b, f), Mihaela Popescu (c, f), Gabriela Rahnea-Niță (a,g)

(a): Chronic Disease Hospital “St. Luke”, Department of Oncology – Palliative Care, Bucharest, Romania
(b): “Dr. Constantin Gorgos” Titan Psyhiatric Hospital, Department of Oncology, Bucharest, Romania
(c): Clinical Hospital “Colentina”, Department of Hematology, Bucharest, Romania
(d): MD
(e): nurse
(f): MD, PhD student
(g):MD, oncologist, PhD

Corresponding author: Anda-Natalia Ciuhu, andadum@yahoo.com

Abstract

Background:
Cancer pain is a complex syndrome. It may occur at all stages of the disease, sometimes being present since the onset of the disease. Efficient analgesia prevents the development of chronic pain syndromes, increases patients’ quality of life and allows early diagnosis of recurrence or metastasis.

Materials and methods:
We investigated 231 patients admitted to the ward “Oncology – Palliative Care” of the Hospital of chronic diseases “St. Luke” Bucharest. They were evaluated regarding intensity of pain using Edmonton Symptom Assessment System scale (ESAS). They were also evaluated regarding pain therapy according to WHO steps.

Results:
Pain intensity assessment according ESAS: without pain = 40.6%, low intensity of pain = 17.9%, moderate pain intensity = 24.8%, severe pain intensity = 16.6%.

Regarding the treatment of pain: step I 58.5% patients, step II 24.8% patients and step III 16.6% patients.

Discussion:
A relatively large group of patients (four out of ten) had no pain. Severe pain (VAS = 10) was reported by over 16%.

Over half of the patients had non-opioid treatment, while over16% had strong opioid treatment.

Conclusions:
Before initiating treatment a careful evaluation of pain must be done.

For effective control of pain it should be evaluated in all its dimensions (physical, functional, psychosocial and spiritual).

Key words: pain, opioids, cancer

(Full text in Romanian)

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