The Process of Pain Management by Cancer Patients: A Grounded Theory Study and Model Presentation.

Abstract

Abstract: Introduction: Cancer pain is a symptom that disrupts all aspects of a person's life and reduces the quality of life. Pain self –management behaviors in patients can improve the outcomes related to both the patient and the health system. There is a limited number of theories or models specific to pain self –management in cancer patients, therefore, in the current investigation, the pain management strategies by cancer patients were determined, and then a practical and appropriate model was designed. Methods: The current study was conducted between 2019 and 2021 in the oncology wards and clinics of Shahid Ghazi Tabatabaei Hospitals, which is affiliated with Tabriz University of Medical Sciences. The process of pain management by cancer patient was explored in the first part of the study using a grounded theory approach. Participants included 22 people, including 17 cancer patients, two caregivers, one physician, and two nurses. Following the identification of the grounded theory of pain management by cancer patients based on Corbin and Strauss' analytical method (2015), a practical model was constructed and presented utilizing the Walker and Avant's (2011) theory synthesis strategy. Results: Data analysis showed that the main concern of cancer patients is "suffering from the persistent pain". The contextual factors that give rise to this main concern include "the divine origin of pain", "sensory perception of pain", "multiple generations of increasing pain" and "pain reliving barriers". Patients use the core variable "doubtful persistent pain relief effort" to address the main concern. Eventually, the application of the these strategies sometimes led to the continuation of normal life and in most cases due to the lack of these strategies to neuroticism, worthlessness and chaos in life. In the next stage, the core variable of the grounded theory, as the central concept of the prescribing model, and meta-paradynamic concepts of human, health, nursing and environment, as the conceptual framework of the applied model, were used to design a model entitled "comprehensive self-management pain support for cancer patients". Conclusion: When cancer patients experience chronic pain, they attempt to manage it through a variety of strategies known as doubtful persistent pain relief effort. A practical model of comprehensive pain self –management support for cancer patients was established to give a clinical and practical approach for promoting pain self-management in this population. Improving pain self-management abilities in patients, empowering physicians and nurses, and improving organizational structure are all required for effective pain management in cancer patients, according to this model.