Assessment of Pain Coping Behaviors: An Experience of Saudi Advanced Cancer Patients

Background: Cancer is one of the major health problems thoughout the world. The number of cancer patientsis increasing, out of the estimated nine million new cancer cases every year, more than half are in developingcountries. The majority of these patients are incurable by the time their disease is diagnosed. Therefore, cancermortality is expected to continue to rise in those regions of the world (WHO, 2002). In Saudi Arabia, the latestreport from the Saudi Cancer Registry SCR for 2004 registered 9,381 new cases, of these cases 7,138 wereSaudis. The crude incidence rate CIR of all cancers among Saudis was 41.9/100,000. The total number of adultcancer incidence cases reported was 8595, and for children were 713 cases (NCR, 2004). The most commonfeared symptom encountered in advanced cancer is pain. Through their perpetual encounter with pain, advancedcancer patients usually maintain different coping behaviors. Internationally speaking, there are limited researchesand investigations that deal with cancer pain, and the importance of using adaptive coping behaviors to controlit. In Saudi Arabia, specifically, pain coping behaviors has never been assessed or discussed before, so is theimpact of cancer pain on the quality of life. The presence of any maladaptive coping behaviors with cancer painwill interfere with the patient's life style and their quality of life, and will affect the nurse's role in caring,planning, and implementing effective nursing interventions to reduce and control cancer patient's pain. Materialsand
Methods: A descriptive design was used for this study to assess the pain coping behavior Among Saudipatients suffering from advanced cancer. The study was conducted at the two tumor centers which deal withcancer patients in Jeddah City. A convenient sample of 132 patients with advanced cancer who were returningto the clinics, radiation therapy and medical oncology departments of the aforementioned tumor centers wereincluded in the study. Data were collected by an interview schedule specially designed for this study, and thetime ranged between 20-40 minutes. Tool's content validity and reliability were checked and established at 89%and 85%, respectively. Administrative approval from the two tumor centers in Jeddah City was obtained forstudy conduction. Different statistical methods were used for data analysis and interpretation to specify thevalue of correlation between study variables using SPSS v 10.
Results: Patients age were almost equallydistributed among thirties (22%), forties (24.2%), fifties (20.5%), and sixties (22.7%). Females (59.1%) wereslightly more than males (40.9%). About one half (47%) of them were diagnosed since one - two years age, andslightly more than half (56.8%) of them were unaware of their diagnosis. The major adaptive and Active paincoping behaviors included: religious practices such as: praying (99.2%); and listening or reciting the HolyQura'an (98.5%). Cognitive methods such as: thinking that one is more stronger than the pain (99.2%); thinkingthat one is still in a satisfactory health despite the pain (98.5%); distracting oneself from pain (93.9%); visualizationof pleasant scenes (92.4%); thinking about pleasant things (90.9%). The major maladaptive and passive paincoping behaviors included: decreasing activities by: specified positioning (97.7%); protecting the painful area(90.9%); and remaining still and avoiding movement (78%). Expression of feelings by: seeking help from others(90.2%); and crying or moaning (80.3%). Suppression of feelings and tolerating pain as it is (97%).
Conclusions:Most of the adaptive and active pain coping behaviors were coming from patient's belief in god & their faith andtrust and holding and obeying Islamic commands. The informational support by the health care professionalswas unprovidable in the study sample, which brings the attention to the importance of nursing interventions inthis area by providing coordinated and directed programs.