| Objective To explore the pain beliefs and perceptions held by patients with digestive system cancer, and to investigate the intervention of therapeutic communication system on pain beliefs in gastric cancer patients during chemotherapy.Methods This study was divided into three parts. Part Ⅰ: 10 patients with digestive system cancer were interviewed for exploration of their pain beliefs and perceptions. The Data was collected using in-depth interview. Part Ⅱ: Convenience sampling method was used to recruit patients with digestive system cancer from December 2013 to July 2014 in the first affiliated hospital of Anhui medical university. The measurement tool included Numerical Rating Scale(NRS), Pain beliefs and Perceived inventory(PBPI), Functional Assessment of Cancer Therapy-General(FACT-G). Part Ⅲ: Convenience sampling method was used to recruit patients with gastric cancer from July 2014 to January 2015 in the first affiliated hospital of Anhui medical university. Those patients received the routine clinical care and therapeutic communication system. The baseline survey were conducted in the 1st day at the hospital, group meeting and personalized guidance were provided subsequently, telephone follow-up guidance were offered in the 7th day of discharge, data after the intervention were collected in the 1st day of next cycle of chemotherapy. The measurement tool included Numerical Rating Scale, Pain beliefs and Perceived inventory, Functional Assessment of Cancer Therapy-General and intervention evaluation questionnaire designed by researcher. The data of quantitative study was analyzed with Colaizzi method. Descriptivestatistics, one-way ANOVA, Two independent sample t-test analysis, Pearson correlation analysis and Spearman correlation analysis was used to analyze the pain beliefs, and its relationships between QOL of the sample. Paired-Sample t test was used to compare the pain beliefs and QOL level before and after intervention.Results Part I: The beliefs and perceptions held by patients with digestive system cancer were presented as: negative pain behavior, negative emotional perceptions, view social support as important resources. Negative pain behavior include lack of pain express, attributed to physiological symptoms and worried about drug addiction; Negative emotional experience including depression, helplessness, fear and despair; Social support including family support and medical care personnel support. Part Ⅱ: 125 digestive cancer patients med the inclusion criteria completed the effective questionnaire in the descriptive study. In the study, 3 patients with mild pain, 78 patients with moderate pain and 44 patients with severe pain. The average score of the Constancy dimension is 0.08±0.48, and the Permanence dimension is-0.09±0.88, and the Mystery dimension is 0.46±0.59, and the Self-Blame dimension is 0.09±0.76. One way ANOVA and Two independent sample t-test analysis showed that patients with different marital status, educated level, health care type, residential area, work and economic income had different pain beliefs(P<0.05). The total score of FACT-G is 62.45±12.07. The positive correlation was found between pain and pain beliefs(P<0.05), the negative correlations were found between pain and QOL(P<0.05), pain beliefs and QOL(P<0.05). Part Ⅲ: 36 gastric cancer patients completed the intervention. After the intervention, the score of pain and beliefs were significantly lower(P<0.05), the score of QOL were significantly higher than before(P<0.05). From the intervention evaluation questionnaire designed by researcher, we found that all the patients liked the intervention model, obtained useful problem-solving methods, willing to participate the new round of group meeting. However, 36.11% of patients thought the manual is difficult to use,b19.44% of patients felt the manual is helpless, 36.11% didn’t like the telephone follow-upguidance. Nevertheless, all the patients defined their attitude that in the future, they will express pain timely, prescribe medicine, use relaxation techniques, and take positive attitude in the face of disease.Conclusion The pain beliefs and perceptions digestive system cancer pain patients held were negative. Patients with different marital status, educated level, health care type, residential area, work and economic income had different pain beliefs. Pain beliefs is positively correlated with pain level and negatively correlated with QOL. Clinical health cares should pay attention to the role of beliefs in pain management, and help patients to build positive pain beliefs through utilizing social support resources effectively. Therapeutic communication system is one of the important way to symptom management in cancer patients. It can reduce the level of pain in gastric cancer patients during chemotherapy, encourage patients to take positive pain beliefs and improve the QOL. |
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