Background & Aims
Background: In general medical practice, recovery is a concept commonly associated with the absence of symptoms. However, this assumption might not be the case, especially, for example, in cases of pain, psychiatric, or surgical interventions, when we do not have any assurance that the treatment will be able to eradicate that symptom (1,2),(3). In this matter, pain intensity reduction might not necessarily improve suffering or quality of life (4), and the reasons for this gap still need more comprehension. Aim: As a way to better understand differences, the purpose of this study is to investigate pain relief symptoms from suffering from pain. Secondly, our research focuses on examining and detailing the experiences of individuals with chronic pain who encounter abrupt pain relief post-surgery.
Methods
Our prospective longitudinal qualitative study was based on three open face-to-face interviews with 15 patients suffering from refractory cancer pain (n= 6 ), and trigeminal neuralgia (n= 9 ).The research was carried out longitudinally at three different moments related to the surgery: before, one month after, and six months after. Patient ‘s reports were collected through pain assessment scales Douleur neuropathique-4 questionnaire (DN4)(5,6); Neuropathic Pain Symptom Inventory (NPSI)(7); Brief Pain Inventory (BPI)(8) ; Short-form McGill Pain Questionnaire (MPQ)(9); Pain Catastrophizing Scale (PCS) (10) and active listening (interview).
Results
Results were organized into five main themes: i. length of time until the diagnosis of the pain syndrome; ii. relationship with spouse and family; iii. work-related issues; iv. personal view of death; and v. expectation of improvement. This research highlighted the extensive and often challenging journey towards a correct diagnosis of chronic pain conditions, revealing profound challenges within the healthcare system. The impact of pain on family relationships was also significant, reinforcing the importance of family support in the recovery trajectory. Observations indicated that pain led some participants to cease working, and their return to the workplace was frequently viewed as an indicator of improvement, though fears of pain recurrence continued to impact their professional lives. Participants expressed desires for a life free from suffering, which was a significant influence on their personal views on death. In terms of post-treatment expectations, there was a wide range of per
Conclusions
The participant’s narratives revealed different views regarding post-treatment outcomes, highlighting the multidimensional nature of the recovery process. This finding reveals the need for a more comprehensive approach in terms of pain and suffering strategies.
References
1.Cassell EJ. The Nature of Suffering and the Goals of Medicine. Oxford University Press; 2004. 336 p.
2.Cassel EJ. The nature of suffering and the goals of medicine. 1986. 7 p.
3.Sensky T. Suffering. Int J Integr Care. 2010 Jan 29;10 Suppl(Suppl):e024.
4.Bustan S, Gonzalez-Roldan AM, Schommer C, Kamping S, Löffler M, Brunner M, et al. Psychological, cognitive factors and contextual influences in pain and pain-related suffering as revealed by a combined qualitative and quantitative assessment approach. PLoS One. 2018 Jul 31;13(7):e0199814.
5.Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005 Mar;114(1-2):29–36.
6.Santos JG, Brito JO, de Andrade DC, Kaziyama VM, Ferreira KA, Souza I, et al. Translation to Portuguese and validation of the Douleur Neuropathique 4 questionnaire. J Pain. 2010 May;11(5):484–90.
7.Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E, et al. Development and validation of the Neuropathic Pain Symptom Inventory. Pain. 2004 Apr;108(3):248–57.
8.Ferreira KA, Teixeira MJ, Mendonza TR, Cleeland CS. Validation of brief pain inventory to Brazilian patients with pain. Support Care Cancer. 2011 Apr;19(4):505–11.
9.Ferreira KASL, de Andrade DC, Teixeira MJ. Development and validation of a Brazilian version of the short-form McGill pain questionnaire (SF-MPQ). Pain Manag Nurs. 2013 Dec;14(4):210–9.
10.Darnall BD, Sturgeon JA, Cook KF, Taub CJ, Roy A, Burns JW, et al. Development and Validation of a Daily Pain Catastrophizing Scale. J Pain. 2017 Sep;18(9):1139–49.
Presenting Author
Valquíria Aparecida da Silva
Poster Authors
Valquiria Silva
PhD
Hospital das clinicas da faculdade de São Paulo
Lead Author
ADRIANA Carneiro
University of Sao Paulo
Lead Author
Marina Valente Guimarães Cecchini
Pain Center, LIM 62, Department of Neurology, University of São Paulo, Brazil;
Lead Author
Daniel de Andrade
University of Aalborg
Lead Author
Topics
- Assessment and Diagnosis