Interviews with patients with advanced cancer—another step towards an international cancer pain classification system
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Patients’ involvement in the development of assessment tools is recommended, and the European Palliative Care Research Collaborative has adhered to this when developing a shared language for cancer pain, an international assessment and classification system. Study objectives were to investigate how patients ranked the relevance of several previously identified pain domains, to investigate patients’ perception of the pain experience and to disclose additional, relevant pain domains for cancer pain classification to those identified in the literature.
Semistructured interviews with advanced cancer patients treated with opioids were performed and analysed verbatim. Patients scored the relevance of predefined pain domains on an 11-point Numerical Rating Scale.
Thirty-three Norwegian and Austrian patients were included (16 females and 17 males); the mean age was 63 years, and the mean Karnofsky performance score was 65. The ranking of domains was as follows etiology (mean Numerical Rating Scale score, 8.5), duration (8.0), intensity (7.4), coping (7.1), physical (5.9) and psychological functioning (5.8). Sleep was identified as a new candidate domain to include in the system. The patients emphasised consequences of having pain, for example, poor physical functioning and psychological distress.
Previously identified pain domains were confirmed to be relevant to the patients; however, the ranking differed from the experts’ ranking. Sleep disturbances may be added as a domain in a future classification system.
KeywordsCancer Classification Pain Palliative care Qualitative method PROs
We would like to thank all the patients for their kind and generous sharing of thoughts and experiences.
Thanks to Bente Moldaunet for conscientious transcribing of the interviews and to Hanne Paltiel for proofreading the translated quotations.
This study was supported by the EU’s 6th framework, contract no. 037777, PI Stein Kaasa, and funding from Trondheim University Hospital, Norway. Anne Kari Knudsen received a grant from the Central Norway Regional Health Authority.
Conflict of interest
None of the authors have a relationship with any entities that have a financial interest in this topic.
The authors have full control of all primary data; the journal is allowed to review the data upon request.
- 2.Blazeby J, Sprangers M, Cull A, Groenvold M, Bottomley A (2008) The EORTC Quality of Life Group guidelines for module development http://groups.eortc.be/qol/downloads/200208module_development_guidelines.pdf. Accessed 02 December 2012
- 6.EPCRC (2011) The European Palliative Care Research Collaborative (EPCRC). http://www.epcrc.org Accessed 14 December 2011
- 7.Fainsinger RL, Nekolaichuk C, Lawlor P, Hagen N, Bercovitch M, Fisch M, Galloway L, Kaye G, Landman W, Spruyt O, Zhukovsky D, Bruera E, Hanson J (2010) An international multicentre validation study of a pain classification system for cancer patients. Eur J Cancer 46:2896–2904PubMedCrossRefGoogle Scholar
- 8.Fainsinger RL, Nekolaichuk CL (2008) A “TNM” classification system for cancer pain: The Edmonton Classification System for Cancer Pain (ECS-CP) Support Care CancerGoogle Scholar
- 10.Fayers PM (2007) Developing a quationnaire Quality of Life The assessment, analysis and interpretation of patient-reported outcomes. Wiley, West Sussex, pp 55–58Google Scholar
- 14.Giorgi A (1985) Sketch of a psychological phenomenological method. In: Giorgi A (ed) Phenomenology and psychological research. Dusquesne University Press, Pittsburgh, pp 8–22Google Scholar
- 19.IASP International Association for the Study of Pain http://www.iasp-pain.org/Content/NavigationMenu/GeneralResourceLinks/PainDefinitions/default.htm Accessed 13 December 2011
- 23.Laugsand EA, Jakobsen G, Kaasa S, Klepstad P (2010) Inadequate symptom control in advanced cancer patients across Europe Support Care CancerGoogle Scholar
- 25.Merskey H, Bogduk N (1994) International Association for the Study of Pain: Classification of Chronic Pain. IASP Press, SeattleGoogle Scholar
- 28.NICE National Institute for Health and Clinical Excellence. http://www.nice.org.uk/. Accessed 20 June 2011
- 29.Patton MQ (2002) Qualitative designs and data collection: qualitative research and evaluation methods. Sage Publications, Thousand Oaks, pp 242–246Google Scholar
- 30.Patton MQ (2002) Qualitative interviewing. In: Patton MQ (ed) Qualitative research and evaluation methods. Sage Publications, Thousand Oaks, pp 344–347Google Scholar
- 31.Patton MQ (2002) Qualitative Research and Evaluation Methods. Sage Publications, Thousand OaksGoogle Scholar
- 35.Sharma N, Hansen CH, O’Connor M, Walker J, Kleiboer A, Murray G, Espie C, Storey D, Sharpe M (2011) Sleep problems in cancer patients: prevalence and association with distress and pain Psychooncology Jul 1. [Epub ahead of print]Google Scholar
- 37.Sprangers MA, Cull A, Groenvold M, Bjordal K, Blazeby J, Aaronson NK (1998) The European Organization for Research and Treatment of Cancer approach to developing questionnaire modules: an update and overview. EORTC Qual Life Stud Group Qual Life Res 7:291–300Google Scholar