A qualitative study to explore psychological distress and illness burden associated with opioid-induced constipation in cancer patients with advanced disease.
Palliat Med
; 27(5): 447-56, 2013 May.
Article
em En
| MEDLINE
| ID: mdl-22707180
ABSTRACT
BACKGROUND:
Constipation affects many patients receiving long-term opioid therapy for cancer pain. Little is known about the nature of psychological distress and the burden associated with this problem. This information may inform the development of effective treatment strategies and ameliorate distress.AIM:
The objective was to use qualitative research methods to better understand psychological distress and the burden associated with opioid-induced constipation and its treatment in advanced cancer patients.DESIGN:
In this qualitative study, semi-structured interviews explored perceptions of psychological distress and burden from opioid-induced constipation. Interviews were analyzed using a thematic content analysis approach involving descriptive and interpretive coding and identification of recurring themes. SETTING/PARTICIPANTS:
Twelve advanced cancer patients with opioid-induced constipation were recruited from a large urban hospital.RESULTS:
Patients experienced various types of negative affect and cognitions associated with opioid-induced constipation. Analyses indicated three major themes (1) irrational thoughts and educational needs; (2) psychological distress from constipation and (3) the effects of constipation on the decision to use opioid analgesics. Irrational thoughts and educational needs included beliefs that nutrition could improve constipation, the supposition that constipation indicated deteriorating health, and catastrophic beliefs. Psychological distress included depressive symptoms and anticipatory anxiety related to constipation. Decision-making revealed cognitive dissonance about using opioids and conflicting preferences about continuing use.CONCLUSIONS:
Future investigation of the multiple components of cognitive and affective burden from opioid-induced constipation is warranted. Understanding the varied nature of this burden may improve clinical recognition and assessment and promote more intensive management consistent with the distress it produces.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Dor
/
Estresse Psicológico
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Efeitos Psicossociais da Doença
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Constipação Intestinal
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Analgésicos Opioides
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Neoplasias
Tipo de estudo:
Etiology_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Palliat Med
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Estados Unidos