Psychological issues on Person-centered Care for Cancer Pain

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Marijana Bras


Pain is one of the most distressing symptoms in ­­cancer patients. Although medications and other methods for cancer pain treatment are available, a significant number of patients suffer from intolerable pain. Current conceptualizations of cancer pain adopt a person-centered perspective. The patient’s emotional experiences, beliefs and expectations may determine the outcome of treatment, and are fully emphasized in the focus of treatment interventions. Complex and disabling pain conditions often require comprehensive pain treatment programs, involving interdisciplinary and multimodal treatment approaches. Psychological/psychiatric aspects have an important place in all phases of treatment, with an important role in research and education. Person-centered medical interview is an important bridge between personalized and person-centered medicine in the treatment of patients with cancer pain. There are many roles that the psychiatrist can perform in the assessment and treatment of patients with cancer pain. Psychological treatment can and should be individually tailored to meet the specific needs of the patient.  Education of professionals about biopsychosocial approaches and  communication skills, quality of interactions between health professionals and patients,  psychological interventions and continuing care should all be present. It is also important to  help cancer patients communicate more effectively about pain and become more involved in deciding pain management treatment.

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Bruera, E., Kim H.N. (2003). Cancer pain. JAMA 290, 2476-2479.

Foley, K.M. (1998). Pain assessment and cancer pain syndromes. In: Textbook of palliative medicine 2nd ed. (ed. Doyle, D., Hanks, G., McDonald, N.) eds. Textbook of palliative medicine.pp. 310-331.

Higginson, I.J., Gao, W. (2008). Caregiver assessment of patients with advanced cancer: concordance with patients, effect of burden and positivity. Health Qual Life Outcomes 6,42.

Vainio, A., Aveinen, A. (1996). Prevalence of symptoms among patients with advanced cancer: an international collaborative study. J Pain Symptom Manage 12, 3-10.

Saunders, C.M.(1978). The Management of Terminal Disease.Arnold, London.

Felce, D., Perry, J. (1995). Quality of life: its definition and measurement. Res Dev Disabil 16, 51-74.

Mezzich, J.E, Snaedal, J., van Weel, C., Botbol, M., Salloum, I.M.(2010). Introduction to Person-Centered Medicine: From Concepts to Practice. Journal of Evaluation in Clinical Practice 17(2), 330-332.

Symreng, I., Fishman, S.M. (2004). Anxiety and Pain. Pain Clinical Updates, IASP 12(7).

Pirl, W.F. (2004). Evidence report on the occurrence, assessment, and treatment of depression in cancer patients. J Natl Cancer Inst Monogr. 32-39.

Massie, M.J. (2004). Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr. 57-71.

Chapman, C.R., Gavrin, J. (1999) Suffering: the contributions of persistent pain. Lancet. 353, 2233-2237.

Glover, J., Dibble, S.L., Dodd, M.J. (1995). Mood states of oncology outpatients: does pain make a difference? J Pain Symptom Manage 10, 120-128.

Breitbart, W. (2003). Reframing hope: meaning-centered care for patients near the end of life. Interview by Karen S. Heller. J Palliat Med 6, 979-88.

Chochinov, H.M. (2002). Dignity-conserving care-a new model for palliative care: helping the patient feel valued. 287, 2253-60.

Braš, M., Fingler, M., Filaković, P. (2006) Chronic Pain. In: Liaison psychiatry. Psychiatric and psychological problems in somatic medicine (ed Gregurek, R). Zagreb, Školska knjiga, 101-12.

Braš, M (2009) Antidepressants in the treatment of chronic pain, in psychooncology and palliative medicine. In: Antidepressants in clinical practice (Mihaljević-Peleš A., Šagud M, eds.) Zagreb, Medicinska naklada, 41-54.

Leo, R.J, Barkin, R.L. (2003). Antidepressant use in chronic pain management: Is there evidence of a role for duloxetine? Prim Care Companion J Clin Psychiatry. 5, 118-23.

DiMatteo, M.R, Giordani, P.J, Lepper, H.S, Croghan, T.W. (2002). Patient adherence and medical treatment outcomes: a meta-analysis. Med Care 40, 794-811.

Mezzich, J.E, Snaedal, J., van Weel, C.(2010). Person-centered Medicine: A Conceptual Exploration. International Journal of Integrated Care. Suppl.10.

Braš, M., Dorđević, V., Milunović, V., Brajković, L., Miličić, D., Konopka, L.(2011). Person-centered medicine versus personalized medicine: is it just a sophism? A view from chronic pain management. Psychiatr Danub. 23(3):246-50.

Dorđević, V., Bras, M., Brajković, L.(2012). Person-centered medical interview. Croat Med J.53(4), 310-3.