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.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Dhingra L,Shuk E,Grossman B,Strada A,Wald E,Portenoy A,Knotkova H,Portenoy Rdoi
10.1177/0269216312450358subject
Has Abstractpub_date
2013-05-01 00:00:00pages
447-56issue
5eissn
0269-2163issn
1477-030Xpii
0269216312450358journal_volume
27pub_type
杂志文章abstract::Depression is the most common psychiatric illness in patients with terminal cancer. Depression not only lowers the quality of life for the patients and their families, but patients who are depressed may also have physical symptoms that are difficult to palliate and that improve as their depression is appropriately tre...
journal_title:Palliative medicine
pub_type: 杂志文章
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journal_title:Palliative medicine
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journal_title:Palliative medicine
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abstract:BACKGROUND:ENABLE (Educate, Nurture, Advise Before Life Ends) II was one of the first randomized controlled trials (RCTs) examining the effects of a concurrent oncology palliative care intervention on quality of life, mood, and symptom control for advanced cancer patients and their caregivers. However, little is known ...
journal_title:Palliative medicine
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journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
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更新日期:2005-04-01 00:00:00
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abstract:BACKGROUND:the right for patients of all diagnoses to be in receipt of palliative care from an early point in the diagnosis of a life-limiting condition is now enshrined in policy in a number of countries and increased emphasis is placed upon the role of generalist palliative care. However, little is known as to how th...
journal_title:Palliative medicine
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更新日期:2015-05-01 00:00:00
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更新日期:2013-10-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2000-11-01 00:00:00
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更新日期:2003-10-01 00:00:00
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更新日期:2010-07-01 00:00:00
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journal_title:Palliative medicine
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更新日期:1994-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2016-12-01 00:00:00
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更新日期:2018-02-01 00:00:00
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