Pain coping behaviors of saudi patients suffering from advanced cancer: a revisited experience.

BACKGROUND Cancer is one of the major health problems throughout the world. The number of cancer patients is increasing, out of the estimated nine million new cancer cases every year, more than half are in developing countries. The majority of these patients are incurable by the time their disease is diagnosed. Therefore, cancer mortality is expected to continue to rise in those regions of the world (WHO, 2002). In Saudi Arabia, the latest report from the Saudi Cancer Registry SCR for 2004 registered 9,381 new cases, of these cases 7,138 were Saudis. The crude incidence rate CIR of all cancers among Saudis was 41.9/100,000. The total number of adult cancer incidence cases reported was 8595, and for children were 713 cases (NCR, 2004). The most common feared symptom encountered in advanced cancer is pain. Through their perpetual encounter with pain, advanced cancer patients usually maintain different coping behaviors. Internationally speaking, there are limited researches and investigations that deal with cancer pain, and the importance of using adaptive coping behaviors to control it. In Saudi Arabia, specifically, pain coping behaviors has never been assessed or discussed before, so is the impact of cancer pain on the quality of life. The presence of any maladaptive coping behaviors with cancer pain will interfere with the patient's life style and their quality of life, and will affect the nurse's role in caring, planning, and implementing effective nursing interventions to reduce and control cancer patient's pain. MATERIALS AND METHODS A descriptive design was used for this study to assess the pain coping behavior Among Saudi patients suffering from advanced cancer. The study was conducted at the two tumor centers which deal with cancer patients in Jeddah City. A convenient sample of 132 patients with advanced cancer who were returning to the clinics, radiation therapy and medical oncology departments of the aforementioned tumor centers were included in the study. Data were collected by an interview schedule specially designed for this study, and the time ranged between 20-40 minutes. Tool's content validity and reliability were checked and established at 89% and 85%, respectively. Administrative approval from the two tumor centers in Jeddah City was obtained for study conduction. Different statistical methods were used for data analysis and interpretation to specify the value of correlation between study variables using SPSS v 10. RESULTS Patients age were almost equally distributed among thirties (22%), forties (24.2%), fifties (20.5%), and sixties (22.7%). Females (59.1%) were slightly more than males (40.9%). About one half (47%) of them were diagnosed since one--two years age, and slightly more than half (56.8%) of them were unaware of their diagnosis. The major adaptive and Active pain coping behaviors included: religious practices such as: praying (99.2%); and listening or reciting the Holy Qur'an (98.5%). Cognitive methods such as: thinking that one is more stronger than the pain (99.2%); thinking that one is still in a satisfactory health despite the pain (98.5%); distracting oneself from pain (93.9%); visualization of pleasant scenes (92.4%); thinking about pleasant things (90.9%). The major maladaptive and passive pain coping behaviors included: decreasing activities by: specified positioning (97.7%); protecting the painful area (90.9%); and remaining still and avoiding movement (78%). Expression of feelings by: seeking help from others (90.2%); and crying or moaning (80.3%). Suppression of feelings and tolerating pain as it is (97%). CONCLUSIONS Most of the adaptive and active pain coping behaviors were coming from patient's belief in god and their faith and trust and holding and obeying Islamic commands. The informational support by the health care professionals was unprovidable in the study sample, which brings the attention to the importance of nursing interventions in this area by providing coordinated and directed programs.