Occupational Therapy Modulates the Pain in Cancer Patient Under Palliative Care
- Conditions
- CancerTerminal DiseasePain
- Interventions
- Other: TapestryOther: Regular occupation therapyOther: Weaving a scarf on a nail frameOther: Domino game
- Registration Number
- NCT02102178
- Lead Sponsor
- Barretos Cancer Hospital
- Brief Summary
Pain is one of the most incapacitating symptoms because it is a complex experience that includes sensory and emotional perceptions, in which sensory, affective, cognitive, behavioral, cultural and social characteristics interact. Around 79% of advanced cancer cases present pain.
There is evidence that non-pharmacological therapeutic activities are useful for controlling oncological pain and other symptoms resulting from such diseases.
This study evaluated the results relating to pain modulation and improvement of emotional symptoms and quality of life, from an occupational therapy program applied to oncological patients who were receiving palliative care.
- Detailed Description
Occupational therapy provides a variety of practical and psychosocial interventions to enable individuals to adapt to the difficulties that result from advanced disease. In this form of therapy, the use of certain manual play activities are highlighted as a working tool, with the aim of intervening in relation to the limitations and/or physical and psychological diseases. Such interventions may transform some of these patients' interests in life, facilitate the development of undiscovered talents and skills and allow them to discover their artistic, artisanal or physical potentials.
The role and interventions of occupational therapy within palliative care are wide-ranging and challenging, with a vocation to help individuals to value the remainder of their lives and live for the present moment in the best way possible, through providing options for them to keep themselves in a physical and emotional condition that allows them to carry out activities that would be gratifying and stimulating. The effects from this will assist them in preparing for the end of life with more dignity and respect.
The relevance of occupational therapy interventions in relation to oncology and, in particular, palliative care has been little studied. However, it is known that this may contribute towards improving the quality of life in interpersonal relationships and diminishing pain and distress, through providing guidance regarding activities of daily living and through the use of therapeutic activities, especially in relation to hospitalization processes.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 58
- > 18 years old
- advanced neoplasia without therapeutic possibilities for cure
- intensity of pain greater than or equal to 5 on the 10-centimeter VAS.
- expected to live for more than three months,
- Karnofsky Performance Status (KPS) of between 40 and 70%
- Patients not candidate to palliative and antalgic chemotherapy and/or radiotherapy.
- Patients or their legal representatives must be able to read, understand and provide written informed consent to participate in the study.
- Presence of aphasia and/or severe visual disturbances;
- Patients admitted to hospital for pain control in situations considered to be pain emergencies such as bone fracture, infection, medullary compression or metastasis in the central nervous system
- Patients with poor cognitive capacity (unable to understand the research questionnaires)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Group 1 (Intensive occupational therapy) Tapestry All patients received pharmacological treatment for pain in accordance with the World Health Organization (WHO)'s analgesic ladder and occupational therapy follow-up, with guidance regarding activities of daily living (ADLs). They also carried out therapeutic activities such as embroidery onto gauze (tapestry), weaving a scarf on a nail frame and playing dominos. Group 1 (Intensive occupational therapy) Regular occupation therapy All patients received pharmacological treatment for pain in accordance with the World Health Organization (WHO)'s analgesic ladder and occupational therapy follow-up, with guidance regarding activities of daily living (ADLs). They also carried out therapeutic activities such as embroidery onto gauze (tapestry), weaving a scarf on a nail frame and playing dominos. Group 1 (Intensive occupational therapy) Weaving a scarf on a nail frame All patients received pharmacological treatment for pain in accordance with the World Health Organization (WHO)'s analgesic ladder and occupational therapy follow-up, with guidance regarding activities of daily living (ADLs). They also carried out therapeutic activities such as embroidery onto gauze (tapestry), weaving a scarf on a nail frame and playing dominos. Group 1 (Intensive occupational therapy) Domino game All patients received pharmacological treatment for pain in accordance with the World Health Organization (WHO)'s analgesic ladder and occupational therapy follow-up, with guidance regarding activities of daily living (ADLs). They also carried out therapeutic activities such as embroidery onto gauze (tapestry), weaving a scarf on a nail frame and playing dominos. Group 2 (Regular occupation therapy) Regular occupation therapy All patients received pharmacological treatment for pain in according to WHO's analgesic ladder and only guidance regarding ADLs from the occupational therapist.
- Primary Outcome Measures
Name Time Method Change in pain intensity Before and after occupational therapy intervention every day up to day 10 The pain intensity was assessed every day before and after each intervention by means of the 10 cm VAS. The McGill pain questionnaire was used on the first and last (tenth) day of the study.
- Secondary Outcome Measures
Name Time Method Quality of life score Baseline and day 10 Quality of life was evaluated by means of the SF-12 Health Survey, which is a shortened version of the SF-36 Health Survey.
Anxiety rate Baseline and day 10 The anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS).
Depression rate Baseline and day 10 The depression symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS)