Assessment of total pain in people in oncologic palliative care: integrative literature review

Abstract

The promotion of comfort and quality of life of people with cancer in palliative care requires flawless evaluation and management of pain, understood in its multidimensionality and integrality. The objective of this study was to present an overview of the scientific production referring to evaluation of the pain and total pain of patients with advanced cancer in palliative care. The study involved an integrative literature review, searching the databases PubMed, Embase, Cinahl, Lilacs and Web of Science using the descriptors ‘Total Pain’, ‘Cancer Pain’, ‘Pain’, ‘Symptom Assessment’, ‘Pain Measurement’, ‘Pain Evaluation’, ‘Neoplasms’, ‘Cancer’, ‘Tumor’, ‘Palliative Care’, ‘Hospice Care’ , and ‘Terminal Care’. To select the studies, the authors used the reference manager Mendeley and the application Rayyan™, as well as blind and independent peer review. Twenty-two articles were selected, published between 2002 and 2020 in different countries, and classified into two thematic units: ‘Physical, social, emotional, and spiritual factors related to pain in cancer’ ( N = 13) and ‘Importance of the overall evaluation and multidisciplinary team in the management of pain’ ( N = 9). Advanced cancer is associated with high mortality, a decline in health status, the presence of pain, and complex psychosocial concerns. Pain and symptoms in patients in palliative care should be evaluated as a whole and controlled thorough the work of an interdisciplinary team. The qualitative synthesis of the results demonstrates that most of the evaluated studies have a mixed nature; there are significant methodological differences among them and a low level of evidence in studies relating to the subject of pain evaluation in palliative care.