Occupational Therapy Modulates the Pain in Cancer Patient Under Palliative Care

Barretos Cancer Hospital

Status and phase: Completed; Phase 2

Conditions: Terminal Disease; Cancer; Pain

Treatments: Other: Weaving a scarf on a nail frame; Other: Tapestry; Other: Regular occupation therapy; Other: Domino game

Study type: Interventional

Funder types: Other

Identifiers

NCT02102178

7683857344959085

Details and patient eligibility

About

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.

Full 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.

Enrollment: 58 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• > 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.

Exclusion criteria

• 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)

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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58 participants in 2 patient groups

Group 1 (Intensive occupational therapy)

Experimental group

Description:

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.

Treatment:

Other: Domino game

Other: Weaving a scarf on a nail frame

Other: Regular occupation therapy

Other: Tapestry

Group 2 (Regular occupation therapy)

Active Comparator group

Description:

All patients received pharmacological treatment for pain in according to WHO's analgesic ladder and only guidance regarding ADLs from the occupational therapist.

Treatment:

Other: Regular occupation therapy