In my PhD project the general purpose is to describe pain in head and neck cancer (HNC) patients and to develop pain relief treatment and to help preserve the quality of life and the daily functions of HNC patients and their relatives. HNC often requires arduous treatment that causes severe adverse effects e.g. painful oral mucositis is a common adverse effect of radiotherapy treatment. About 75% of patients with HNC experience physical pain despite pain relief treatment.
When a person is diagnosed with cancer, the quality of life and the everyday lives of close relatives risk being negatively impacted. Head and neck cancer patients require extensive care and support, and it can be difficult for relatives to provide sufficient assistance.
focused on HNC patients. It showed that as early as in the treatment phase these patients experienced existential pain in the form of fear of death, a sense of meaninglessness and feelings of guilt. Physical pain, psychological suffering and social withdrawal were also prominent in the group. The patients did not express any clear links between physical pain and psychological suffering and the conclusion was that, in the main, the patients had a biomedical view of pain. Future efforts aimed at making HNC patients aware of and understanding the interplay between pain and psychosocial factors would likely help patients deal with the pain commonly associated with this illness.
focused on how relatives experienced the situation of HNC patients with regard to pain and on how the relatives themselves experienced the situation. For relatives, supporting HNC patients (who often suffered from several dimensions of pain) was a demanding task. Relatives described their own situations negatively, reporting psychological distress, lack of involvement and a lack of support and care from caregivers. Well-tailored care and easily accessible information about practical matters should complement the medical treatment provided to HNC patients and their relatives.
Study III and IV
comprises of an ongoing intervention study to be tested in the following hypothesis: Head and neck cancer patients who undergo radiotherapy experience less physical pain and greater well-being through pain education, self-care activities and the systematic follow-up of their situation by health care providers via an online pain diary than HNC patients who have conventional follow-ups by health care providers.
The significance of the dissertation project
The results of the qualitative studies (I and II) provided a valuable foundation on which to develop and improve treatment strategies, nursing and rehabilitation for patients suffering HNC in the ongoing intervention study, study III and IV.