Dealing with pain and feeling stressed in hospice patients

Aim of the study
To assess pain severity and stress level in home hospice and in-patient hospice patients, and to present psychological strategies taken by patients and their impact on pain sensations and stress level.

Material and methods
The study covered 62 adult patients under in-patient and home hospice care. The method used in this study was a diagnostic survey using the Coping Strategy Questionnaire (CSQ), Distress Thermometer and Numerical Rating Scale (NRS).

Results
More than half of the patients 62.9% (n = 39) were treated with strong opioids. The study showed that the most common causes of stress among hospice patients were problems within the physical sphere, i.e. fatigue (74.19%), sleep problems (52.8%), and pain (36.8%), in terms of practical problems, housing difficulties (48.39%), in terms of emotional problems, sadness (72.58%), worry (67.72%) and anxiety (53.23%), while religious or spiritual problems most often concerned the loss of interest in everyday matters (29.03%) or relations with God (20.97%). The hospice patients experienced moderate pain (2.39/10 pts) and stress (4.08/10 pts). A higher level of pain was reported by home hospice patients (3.32/10 pts) much more often than by in-patient hospice patients (1.45/10 pts).

Conclusions
Patients receiving hospice care experienced moderate pain, while inhabitants of towns and cities experienced higher severity of pain than residents of rural areas. Patients’ problems were associated with housing, sadness, fatigue, sleep problems and pain. Patients were more likely to use cognitive than behavioral strategies in the fight against pain.