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Title: Pain in Lebanese children with cancer
Author: Madi, Dina
ISNI:       0000 0004 2739 9381
Awarding Body: University of Manchester
Current Institution: University of Manchester
Date of Award: 2013
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Pain is a significant health issue in the paediatric oncology population. No study to date exists documenting the experience and characteristics of pain in Lebanese children with cancer. The primary aim of this research study is to identify the characteristics of the painful experience of paediatric cancer pain in Lebanese children and how pain is managed from the child’s own perspectives. A secondary aim is to assess the cross-cultural context of the Adolescent Paediatric Pain Tool (APPT) and the Functional Disability Inventory (FDI). The specific objectives that will be addressed are:1. To describe the demographic and clinical characteristics of Lebanese children experiencing cancer pain at the CCCL including: type of cancer, time since diagnosis, metastasis, and current treatment in outpatients and inpatients.2. To describe the characteristics of pain including: intensity, frequency, duration, location, and quality in Lebanese children with cancer at the CCCL. 3. To identify the major sources of pain (cancer-related, treatment-related, or procedure-related) in Lebanese children with cancer at the CCCL.4. To examine the impact of pain on activities of daily living in Lebanese children with cancer at the CCCL. 5. To determine the factors associated with the intensity of pain in Lebanese children with cancer at the CCCL. 6. To determine how pain is managed in Lebanese children with cancer at the CCCL from their own perspective. To meet the above aims and objectives a cross-sectional correlational design was used. A consecutive sample (n=62) was recruited from the Children Cancer Centre of Lebanon at the American University of Beirut Medical Centre (CCCL-AUBMC). Data was collected through face-to-face interviews using a structured questionnaire. The mean age of participants was 12.3 (SD 2.9). The mother was the primary caregiver in the majority of cases (69.4%). The overall mean intensity rating was 5.06 (SD 1.87) on a 10 cm Word Graphic Rating Scale. The majority (57.4%) of children reported a frequency of “sometimes”. The median duration of pain was two hours per pain episode. The most frequent locations were: the forehead, the abdomen, and lower back. Sensory words were most often used to qualify pain. The functional disability levels were moderate as measured by the FDI. Factors associated with overall pain intensity were: frequency, duration, location, affective words, and treatment-related pain. Time since diagnosis, treatment, surgery in the past, radiotherapy, pain duration and frequency of pain predicted pain intensity in the sample. Children reported receiving pharmacological help from nurses, and non-pharmacological measures from their mothers. The main self-initiated coping strategies used by children were behavioural avoidance and behavioural distraction. The most suggested coping strategy was stressor modification. The majority (56/62) did not expect to experience that much pain from cancer and treatment modalities.Pain assessment and management in Lebanese children with cancer are of concern. Health care professionals, policy makers, and institution stakeholders are urged to take action.
Supervisor: Mchugh, Gretl; Beaver, Kinta Sponsor: American University of Beirut ; School of Nursing
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Pain ; Cancer ; Children ; Assessment ; Management