Managing One’s Symptoms

Abstract

Background African Americans endure disproportionately high advanced cancer rates and also are disproportionately represented in the lower socioeconomic strata. These individuals work to manage symptoms in order to function and have a satisfactory quality of life. Objective The purpose of this study was to discover what low-income African American adults with advanced cancer do on a day-to-day basis to relieve and manage symptoms. This study viewed the individuals as experts and asked them not what they are told to do, but rather what they actually do. Methods A purposive sample of 27 individuals participated in semi-structured interviews conducted by two research interviewers. This qualitative descriptive approach used content analysis to develop themes to describe symptom self-management. Results Participants described two approaches: making continual adjustments and finding stability through spirituality. In seeking comfort from the distress of their symptoms, they were constantly altering their activities and fine-tuning strategies. They adjusted medical regimens and changed the speed and selection of daily activities, including comfort measures and diet modifications. In contrast, their spirituality was a consistent presence in their lives that provided balance to their unstable symptom experience. Conclusions This study illustrates that people with advanced cancer actively engage in multiple complex self-management strategies in response to symptoms. Implication for Practice As providers assess how individuals manage their symptoms, they must find ways to support those efforts. Providers then will recognize the challenges faced by advanced cancer patients in obtaining the best quality of life while managing multiple symptoms, activities, and family responsibilities.

Factors Related to Adherence to Opioids in Black Patients With Cancer Pain

“…This study and others 14,43 show that cancer patients who are prescribed ATC opioids are not taking their pain medication as prescribed despite reporting moderate pain. A change in pain between the baseline and follow-up assessment was associated with better adherence which likely means patients adjust medication when pain changes.…”

Living experiences of people with advance cancer with low socioeconomic status: A systematic review of qualitative evidence

“…A philosophical perspective was mentioned in only three of the included studies. 9,37,49 Three studies did not clarify the impact of researchers on the study, 37,50,51 and one study did not have a statement locating the researcher culturally or theoretically 49 (Supplemental Material 2).…”

“…It was always defined as a negative life experience from the participants' perspectives, no matter the variation in their location and other characteristics. 26,37,38,50,52…”

“…Medication management was used as a significant way to ameliorate uncomfortable physical symptoms. 37,53 However, some participants believed that the symptom management scheme prescribed was too complex to follow, and they preferred to listen to their own bodies to determine what they needed, engaging in independent medicine management. 37 'I felt myself how the pain was doing me.…”

“…However, it is difficult for those with low socioeconomic status to obtain relevant services consistently and adequately due to individual and regional financial and other resource constraints. 37,38 They concurrently report greater distress due to lower perceived quality of health care because of financial hardship. 39,40 Some qualitative studies have found more life difficulties in advanced cancer patients with low socioeconomic status than that in other advanced cancer patients, with the patients expressing stronger feelings of social exclusion and isolation in their fragile relations.…”