Background: Pain is a common symptom in dying patients.
Previous studies have paid little attention to pain and pain
control in terminally ill patients with diseases other than
cancer.
Aims: This study investigated whether there were differences
in healthcare workers’ documentation of pain
characteristics in cancer and noncancer patients. We
investigated what types of analgesics were administrated to
dying patients, and if there were differences in the
administration routes of opiates in cancer patients compared
to noncancer patients in the last 3 days of life.
Methods: Data were collected retrospectively in a crosssectional
comparative study at a hospital. The sample
included 220 deceased patients (110 died of cancer and 110
died of other causes). Data were extracted from patients’
medical records using the Resident Assessment Instrument
of Palliative Care.
Results: Healthcare workers consistently documented more
pain in cancer patients during their last 3 days of life than
in noncancer patients. The odds for having severe to
excruciating pain was four times higher in cancer patients
compared to noncancer patients. Morphine was the most
frequently administrated analgesic for all dying patients;
however, the odds ratio of cancer patients compared to
noncancer patients receiving morphine plus scopolamine
was 0.27. The odds of a cancer patient receiving analgesics
classified as fentanyl, ketobemidone and oxycodone was
more than 4–5 times higher than for noncancer patients.
Opiates were more frequently administered transdermally
or by oral administration on an as-need basis in cancer
patients; 10% in both groups did not receive adequate pain
control.
Conclusions: Pain is a highly prevalent symptom among
dying hospitalized patients. Healthcare workers consistently
documented more pain in cancer patients and also
assessed that the intensity of pain was more severe in these
patients than in noncancer patients. The dying patients’
intensity of pain was poorly documented.