Coping-Strategien und deren Effektivität bezogen auf das Therapieziel Schmerzreduktion untersucht an Tumorpatienten in palliativen Behandlungssituationen in Kerala, Indien

Purpose/Objectives: To identify coping- and pain-relieving methods of patients in pain receiving palliative care in Kerala, India. We wanted to investigate the use of different factors and their efficacy, bearing in mind the different religions of our patients. The cause of their pain and the role of pain in their respective lives also formed part of the interviews. Design: Qualitative interview study Setting: Participants´ homes in mostly rural and poor areas in Kerala, India Sample: 32 participants over the age of 18, who received palliative care from a non profit palliative care organisation (Pallium India) Methods: broad, semi-structured interviews, face-to-face audiotaped, translated from Malayalam into English back and forth, transcribed verbatim and analyzed using a mixed content analysis containing qualitative as well as quantitative components. Findings: Reasons for pain were mostly: financial worries, social changes and the diagnosis itself. Patients had to suffer from their pain; this suffering mostly concerned their daily-activities, social changes, goals in/ attitude towards life as well as their family-life. Most often used coping- and pain-relieving-strategies in individual order were: medication, God and religion, social environment. Some patients also mentioned exercising, resting, operational procedures for those with physical problems, traditional ayurvedic medicine. We identified religious differences concerning the use of different coping- and pain relieving-methods. Conclusions: Coping- and pain-relieving-strategies seem to be specific to the patient. Overall it is important to combine medication with a social component in order to soothe pain. The respective partner, family, friends, a doctor, society as well as God could all provide this social component. The pain-categories (physical, emotional, unspecific) influence each other positively (pain-relieving) as well as negatively (pain-increasing)