A longitudinal application of the Actor Partner Interdependence Model extended Mediations to the health effects of dyadic support

Cancer Pain Experience Through the Lens of Patients and Caregivers: Mixed Methods Social Media Study

BACKGROUND

Cancer pain represents a challenge for cancer patients and their family members. Despite progression in pain management, pain is still underreported and undertreated, and there is limited information on the related needs that patients and caregivers may have. Online platforms represent a fundamental tool for research to reveal the unmet needs of these users and their emotions outside the medical setting.

OBJECTIVE

This study aimed to (1) reveal the unmet needs of both patients and caregivers and (2) detect the emotional activation associated with cancer pain by analyzing the textual patterns of both users.

METHODS

A descriptive and quantitative analysis of qualitative data was performed in RStudio v.2022.02.3 (RStudio Team). We analyzed 679 posts (161 from caregivers and 518 from patients) published over 10 years on the "cancer" subreddit of Reddit to identify unmet needs and emotions related to cancer pain. Hierarchical clustering, and emotion and sentiment analysis were conducted.

RESULTS

The language used for describing experiences related to cancer pain and expressed needs differed between patients and caregivers. For patients (agglomerative coefficient=0.72), the large cluster labeled unmet needs included the following clusters: (1A) reported experiences, with the subclusters (a) relationship with doctors/spouse and (b) reflections on physical features; and (1B) changes observed over time, with the subclusters (a) regret and (b) progress. For caregivers (agglomerative coefficient=0.80), the main clusters were as follows: (1A) social support and (1B) reported experiences, with the subclusters (a) psychosocial challenges and (b) grief. Moreover, comparison between the 2 groups (entanglement coefficient=0.28) showed that they shared a common cluster labeled uncertainty. Regarding emotion and sentiment analysis, patients expressed a significantly higher negative sentiment than caregivers (z=-2.14; P<.001). On the contrary, caregivers expressed a higher positive sentiment compared with patients (z=-2.26; P<.001), with trust (z=-4.12; P<.001) and joy (z=-2.03; P<.001) being the most prevalent positive emotions.

CONCLUSIONS

Our study emphasized different perceptions of cancer pain in patients and caregivers. We revealed different needs and emotional activations in the 2 groups. Moreover, our study findings highlight the importance of considering caregivers in medical care. Overall, this study increases knowledge about the unmet needs and emotions of patients and caregivers, which may have important clinical implications in pain management.

A Comprehensive Analysis of the Cancer Chronic Pain Experience: A Narrative Review

Cancer-related chronic pain (CP) represents a critical clinical issue through the disease, severely compromising the quality of life (QoL) of patients and the family environment. The current review employed a narrative method to synthesize the main results about the impact of cancer-related CP on QoL, adopting a multidimensional and threefold vision: patients, caregivers, and patient–caregiver perspective. Evidence emphasizes the importance of considering a bidirectional perspective (patient–caregiver) to understand better the pain experience throughout the cancer continuum and its consequences on QoL of patients and caregivers. Moreover, a holistic and multidimensional approach to cancer-related CP and its impact on QoL of patients and caregivers is still needed, in which the interconnection between physical, psychological, and social factors should be analyzed. Theoretical and methodological issues for orienting future social and family research initiatives were discussed.