Different semantic and affective meaning of the words associated to physical and social pain in cancer patients on early palliative/supportive care and in healthy, pain-free individuals.

Eleonora Borelli,Fabio Ferlazzo,Mario Luppi,Giorgia Razzini,Elena Bandieri,Antonella Pasqualini,Cristina Cacciari,Claudia Mucciarini,Katia Cagossi,Sonia Eliardo,Sarah Bigi,Leonardo Potenza,Massimiliano Cruciani,Fabio Efficace,Eduardo Bruera,Fausta Lui,Carlo Adolfo Porro,Fabrizio Artioli,Tim Luckett

doi:10.1371/journal.pone.0248755

Abstract

Early palliative/supportive care (ePSC) is a medical intervention focused on patient’s needs, that integrates standard oncological treatment, shortly after a diagnosis of advanced/metastatic cancer. ePSC improves the appropriate management of cancer pain. Understanding the semantic and emotional impact of the words used by patients to describe their pain may further improve its assessment in the ePSC setting. Psycholinguistics assumes that the semantic and affective properties of words affect the ease by which they are processed and comprehended. Therefore, in this cross-sectional survey study we collected normative data about the semantic and affective properties of words associated to physical and social pain, in order to investigate how patients with cancer pain on ePSC process them compared to healthy, pain-free individuals. One hundred ninety patients and 124 matched controls rated the Familiarity, Valence, Arousal, Pain-relatedness, Intensity, and Unpleasantness of 94 words expressing physical and social pain. Descriptive and inferential statistics were performed on ratings in order to unveil patients’ semantic and affective representation of pain and compare it with those from controls. Possible effects of variables associated to the illness experience were also tested. Both groups perceived the words conveying social pain as more negative and pain-related than those expressing physical pain, confirming previous evidence of social pain described as worse than physical pain. Patients rated pain words as less negative, less pain-related, and conveying a lower intense and unpleasant pain than controls, suggesting either an adaptation to the pain experience or the role played by ePSC in improving patients’ ability to cope with it. This exploratory study suggests that a chronic pain experience as the one experienced by cancer patients on ePSC affects the semantic and affective representation of pain words.

Highlights

Palliative/supportive care is a medical intervention integrated with standard oncological care, shortly after a patient is diagnosed with advanced/metastatic cancer. Early palliative/supportive care (ePSC) focuses on the patients’ needs and is meant to offer the best possible quality of life to cancer patients and their caregivers
In the last years, several randomized controlled trials have shown that ePSC may lead to a better quality of life and decreased depression [1,2,3,4,5,6], lower rates of chemotherapy near death [1,3,7], increased prognosis awareness [5,8], and longer survival [1,2,9]
Saunders coined the expression “total pain” to capture the complexity of cancer pain that results from a combination of physical and psychosocial sufferings simultaneously caused by the disease, oncologic treatments, and patients’ thoughts and feelings [12]

Summary

Introduction

Palliative/supportive care (ePSC) is a medical intervention integrated with standard oncological care, shortly after a patient is diagnosed with advanced/metastatic cancer. ePSC focuses on the patients’ needs and is meant to offer the best possible quality of life to cancer patients and their caregivers. EPSC focuses on the patients’ needs and is meant to offer the best possible quality of life to cancer patients and their caregivers. According to the World Health Organization, the beneficial effects of ePSC arise from an “early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual” [10]. Saunders coined the expression “total pain” to capture the complexity of cancer pain that results from a combination of physical and psychosocial sufferings simultaneously caused by the disease, oncologic treatments, and patients’ thoughts and feelings [12]. The multidisciplinary approach standing behind ePSC has proved to be effective in the assessment and management of total pain in cancer patients [13]

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