Pain scale tool not effective in detecting pain in cancer patients, says researcher

Every year, several thousand cancer patients in Sweden risk receiving too little pain relief in the end of life, as the health care system fails to detect that the patients are suffering from pain. When patients cannot verbalize their pain, the pain assessment instrument Abbey Pain Scale is sometimes used instead—but it does not work for patients with cancer, according to a thesis.

“Even though half of the patients self-reported moderate or severe pain, the instrument showed only mild pain according to our study. This can lead to undertreatment of the pain for many dying patients with cancer,” says Sussi Tegenborg, doctoral student.

The Abbey Pain Scale is one of three recommended pain assessment instruments in Sweden for patients who, for various reasons, cannot self-report their pain. The problem is that available instruments are designed to find pain in patients with dementia and not in those suffering from cancer.

“There is no assessment instrument specifically developed for cancer patients. When we interviewed health care professionals about the instrument, they pointed out that some parts of the instrument are not adapted to how cancer patients physically express pain at the end of life,” says Tegenborg.

“If we succeed in developing a well-functioning instrument, it will not only be able to help patients here in Sweden, but potentially also cancer patients around the world.”

On Wednesday 5 June, Tegenborg, Department of Diagnostics and Intervention at Umeå University, will defend her dissertation, titled “Pain or not pain? That is the question. An evaluation of the observational Abbey Pain Scale when used in patients with cancer.”