Tatsuya Sugino (doctoral student) and Professor Shu Morioka of Kio University Graduate School evaluated the pain of hospitalized patients with chronic cancer-related pain and revealed that, at the group level, the intensity of pain remained relatively stable throughout the day.
Pain is not determined solely by the state of the disease or tissue, but is a subjective experience influenced by psychological state, activity level, treatment, medication, and living environment. Some cases of chronic pain have been reported to exhibit time-of-day changes, such as being stronger in the morning or worsening from evening to night. However, there have been limited studies that have repeatedly measured the progression of pain from waking to bedtime in patients with chronic cancer-related pain during hospitalization.
Therefore, the research group conducted an observational study on 68 adult hospitalized patients (38 with chronic cancer-related pain and 30 with chronic non-cancer pain) whose chronic pain had persisted for more than three months. Assessments were repeated six times a day for three days, from waking up to going to bed.
The results showed that in chronic cancer-related pain, the intensity of pain at the population level remained relatively stable from waking up to going to sleep. On the other hand, in chronic non-cancer pain, a different trend was observed, with pain being higher upon waking and going to sleep, and decreasing in the morning.
However, since the patient characteristics of the two groups differed significantly, this study did not directly examine the differences between the two groups. Furthermore, in the chronic cancer-related pain group, a correlation was found between a stronger average pain over three days and the length of the disease, symptoms related to central sensitization, catastrophic thinking about pain, and the severity of depressive symptoms.
The findings of this study do not indicate that cancer-related pain does not change throughout the day, but rather highlight the need to evaluate individual patients' pain in conjunction with physical function, medication, treatment, psychological factors, and hospital environment.
Article information: [Journal of Palliative Medicine] Within-Day Pain Profiles in Hospitalized Patients with Chronic Cancer-Related Pain: Implications for Inpatient Symptom Assessment
