Barriers Associated With Pain Management among Patients with Advanced Breast Cancer

  • Joan Chepkemei Maiyo
  • Sanaa Alaa Eldin
  • Rasha Yakout
Keywords: Advanced Breast Cancer; Pain; Barriers.


Cancer is a cause of morbidity and mortality in Kenya.A patient diagnosed with advanced breast cancer has to live with a chronic disease faced with structural, physiological and psychological, as well as socioeconomic challenge. Appropriate pain assessment and management are key indicators of pain care quality and patients satisfaction, regardless of health care setting. Inadequate pain management can be attributed to barriers related to health care professionals, patient, health care system, medication and sociocultural barriers. Objective: Identify barriers associated with pain management among patients with advanced breast cancer. Setting: The study was conducted at the Chandaria Cancer and Chronic Disease Center (CCCDC) at Moi Teaching and Referral Hospital in Kenya. Subjects: A purposive sample of 115 female patients diagnosed with stage III or stage IV Advanced Breast Cancer (ABC) from the CCCDC outpatient clinic, was included in the study. Tools: Two tools were used for data collection; Advanced Breast Cancer Pain Management Barriers Structured Interview Schedule (ABCPMIS) and Visual analog scale (VAS). Results: The study implies that patient related barriers and sociocultural barriers are the most prevalent barriers to pain management in advanced breast cancer patients attending the CCCDC. There were significant statistical differences between levels of barriers experienced and patients’ current status of disease, seeking of medical advice when in pain and their reported VAS levels. Conclusion: Patients with advanced breast cancer face various barriers to pain management related to their patient characteristics, sociocultural factors and system barriers in the health care systems. Recommendation: Implementing supportive and clinical pain management programs to advanced breast cancer patients to alleviate the pain and suffering is recommended.