Table 3 Categories and Concepts

Unexpressed pain

Difficulty in communicating pain

Difficulty communicating pain to healthcare professionals and others, because of difficulties in communicating pain, such as different standards for different people, even when trying to convey how painful it is

Resistance to narcotics

Fear of drug addiction

Avoiding taking narcotic rescue as much as possible because of concerns that medical narcotics may have negative effects on the body, such as dependence

Experiencing the painful adverse event of narcotics

Difficult experience with medical narcotics due to strong side effects such as drowsiness, constipation, nausea, and delirium

Concerns about medication

Hard-to-obtain narcotics

Not being able to get medicines quickly because community pharmacies often do not stock medical narcotics

Anxiety about side effects

Worrying about the effects on the body of having to take so many different medicines to stop the pain

Difficulty in rescue opioid timing

Difficulty in deciding when to use rescue and at what intervals

Hesitation towards consultation

Atmosphere of difficulty to consult

Finding it difficult to ask questions of medical professionals about uncertainties regarding treatment and use of medicines

Exhaustion due to waiting times

Long waiting times at both hospitals and community pharmacies, and the enormous amount of effort required to see a doctor and receive medicines while being unwell

Considerations for medical professionals

Refraining from asking medical professionals for more information or making requests because the outpatient clinic or community pharmacy seems too busy

Pain endurance

Choosing patience

Choosing to persist at home, even in the presence of severe pain

Coping by self-judgment

Managing pain and symptoms at home by self-medicating when symptoms or changes in physical condition occur

Opioid rescue savings

Having to save and take rescue internally to avoid running out of narcotic rescue before the next visit to the doctor

Persistent pain

Untreated pain

Going about their daily life with pain that did not subside, even when treated with medication

Exacerbation of pain

Increased pain symptoms at home

Anguish over pain

Pessimism about pain

Feeling resigned to pain persisting

Anxiety about the future

Suffering from a lack of visibility about their illness and what their treatment will look like in the future

Mental anguish

Undergoing treatment while having mental anguish

Emergency hospitalization

Pain beyond endurance

Emergency hospitalization due to severe and unbearable pain at home

Approach by medical professionals

Medical professionals who always care

The presence of a medical professional who is always caring toward them

Remote follow-up suggestion

That the medical professional has made a suggestion to follow-up remotely by telephone at home

Consistent follow-up

Remote follow-up reassurance

Being reassured by having a remote check of their condition at home from a medical professional

Multidisciplinary support

Being supported by multiple professions in pain management

Multidisciplinary information sharing

Feeling that consultations were shared with many different professions

Teleconsultation

Consultation at home

Being able to consult remotely from home when there was a change in their health condition

Medical professionals to consult

Having a medical professional to consult when feeling unwell or in need of help

Urgent hospital visit

Encouragement to consult a doctor

Being encouraged to consult a medical professional about changes in their condition at home and to see a doctor

Improvement of pain

Appropriate use of drugs

Improved pain and ability to move with the appropriate use of medication for pain relief