Pain, symptom distress, and pain barriers by age among patients with cancer receiving hospice care: Comparison of baseline data

2021 ◽  
Author(s):  
Saunjoo L. Yoon ◽  
Lisa Scarton ◽  
Laurie Duckworth ◽  
Yingwei Yao ◽  
Miriam O. Ezenwa ◽  
...  
Keyword(s):  
Hospice Care ◽  
Symptom Distress ◽  
Baseline Data ◽  
Pain Symptom ◽  
Patients With Cancer

scholarly journals Family Perspectives on Hospice Care Experiences of Patients with Cancer

2017 ◽  
Vol 35 (4) ◽  
pp. 432-439 ◽  
Author(s):  
Pallavi Kumar ◽  
Alexi A. Wright ◽  
Laura A. Hatfield ◽  
Jennifer S. Temel ◽  
Nancy L. Keating
Keyword(s):  
Propensity Score ◽  
Goal Attainment ◽  
Hospice Care ◽  
Symptom Relief ◽  
Patients With Cancer ◽  
Percentage Points ◽  
The Right ◽  
Hospice Use ◽  
Eol Care

Purpose To determine whether hospice use by patients with cancer is associated with their families’ perceptions of patients’ symptoms, goal attainment, and quality of end-of-life (EOL) care. Methods We interviewed 2,307 families of deceased patients with advanced lung or colorectal cancer who were enrolled in the Cancer Care Outcomes Research and Surveillance study (a multiregional, prospective, observational study) and died by 2011. We used propensity-score matching to compare family-reported outcomes for patients who did and did not receive hospice care, including the presence and relief of common symptoms (ie, pain, dyspnea), concordance with patients’ wishes for EOL care and place of death, and quality of EOL care. We also examined associations between hospice length of stay and these outcomes among hospice enrollees. Results In a propensity-score-matched sample of 1,970 individuals, families of patients enrolled in hospice reported more pain in their patient compared with those not enrolled in hospice. However, families of patients enrolled in hospice more often reported that patients received “just the right amount” of pain medicine (80% v 73%; adjusted difference, 7 percentage points; 95% confidence interval [CI], 1 to 12 percentage points) and help with dyspnea (78% v 70%; adjusted difference, 8 percentage points; 95% CI, 2 to 13 percentage points). Families of patients enrolled in hospice also more often reported that patients’ EOL wishes were followed (80% v 74%; adjusted difference, 6 percentage points; 95% CI, 2 to 11 percentage points) and “excellent” quality EOL care (57% v 42%; adjusted difference, 15 percentage points; 95% CI, 11 to 20). Families of patients who received > 30 days of hospice care reported the highest quality EOL outcomes. Conclusion Hospice care is associated with better symptom relief, patient-goal attainment, and quality of EOL care. Encouraging earlier and increased hospice enrollment may improve EOL experiences for patients with cancer and their families.

Hospice Use Among Patients With Cancer: Trends, Barriers, and Future Directions

2020 ◽  
Vol 16 (12) ◽  
pp. 803-809
Author(s):  
Mihir N. Patel ◽  
Jonathan M. Nicolla ◽  
Fred A.P. Friedman ◽  
Michala R. Ritz ◽  
Arif H. Kamal
Keyword(s):  
End Of Life ◽  
Advanced Cancer ◽  
End Of Life Care ◽  
Hospice Care ◽  
Rapid Development ◽  
Spiritual Needs ◽  
Life Care ◽  
General Acceptance ◽  
Patients With Cancer ◽  
Hospice Use

Patients with advanced cancer and their families frequently encounter clinical and logistical challenges related to end-of-life care. Hospice provides interdisciplinary and holistic care to meet patients’ biomedical, psychosocial, and spiritual needs in the last phases of life. Despite increasing general acceptance and use among patients with cancer, hospice remains underused. Underuse stems from ongoing misconceptions regarding hospice and its purpose, coupled with the rapid development of novel anticancer treatments, such as immunotherapies and targeted therapies, that have changed the landscape of possibilities. Furthermore, rapid evolutions in how end-of-life care is structured and reimbursed for will affect how oncology patients will intersect with hospice care. In this review, we explore the current and future challenges to greater integration of hospice care in the care of patients with advanced cancer and propose five recommendations as part of the path forward.

scholarly journals Hope of Recovery in Patients in the Terminal Phase of Cancer under Palliative and Hospice Care in Poland

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bożena Baczewska ◽  
Bogusław Block ◽  
Beata Kropornicka ◽  
Antoni Niedzielski ◽  
Maria Malm ◽  
...  
Keyword(s):  
Palliative Care ◽  
Hospice Care ◽  
Terminal Phase ◽  
Family Socioeconomic Status ◽  
Terminally Ill Cancer Patients ◽  
Patients With Cancer ◽  
Causal Treatment ◽  
Low Levels ◽  
The Individual ◽  
Oncologic Therapy

Introduction. The objective of the presented research is to characterize hope in the situational dimension, i.e., health, in the patients with cancer in the terminal phase of the disease, being treated in hospices and palliative care centers. Hope is very important for all the patients, especially for patients with cancer in various phases of the disease. Giving up on oncologic therapy and causal treatment is often associated with a transition into palliative care. When death and a loss of values become a threat, the individual has got hope to rely on. Material and Methods. The study relies on the Test to Measure Hope in the Health Context (NCN-36) by B.L. Block. 246 patients in the terminal phase of cancer participated in the study. Results. The internal structure of hope of recovery in the patients’ group was varied. The patients showed low levels of hope of recovery since they do not believe in the effectiveness of treatment. They were also not convinced of the effectiveness of modifications in dieting, lifestyle, or the use of nonconventional medicine. They trusted the doctor in charge and were moderately satisfied with the therapy in use. The intensity of hope of recovery was on the low level in the patients in the terminal phase of cancer. Age, sex, place of living, and marital status had a significant influence on the level of hope of recovery. Variables such as living on one’s own or living with one’s family, socioeconomic status, education, or profession did not affect the level of hope of recovery. Conclusions. The presented results allowed as to conclude that the assessment of hope in terminally ill cancer patients can be considered as one of the important tools enabling the personalization and the improvement of palliative care.

scholarly journals Using patient reported outcomes in oncology clinical practice

2016 ◽  
Vol 13 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Sarah A. Kelleher ◽  
Tamara J. Somers ◽  
Tracie Locklear ◽  
Alexandra D. Crosswell ◽  
Amy P. Abernethy
Keyword(s):  
Symptom Severity ◽  
Psychosocial Functioning ◽  
Self Efficacy ◽  
Symptom Management ◽  
Patient Reported Outcomes ◽  
Tablet Computer ◽  
Cancer Type ◽  
Pain Symptom ◽  
Patients With Cancer ◽  
Patient Reported

AbstractBackground and aimsPatient reported outcomes (PROs) are increasingly being implemented into the care of patients with cancer. The use of a standard set of PROs (e.g., pain) in cancer is becoming established and there is interest in what additional PROs might provide valuable information. The goal of this observational study was to examine how the PROs of self-efficacy for pain and other symptoms assessed at the point of service were associated with pain, symptom severity and distress, and physical and psychosocial functioning in a sample of breast and gastrointestinal patients. We also sought to examine differences in these relationships by cancer type (breast and gastrointestinal) as well as understand differences in self-assessment mode (paper/pencil or electronic tablet).Methods178 patients with breast (n = 65) and gastrointestinal cancer (n = 113) completed the Chronic Pain Self Efficacy Scale, M.D. Anderson Symptom Inventory, and Functional Assessment of Cancer Therapy – General questionnaires. Measures were completed with paper and pencil and electronically using a tablet computer while patients waited for their clinical appointment. Responses from the initial completed questionnaires on both the paper and electronic instruments were analyzed.ResultsPatients’ self-efficacy scores for pain and other symptoms correlated positively with pain, symptom severity and distress, and physical and psychosocial functioning; patients with lower levels of self-efficacy reported poorer outcomes and functioning overall. The results were independent of cancer type and mode of assessment. No statistically significant differences were found in the PROs when collected by electronic technology versus paper-pencil mode; patients were very satisfied with using the tablet computer to complete the PRO measures.Conclusions and implicationsOur results suggest that self-efficacy for pain and symptom management may be a beneficial addition to clinic-based PRO assessment batteries for patients with cancer and other chronic diseases. Existing short, validated symptom self-efficacy scales could easily be integrated into clinical practice to help healthcare providers identify patients that might benefit from intervention. Study results also support existing research that suggests electronic approaches are a practical way to collect PRO data, including self-efficacy data, in the clinic. Overall, our data suggest that patients who have particularly low levels of self-efficacy for pain and symptom management may be at risk for higher levels of pain and disability. Thus, if self-efficacy for pain and symptom management were routinely collected at the time of clinical service, psychosocial interventions to improve self-efficacy for pain and symptom management, and in turn overall quality of life, could be implemented in a timely fashion.

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