Clinical evaluation of the Mood and Symptom Questionnaire (MSQ) in a day therapy unit in a palliative support centre in the United Kingdom

2008 ◽  
Vol 6 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Elizabeth Chapman ◽  
Judith Whale ◽  
Annette Landy ◽  
David Hughes ◽  
Margaret Saunders
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Care Center ◽  
Psychosocial Interventions ◽  
Physical Symptoms ◽  
Clinical Tool ◽  
Psychological Issues ◽  
Training Tool ◽  
Symptom Questionnaire

ABSTRACTObjective:To evaluate the use of the Mood and Symptom Questionnaire (MSQ) within a program of structured psychosocial interventions in a Supportive and Palliative Care Center. Palliative care patients have a range of psychological symptoms as well as physical symptoms. Considerable expertise in controlling pain and fear of pain, other physical symptoms, and psychosocial distress has been built up in hospices and palliative care units. This expertise can be used even at late stages in the patient's illness to improve quality of life.Method:We evaluated the usefulness of the MSQ to record patient responses, as an aid to patient/staff discussions, and as a staff-training tool. The questionnaire consisted of visual analog scales completed by the patient with a staff member present. Using the tool increased the opportunities for staff and patients todiscussproblematic psychosocial issues. Where possible, we obtained data at two time points and compared the responses.Results:The MSQ was rapidly accepted as a clinical tool in the day therapy setting by staff and the patients. Theprocessof completing the questionnaire encouraged patients to face and discuss difficult issues. Discussion of the issues raised on the questionnaire had a wider effect, influencing interactions and communications through the unit and facilitating wider discussion of other nonpain symptoms. The medical psychotherapist associated with the unit used the MSQ responses as a training tool to increase staff awareness and knowledge and understanding of psychological issues related to the patients' total pain experience by discussing the questionnaires with them.Significance of results:The use of this tool helped to identify some psychological issues that proved relatively straightforward to address once uncovered. Patients benefited from this opportunity when their remaining time was relatively short. Their quality of life at the end of their lives was improved.

scholarly journals Severe symptoms and very low quality-of-life among outpatients newly diagnosed with advanced cancer: data from a multicenter cohort study

2020 ◽  
Vol 28 (11) ◽  
pp. 5547-5555
Author(s):  
Waldemar Siemens ◽  
Stefan S. Schönsteiner ◽  
Claudia Lorena Orellana-Rios ◽  
Ulrike Schaekel ◽  
Jens Kessler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cohort Study ◽  
Advanced Cancer ◽  
Physical Symptoms ◽  
Newly Diagnosed ◽  
Multicenter Cohort Study ◽  
European Organization ◽  
Multicenter Cohort

Abstract Purpose The aim of this study was to identify symptoms of severe intensity or very low scores for quality of life (QoL) domains in newly diagnosed outpatients with advanced cancer. Methods This multicenter cohort study from a state-wide palliative care network included adult outpatients with advanced cancer diagnosed within the preceding 8 weeks from four comprehensive cancer centers (DRKS00006162, registered on 19 May 2014). We used the Palliative Outcome Scale (POS), Hospital Anxiety and Depression Scale, and European Organization for Research and Treatment of Cancer QoL Questionnaire-C30. For each questionnaire, cut-off scores defined symptoms and QoL domains that were considered “severe” or “very low.” Results Of 3155 patients screened, 481/592 (81.3%) were analyzed (mean age 62.4; women n = 245, 50.9%). We identified 324/481 (67.4%) patients experiencing at least one severe symptom or a very low QoL domain (median 2; range 0 to 16). Role functioning (n = 180, 37.4%), fatigue (n = 162, 33.7%), and social functioning (n = 126, 26.2%) were most commonly affected. QoL was very low in 89 patients (18.5%). Women experienced more anxiety symptoms, fatigue, and had lower POS scores. Patients often mentioned physical symptoms and fears of adverse events resulting from disease-modifying therapies (e.g., chemotherapy) as most relevant problems. Conclusions Already within the first 8 weeks after diagnosis, the majority of patients reported at least one severe symptom or a very low QoL domain. Gender differences were evident. The findings illustrate the value of early routine assessment of patient burden and the development of multi-professional and interdisciplinary palliative care.

End-stage pulmonary disease

2007 ◽  
pp. 99-102
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Pulmonary Disease ◽  
Physical Symptoms ◽  
Curative Treatment ◽  
Total Care ◽  
End Stage ◽  
Spiritual Problems

End-stage pulmonary disease 100 The WHO defines palliative care as the active total care of patients whose disease is not responsive to curative treatment. The goal of palliative care is achievement of best quality of life for patients and their families. It includes control of pain and other physical symptoms as well as care of psychological, social and spiritual problems....

Palliative Care in the Last Hours of Life

2018 ◽  
Author(s):  
Ahsan Azhar
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
Communication Skills ◽  
Physical Symptoms ◽  
Accurate Assessment ◽  
Effective Management ◽  
Relief Of Suffering ◽  
Key Aspects

Patients with life-limiting illnesses often experience severe distressing psychosocial and physical symptoms during the last hours of life. Prompt relief of suffering is paramount; hence, accurate assessment and effective management of symptoms, along with excellent communication skills, help clinicians not only relieve patients’ distressing symptoms but also provide education about end of life along with psychosocial and emotional support to the caregivers. The aim is for improving the quality of life of patients and caregivers and reduce the incidence of complicated grief especially among the over-whelmed caregivers. This chapter reviews the key aspects of care of patients in the last hours of life.

Palliative care in old age

2001 ◽  
Vol 11 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Raymond SK Lo ◽  
Jean Woo
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Palliative Medicine ◽  
Holistic Approach ◽  
Physical Symptoms ◽  
World Health ◽  
Team Approach ◽  
Curative Therapy ◽  
Care And Support

What is palliative medicine?In 1987, the Royal College of Physicians recognized palliative medicine as a specialty, defining it as ‘the study and management of patients with far-advanced disease for whom the prognosis is limited and the focus of care is quality of life’. In 1990, the World Health Organization added its definition, ‘the active and total care of a person whose condition is not responsive to curative therapy’. The aim of palliative medicine is to control pain and other physical symptoms, together with integration of psychological, social, spiritual care and support. The ultimate goal is to help patients to achieve their best quality of life. Palliative medicine places emphasis on a holistic approach, offering care and support not just for patients but also for their families. Palliative medicine hence requires an interdisciplinary team approach. With the co-ordinated efforts of all disciplines (such as doctors, nurses, therapists, social workers, clinical psychologists, dieticians, pastoral care workers and volunteers), patients can be supported in living their remaining lives as actively as possible, and families can be assisted in coping with illness, death and bereavement. Palliative care neither intends to postpone death nor does so, but affirms life and regards dying as a normal process. When a patient faces an incurable illness, it is incumbent on the palliative care team to provide the best treatment and care, adding life to days when days cannot be added to life.

scholarly journals Clown Care In A Palliative Care Unit: A Useful Paradox? A Preliminary Pilot Study Involving Questionnaires And Text Analysis.

2021 ◽  
Author(s):  
Laoridi Aouridi-Héritier ◽  
Sophie Alonzo ◽  
Pascale Fabbro-Peray ◽  
Marion Guinamard ◽  
Sylvie Blanchard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Pilot Study ◽  
Physical Symptoms ◽  
Palliative Care Unit ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Life Questionnaire ◽  
The Impact

Abstract Title: The impact of Clown Therapy in a Palliative Care Unit (PCU); a pilot studyBackground: Although several studies on clown therapy have demonstrated benefits for children and the elderly, few studies exist on its impact on quality of life in adult terminal patients.We devised this monocentric, prospective, descriptive pilot study, covering both quantitative and qualitative aspects, to test the hypothesis that “clowning” in the PCU would help to improve the quality of life of patients, and benefit those accompanying them and their carers.Methods: 30 terminal patients [age range 63-79, 19 women, 11 men] from the palliative care unit at Nîmes University Hospital were included in the study from 31/03/2016 to 08/11/2016. All had given written informed consent. 2 clowns visited the patients and their companions, inviting them to take part in 15 to 30-minute improvised role-plays to prepare them for the inevitable separation. Primary outcome measures for the impact of the clowns’ interventions were: The Edmonton Symptom Assessment System evaluating patients’ physical symptoms and the McGill Quality of Life Questionnaire assessing patients’ quality of life. The secondary outcome measure was Alceste textual data analysis software to analyse semi-structured interviews held with patients, their companions and carers. Results: However long the clown’s intervention, the ESAS scores indicated a significant improvement in nausea (p=0.0248) and dyspnea (p=0.0476). Scores for depression (p=0.0160) also showed an improvement. A slight difference in the scores for anxiety (p=0.0900) and drowsiness (p=0.0812) was also observed. 2 days after the clowns’ intervention, the Mc Gill scores revealed a significantly greater physical quality of life (p=0.0044) and a very slight increase in the patients’ overall quality of life (p=0.0807). Results of the lexical analysis with Alceste revealed benefits for all those involved and gave an indication for better patient management at the PCU. Conclusions: This pilot study demonstrating the impact of “clowning” on various physical and mental symptoms in adult patients indicates the benefits of such interventions for patients, their companions and carers. Although the usefulness of clowns for children with life-threatening diseases is clear, the results obtained with our study clearly indicate the benefits of these interventions in adult, end-of-life patients. Further studies would be required to confirm these findings.Date of first registration : 20/11/2015Trial registration: ClinicalTrials.gov ID: NCT02610452This research was registered under the following reference : IDRCB 2015-A00719-40 and approved by the local committee for the protection of persons, CPP Sud-Méditerranée III-Nîmes on November 6th, 2015 under the reference 2015.06.03.

Psychiatric and Psychological Interventions for the Control of Pain and Selected Physical Symptoms

2014 ◽  
pp. 103-114
Author(s):  
William S. Breitbart
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Psychiatric Disorders ◽  
Advanced Cancer ◽  
Terminally Ill ◽  
Physical Symptoms ◽  
Diagnosis And Treatment ◽  
Psychological Interventions ◽  
Assessment And Treatment

In addition to the diagnosis and treatment of psychiatric disorders in palliative care settings, pain and other troublesome physical symptoms must also be aggressively treated in efforts aimed at the enhancement of the patient’s quality of life. These symptoms must be assessed by the psycho-oncologist concerned with the assessment and treatment of affective and other syndromes in the terminally ill population. This chapter provides a brief overview of the prevalence, assessment, and management of the commonly encountered, distressing physical symptoms such as pain, insomnia, and nausea among patients with advanced cancer.

scholarly journals Quality of life of community-based palliative care clients and their caregivers

2012 ◽  
Vol 11 (4) ◽  
pp. 323-330 ◽  
Author(s):  
Tanya Connell ◽  
Ritin S. Fernandez ◽  
Duong Tran ◽  
Rhonda Griffiths ◽  
Janeane Harlum ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Physical Symptoms ◽  
Health Related Quality ◽  
Caregiver Quality ◽  
Related Quality ◽  
Health Related ◽  
Matched Data

AbstractObjective:This study aimed to investigate health-related quality of life of palliative care (PC) clients and their caregivers, at baseline and follow-up, following a referral to a community PC service.Method:Quality of life of clients and their caregivers was respectively measured using the McGill Quality of Life instrument (MQoL) and the Caregiver Quality of Life Cancer Index (CQoLC) instruments. Participants were recruited from June 8 to October 27, 2006. This study was undertaken in one zone of an Area Health Service in New South Wales, which has a diverse socioeconomic population. The zone covers an area of 6237 km2 and is divided into five sectors, each with a PC service, all of which participated in this study.Results:Data were obtained from 49 clients and 43 caregivers at baseline, and 22 clients and 12 caregivers at 8 week follow-up. Twenty-one participants died and six moved out of the area during the study. At baseline, clients reported a low mean score for physical symptoms (3.3 ± 1.9) and a high score for support (8.7 ± 1.0). Caregivers scored a total CQoLC of 63.9 ± 21.4 and clients had a total QOL of 6.1 ± 1.3. At follow up, matched data for 22 clients and 13 caregivers demonstrated no statistical differences in quality of life.Significance of results:This study has provided evidence that health-related quality of life questionnaires show lower scores for physical health and higher scores for support, which can directly inform specific interventions targeted at the physical and support domains.

scholarly journals Application Application Of Problems And Needs In Palliative Care Instrument - Short Version (PNPC-Sv) For Assessing The Paliative Care Needs For Cancer Patients

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Ratih Ayuningtyas Pocerattu ◽  
Anggorowati ◽  
Chandra Bagus
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cancer Patients ◽  
Information Needs ◽  
Physical Symptoms ◽  
Short Version ◽  
Care Needs ◽  
Study Approach ◽  
The Right

Background: Assessment of the needs of palliative care is the first step to know about the picture quality of life and determine interventions to solve problems experienced by patients with chronic conditions and terminal. One of the instruments that can be used is the PROBLEMS AND NEEDS IN PALLIATIVE CARE INSTRUMENT - SHORT VERSION (PNPC-sv). Instrument PNPC-sv examines the 8 dimensions of activity and excersice, physical symptoms, autonomy, psychological, spiritual, financial, and information needs. Methods: This research uses qualitative method with case study approach. Data collection was conducted by means of questionnaires filled in the assessment of the needs of palliative care (PNPC-SV),  then performed in-depth interviews in accordance with the results of the assessment and observation on the 6 participants in the space of oncology in one of hospital in Semarang. Result: The theme results of this research are: (1) Self-acceptance as well as support to the family of the condition of the patient, (2) Influence the patient's psychological to the social environment, (3) the right education to improve the quality of life and (4) The basic components assessment  of the needs palliative care should be assessed by the nurse. Conclusion: The assessment which done in a holistic manner can help the nurse to provide nursing care in accordance with the needs of the patient to face the condition of the disease. The needs of the patient in physical, psychological, social and spiritual is very necessary to maintain the balance of her consistency and integrity in the ability to remain accepted, loved and appreciated by others. Keywords: The need for palliative care, PNPC-SV, cancer patients.

Association between attendance at a specialist palliative care day unit and improvement in patient symptoms and quality of life

2021 ◽  
Vol 27 (2) ◽  
pp. 86-97
Author(s):  
Jacqueline Reed ◽  
Mary O'Hara ◽  
Elizabeth O'Sullivan ◽  
Sinead Cobbe ◽  
Martina O’ Reilly
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Day Care ◽  
Positive Impact ◽  
Care Delivery ◽  
Physical Symptoms ◽  
P Value ◽  
Specialist Palliative Care ◽  
Significant Difference

Background: Specialist palliative day care is an area of palliative care which has a notable scarcity of research. Evidence is needed on the role of palliative day care to improve patients' quality of life and symptom management, while recognising the different patient cohorts that use the service. Aim: To determine the symptoms and quality of life of the patient cohort that are affected by the completion of a full therapeutic cycle (8 to 9 weeks) at a specialist palliative care day unit (SPCDU). Method: A retrospective cohort study was carried out from January 2016 to December 2017. Patient related outcome measures (PROMs) were collected as part of routine clinical paperwork at admission and discharge, and these were used to determine symptoms and quality of life pre-attendance and on completion of an 8 to 9 week therapeutic cycle at the SPCDU. Results: Descriptive analysis demonstrated improvement across the many symptoms that were analysed. Quality of life analysis also established improvement. Statistically significant difference was achieved in several areas. Total physical symptoms (p value=.009) confirmed the positive impact attendance at SPCDU has on physical symptoms. Specific symptoms which displayed a statistically significant difference included: poor appetite (p value=.002), weakness (p value=.03) and the anxiety felt by family/friends (p value=.029). The quality of a patient's life also displayed statistically significant difference (p value=.000). Conclusion: This study demonstrates that attendance at a SPCDU may positively impact a patients' symptoms and quality of life. A more uniform national approach to specialist palliative day care delivery, alongside multi-setting research, may further bolster the image of palliative day care. This will improve referrals to and occupancy of SPDCUs and benefit the palliative patient in the community.

Psychosocial impact of mast cell disorders: Pilot investigation of a rare and understudied disease

2016 ◽  
Vol 22 (10) ◽  
pp. 1277-1288 ◽  
Author(s):  
Jennifer Nicoloro-SantaBarbara ◽  
Marci Lobel ◽  
David Wolfe
Keyword(s):  
Quality Of Life ◽  
Mast Cell ◽  
Depressive Symptoms ◽  
Gender Difference ◽  
Depressed Mood ◽  
Psychosocial Interventions ◽  
Physical Symptoms ◽  
Ways Of Coping ◽  
Pilot Investigation

Mast cell disorders are rare, chronic diseases involving unpredictable physical symptoms ranging in severity, duration, and frequency. Almost two-thirds of participants with these disorders ( n = 180) experienced clinically meaningful depressive symptoms. Depressed mood was associated with somatic symptomatology, poorer quality of life, lower resilience, and indirectly with ways of coping. Newly developed measures for this population performed psychometrically well. There was no gender difference in depression but women reported greater use of several ways of coping, greater disease-related distress, poorer quality of life, and more symptoms. Results underscore the need for further research and development of effective psychosocial interventions for this population.

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