Terminal Cancer Patients' Informed Consent for Palliative Care Admission and Their Quality of Life

2012 ◽  
Vol 15 (8) ◽  
pp. 847-847 ◽  
Author(s):  
Tomasz Gradalski ◽  
Elżbieta Wesolek ◽  
Justyna Kleja
Cancer ◽  
2004 ◽  
Vol 101 (5) ◽  
pp. 1090-1098 ◽  
Author(s):  
Antonio Vigano ◽  
Nora Donaldson ◽  
Irene J. Higginson ◽  
Eduardo Bruera ◽  
Salaheddin Mahmud ◽  
...  

2015 ◽  
Vol 25 (6) ◽  
pp. 961-969 ◽  
Author(s):  
A. Bovero ◽  
P. Leombruni ◽  
M. Miniotti ◽  
G. Rocca ◽  
R. Torta

2014 ◽  
Vol 13 (5) ◽  
pp. 1309-1316 ◽  
Author(s):  
In Cheol Hwang ◽  
Bhumsuk Keam ◽  
Young Ho Yun ◽  
Hong Yup Ahn ◽  
Young-Ae Kim

AbstractObjective:There is scarce research on the short-term fluctuations in end-of-life (EoL) care planning for seriously ill patients. The aim of our study was to investigate the stability of preferences regarding treatment in an intensive care unit (ICU) and identify the factors associated with changes in preferences in terms of quality of life (QoL).Method:A prospective examination on preference changes for ICU care in 141 terminal cancer patients was conducted. Patients were categorized according to their change in preference during the final two months of their lives into four categories: (1) the keep–accept group, (2) the keep–reject group, (3) the change to accept group, and (4) the change to reject group. Using multiple logistic analyses, we explored the association between patient demographics, health-related QoL, and changes in ICU preference.Results:The overall stability of ICU preferences near the end of life was 66.7% (κ = 0.33, p < 0.001). Married patients were more likely to change their preference regarding ICU care [adjusted odds ratio (aOR) toward accept 12.35, p = 0.021; aOR toward reject 10.56, p = 0.020] than unmarried patients. Patients with stable physical function tended to accept ICU care (aOR = 5.05, p = 0.023), whereas those with poor performance (aOR = 5.32, p = 0.018), worsened QoL (aOR = 8.34, p = 0.007), or non-aggravated fatigue (aOR = 8.36, p = 0.006) were more likely to not accept ICU care.Significance of results:The attitudes of terminally ill cancer patients regarding ICU care at the end of life were not stable over time, and changes in their QoL were associated with a tendency to change their preferences about ICU care. Attention should thus be paid to patients' QoL changes to improve medical decision making with regard to EoL care.


Author(s):  
Daiane Bruna Leal Burgos

Câncer é o nome dado ao grupo de doenças malignas caracterizadas pelo crescimento celular anormal e que pode se espalhar para várias regiões do corpo. O tratamento dos pacientes oncológicos terminais, sem perspectivas curativas, necessita da multidisciplinaridade da equipe de saúde, incluindo a fisioterapia, que dispõe de técnicas complementares aos cuidados paliativos, tanto na melhora dos sintomas quanto na qualidade de vida desses pacientes. Assim, o presente artigo tem como objetivo descrever os benefícios da atuação do fisioterapeuta nos cuidados paliativos do paciente com câncer terminal. A revisão bibliográfica foi realizada nas bases de dados Lilacs, Medline e SciELO. Sendo os descritores de saúde utilizados: câncer terminal, fisioterapia, oncologia e cuidados paliativos de artigos publicados nas línguas inglesa, espanhola e portuguesa, no período de 2000 a 2014. Dos dez trabalhos incluídos para compor a discussão, oito apresentaram a importância da fisioterapia na equipe multidisciplinar, que trabalha com pacientes oncológicos terminais, sendo estes resultados apresentados por meio dos benefícios de suas técnicas aplicadas a esses pacientes, evidenciada principalmente na dor e na imobilidade. Apenas dois artigos apresentaram objeções quanto ao encaminhamento do tratamento fisioterapêutico paliativo direcionado para pacientes oncológicos terminais, pois em seus estudos, o resultado encontrado foi a falta de investimento público nessa área, o que resulta em desconhecimento da atuação de profissionais fisioterapeutas especialistas em oncologia. Os estudos encontrados mostram que a fisioterapia tem um papel relevante nos cuidados paliativos, entretanto necessita-se de uma maior oferta e implementação deste tratamento nos serviços de saúde.Palavras-chave: Câncer Terminal. Fisioterapia. Oncologia. Cuidados Paliativos.AbstractCancer is the name given to the group of malignant diseases characterized by the abnormal cell growth and can spread to various parts of the body. The treatment of oncological terminal patients without healing perspectives needs a multidisciplinary health team, including physiotherapy that offers complementary techniques to palliative care, both in the symptoms improvement and life quality of these patients. It describes the benefits of the physiotherapist’s role in palliative care of patients with terminal cancer. A literature review was performed using the following databases: Lilacs, Medline and Scielo. The health descriptors used are: terminal cancer, physiotherapy, oncology and palliative care articles published in English, Spanish and Portuguese from 2000 to 2014. Out of the ten papers included to compose the discussion, eight had the importance of the physiotherapy in the multidisciplinary team that works with terminal cancer patients, these results presented through the benefits of its techniques applied to these patients primarily evidenced in pain and immobility. Only two articles had objected to the referral palliative physiotherapy treatment to terminal cancer patients because in their studies, the result found was the lack of public investment in this area which results in a lack of performance from expert physiotherapists in oncology. These studies show that physiotherapy plays an important role in palliative care but a greater supply and implementation of this treatment in health services are needed.Keywords: Terminal Cancer. Physiotherapy. Oncology. Palliative Care.


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