Symptom Assessment

2018 ◽  
Author(s):  
Marvin Omar Delgado Guay
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Advanced Disease ◽  
Psychological Symptoms ◽  
Symptom Assessment ◽  
Optimal Management ◽  
Disease Experience ◽  
Key Aspects ◽  
Routine Assessment

Patients with advanced disease experience severe physical and psychological symptoms which are often underdiagnosed and often addressed only when severe and debilitating. Recent studies have shown that routine assessment of symptoms is significantly associated with improvement of quality of life and extending survival. The optimal delivery of quality palliative care involves improving quality of life by impeccable assessment of physical and psychosocial symptoms. Routine screening of symptoms using validated tools often results in thorough assessment of the significant symptoms and prompt and optimal management of symptom distress. This chapter reviews the key aspects involved in screening and assessment of symptoms.

scholarly journals A mixed-methods pilot study of ‘LIFEView’ audiovisual technology: Virtual travel to support well-being and quality of life in palliative and end-of-life care patients

2020 ◽  
Vol 34 (7) ◽  
pp. 954-965
Author(s):  
Monisha Kabir ◽  
Jill L Rice ◽  
Shirley H Bush ◽  
Peter G Lawlor ◽  
Colleen Webber ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Mixed Methods ◽  
Pilot Study ◽  
Preliminary Data ◽  
Psychological Symptoms ◽  
Well Being ◽  
Assessment System ◽  
Spiritual Well Being

Background: There is evidence that psychosocial and spiritual interventions of short duration, such as reminiscence therapy, provide positive impacts on quality of life and emotional and existential well-being in adults receiving palliative care. Aim: To determine (1) the feasibility of integrating ‘LIFEView’, a video-based software with >1600 videos of world destinations, in palliative care settings, and (2) positive, neutral or harmful effects of using ‘LIFEView’ videos. Design: A mixed-methods pre–post intervention pilot study was conducted to collect feasibility and preliminary data on physical and psychological symptoms, physiological indicators, spiritual well-being and aspects of quality of life. Setting/participants: Adult patients on an inpatient palliative care unit or receiving care from a community palliative care consultation team who were capable of providing consent and completing the outcome measures were eligible participants. Results: Overall, 27/41 (66%) participants took part in the study. Feasibility criteria, including participant acceptability, low participant burden, tool completion rate and retention rate, were fulfilled, though challenges were experienced with recruitment. Modest improvements, though non-significant, were shown on preliminary data collected on physical and psychological symptoms using the Edmonton Symptom Assessment System–revised, spiritual well-being assessed by the 12-item Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being scale and physiological measurements. Qualitative analysis revealed five themes: motivations for using ‘LIFEView’, perceptions of the technology, reminiscence, ‘LIFEView’ as an adaptable technology and ongoing or future use. Conclusion: A future adequately powered study to investigate the impacts of ‘LIFEView’ on patient well-being and quality of life appears to be feasible.

scholarly journals Quality of Life of Patients with Advanced Cancer in Palliative Therapy and in Palliative Care

Aquichan ◽  
2019 ◽  
Vol 19 (3) ◽  
pp. 1-14
Author(s):  
Leonel dos Santos Silva ◽  
Bruna Eloise Lenhani ◽  
Dabna Hellen Tomim ◽  
Paulo Ricardo Bittencourt Guimarães ◽  
Luciana Puchalski Kalinke
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Palliative Therapy ◽  
Symptom Assessment ◽  
Assessment System ◽  
Life Questionnaire ◽  
Edmonton Symptom Assessment System ◽  
Quality Of Life Questionnaire ◽  
Chronic Illness Therapy

Objective: To assess the quality of life of patients with advanced cancer in palliative therapy and in palliative care. Materials and Methods: Quantitative, observational, cross-sectional, and analytic study conducted in a teaching hospital in Paraná, Brazil, from January to June 2018, with 126 patients: 107 in palliative therapy; 19 in exclusive palliative care. The questionnaires for data collection were: Quality of Life Questionnaire-Core 15-Palliative, Functional Assessment of Chronic Illness Therapy-Palliative Care 14, and Edmonton Symptom Assessment System. The Spearman non-parametric coefficient test was used for the analysis. Results: The overall quality of life in palliative therapy and in palliative care was, respectively, 71.54/59.65; when correlating the total score of quality of life of the Quality of Life Questionnaire-Core 15-Palliative with the Functional Assessment of Chronic Illness Therapy-Palliative Care 14 (p = 0.001), and the Edmonton Symptom Assessment System (p = 0.001), significant difference of better quality of life was observed in the palliative therapy. Conclusion: Patients in palliative therapy have good overall quality of life, while the palliative care group reports regular quality of life. The symptoms were milder in the palliative therapy and more intense and with greater significance in palliative care; hence, knowing the compromise of quality of life will help professionals in planning interventions with transdisciplinary approach for patients and for their families.

The Provision of Palliative Care for Noncancer Patients With Advanced Disease: Equity Does Matter

2019 ◽  
Vol 36 (10) ◽  
pp. 932-933
Author(s):  
Abbas Heydari ◽  
Hassan Sharifi ◽  
Ahmad Bagheri Moghaddam
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Clinical Guideline ◽  
Advanced Disease ◽  
World Health ◽  
The World ◽  
Primary Focus ◽  
Health Organization ◽  
Cancer Diseases

According to the World Health Organization, the main mission of palliative care is to optimize the quality of life of patients with serious chronic disease, as well as their caregivers, by providing biopsychosociospiritual care. However, historically, the primary focus of palliative care is on providing care only for cancer diseases. Based on the current literature, it is assumed that palliative care is not provided for many chronic diseases on a regular basis and in many cases, a clinical guideline does not exist for providing palliative care.

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.

“Running Water Won't Freeze”: How people with advanced Parkinson's disease experience occupation

2014 ◽  
Vol 13 (5) ◽  
pp. 1363-1372 ◽  
Author(s):  
Carolyn Murdock ◽  
Wendy Cousins ◽  
W. George Kernohan
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Palliative Care ◽  
Parkinson's Disease ◽  
Occupational Therapy ◽  
Research Network ◽  
Daily Lives ◽  
Advanced Parkinson’S Disease ◽  
Disease Experience

AbstractObjective:Parkinson's disease (PD) is a progressive neurodegenerative condition often resulting in significant disability and impacting on one's ability to participate in an occupation. The present study aimed to explore how people with advanced Parkinson's disease experience the phenomenon of occupation in their daily lives in order to inform the practice of occupational therapy in palliative care.Method:Using a phenomenological approach, in-depth interviews were undertaken with a purposive sample of 10 people in the advanced stages of Parkinson's disease. These interviews were audiotaped, transcribed verbatim, and subsequently analyzed using a thematic content analysis approach. The study received approval from the relevant university ethics committee, as well as the research network of Parkinson's UK.Results:The experience of occupation emerged as being physical, psychological, social, and spiritual with related subthemes. Within each of these themes, participants described their experience of occupation that they valued and that were important to their daily lives. They also identified the strategies they employed to continue participating in certain occupations and described others they were no longer able to engage in and the impact of that loss.Significance of Results:Participants' experiences crossed the domains of palliative care and suggest that adopting a palliative care approach would enhance an enhanced quality of life, experienced in terms of meaningful and valuable occupation. Disruption to participation in occupation caused them distress and frustration, suggesting that access to occupation-focused therapy would significantly improve quality of life for people with PD. As there is a strong link between the ethos of occupational therapy and palliative care, it is proposed that there is a valuable role for occupational therapy intervention to play within palliative care.

Depression, anxiety, and delirium

2021 ◽  
pp. 255-266
Author(s):  
Pamela J. Mosher ◽  
Anna C. Muriel
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Mental Health Professionals ◽  
Psychological Symptoms ◽  
Active Listening ◽  
Paediatric Palliative Care ◽  
Assessment And Treatment ◽  
Close Observation ◽  
Life Threatening

The assessment and treatment of psychological disorders such as depression, anxiety, and delirium can prove challenging in paediatric palliative care (PPC). Clinicians face the difficulties of distinguishing among symptoms of disease progression, medical side effects, and ‘normal’ psychological distress; the roles of cognitive and emotional development; and the lack of standardized assessment measures. Because research in this area is limited, recommendations often are extrapolated from adult palliative care (PC), or paediatric psychiatric or psychological literature in populations without life-threatening conditions. Patient- and family-centred care require that we address these symptoms, which may not meet clear diagnostic criteria, but significantly impair quality of life (QOL). Careful history taking, active listening, and close observation are essential in unearthing psychological symptoms. Collaboration with mental health professionals is recommended whenever possible, to provide specialist assessment and inform non-pharmacological and psychopharmacological treatment. Clinicians must incorporate limited data with clinical judgement and consultation to guide interventions that best reduce suffering and improve quality of life.

Advanced heart disease

2015 ◽  
Author(s):  
Steven Z. Pantilat ◽  
Anthony E. Steimle ◽  
Patricia M. Davidson
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Heart Disease ◽  
Optimal Management ◽  
Improve Quality ◽  
Significant Morbidity ◽  
Optimal Medical Management ◽  
Developed World ◽  
Care Costs

Heart disease is the leading cause of death in the developed world and causes significant morbidity and repeated hospitalization. Optimal medical management and targeted use of devices can improve survival and quality of life for people with heart failure (HF). Despite optimal management of HF symptoms including breathlessness, pain, fatigue and oedema may persist and palliative care interventions may be needed. Palliative care specialists must be aware that referral to HF specialists may be necessary for patients with advanced HF. The risk of sudden death at every stage of HF means that palliative care treatments should be integrated into care for all patients. Palliative care should enhance communication among clinicians and with the patient and family, and should provide options for treatment of symptoms and deactivation of devices. Integrating palliative care alongside HF care can increase quality of life, decrease suffering and health-care costs, and improve quality of care.

Specialized palliative care in advanced cancer: What is the efficacy? A systematic review

2017 ◽  
Vol 15 (6) ◽  
pp. 724-740 ◽  
Author(s):  
Kristina Holmenlund ◽  
Per Sjøgren ◽  
Mie Nordly
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Advanced Cancer ◽  
Psychological Symptoms ◽  
Intervention Group ◽  
Adult Patients ◽  
Controlled Trials ◽  
Specialized Palliative Care

ABSTRACTObjective:Due to the multiple physical, psychological, existential, and social symptoms involved, patients with advanced cancer often have a reduced quality of life (QoL), which requires specialized palliative care (SPC) interventions. The primary objective of the present systematic review was to review the existing literature about SPC and its effect on QoL, on physical and psychological symptoms, and on survival in adult patients with advanced cancer.Method:We utilized a search strategy based on the PICO (problem/population, intervention, comparison, and outcome) framework and employed terminology related to cancer, QoL, symptoms, mood, and palliative care. The search was performed in Embase, PubMed, and the Cochrane Central Register of Controlled Trials. Selected studies were analyzed and categorized according to methods, results, quality of evidence, and strength of recommendation.Results:Six randomized controlled trials (RCTs) were selected for analysis (out of a total of 1,115 studies). Two other studies were found by hand search, one of which was only published in conference abstract form. The RCTs differed in terms of aims, interventions, control groups, and outcomes; however, the primary aim of all of them was to investigate the effect of SPC on patient QoL. Five studies found improved QoL in the intervention group. Physical symptom intensity decreased in two studies, and three studies found improved mood in the intervention group. However, physical and psychological symptoms were secondary outcomes in these studies. Survival was improved in two studies. All the studies offered generalizability, but the level of evidence validity varied among them.Significance of results:Due to several methodological limitations, the evidence offered in these studies ranged from low to high. The evidence in this field of study in general is still nascent, but there is growing support for the utilization of SPC to improve the quality of life of adult patients with advanced cancer. The evidence that SPC reduces physical and psychological symptoms is moderate, while the evidence that it prolongs survival is low.

scholarly journals Piloting A Self-Reported Symptom Assessment Tool In Three Outpatient Oncology Palliative Care Clinics

2021 ◽  
Author(s):  
Mallikaben Bhanubhai Patel ◽  
Ashley Leak Bryant ◽  
Deborah K Mayer ◽  
Gary Winzelberg
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Quality Improvement ◽  
Symptom Assessment ◽  
Comprehensive Cancer Center ◽  
Staff Turnover ◽  
Improvement Project ◽  
Pdsa Cycle ◽  
Edmonton Symptom Assessment Scale

Abstract Background: Palliative care outpatient clinics should assess patients’ symptoms and quality of life prior to visits to guide care and response to treatments. We describe the implementation of a quality improvement initiative to increase symptom and quality of life screening in the outpatient oncology palliative care (OOPC) clinics of one National Cancer Institute-designated Comprehensive Cancer Center. Method: Our quality improvement project structure was based on the RE-AIM framework. Guided by the Plan-Do-Study-Act (PDSA) approach, we focused on assessing effective implementation of the Edmonton Symptom Assessment Scale (ESAS-r ) and one Quality of Life (QoL) question at each OOPC visit. At the end of each 3-week PDSA cycle, barriers and facilitators were recognized and addressed. The implementation’s effectiveness was determined by percentage of adherence using the following formula: [(number of ESAS-r +1 QoL forms completed per clinic/Number of OOPC completed patient appointments per clinic) x 100].Results: A total of 372 patient appointments were completed during the four PDSA cycles, with overall 59% adherence. The first PDSA cycle compliance was 69%, 58% in the second, 52% in the third, and 65% at the last PDSA cycle. The primary barrier was staff turnover.Conclusion: We were able to implement the ESAS-r + 1 QoL form in a complex clinical outpatient setting. We identified barriers for sustainability, including staff turnover. We addressed these barriers by providing robust instructions that outlined an overview of the clinic workflow and education for all staff members involved in the implementation process. Based on our experience, we suggest integrating this form into the electronic medical record to monitor patient outcomes in the outpatient oncology clinics.

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