Lymphoedema and oedema of advanced disease

2021 ◽  
pp. 648-655
Author(s):  
Vaughan Keeley
Keyword(s):  
End Of Life ◽  
Advanced Cancer ◽  
Lymphatic System ◽  
Advanced Disease ◽  
Contributory Factors ◽  
Other Substances ◽  
Drain Fluid ◽  
Physical Treatments

Lymphoedema is chronic swelling developing as a result of failure of the lymphatic system to drain fluid and other substances, such as proteins, from the tissues. This chapter focuses on oedema associated with advanced cancer and other diseases, encountered towards the end of life. It is often of multifactorial origin. Management involves an assessment of contributory factors, consideration of which may be reversible, and treatment, which takes into account the patient’s priorities and the balance of benefit versus burden. Modifications of the combined physical treatments used for chronic lymphoedema are often required in this setting.

Lymphoedema

2015 ◽  
Author(s):  
Vaughan Keeley
Keyword(s):  
Cancer Treatment ◽  
End Of Life ◽  
Advanced Cancer ◽  
Lymphatic System ◽  
Advanced Disease ◽  
The Body ◽  
Other Substances ◽  
Drain Fluid

Lymphoedema is a chronic oedema developing as a result of failure of the lymphatic system to drain fluid and other substances, such as proteins, from the tissues. It typically affects the limbs but can involve any part of the body. The management of all types of lymphoedema is largely palliative in nature in that there are no surgical or other treatments which offer a cure for the problem in the vast majority of cases. This chapter focuses on oedema associated with advanced cancer and other diseases, encountered towards the end of life with some reference to cancer treatment-related lymphoedema, as this may also be present in people with advanced disease.

Psychological Interventions for Patients With Advanced Disease: Implications for Oncology and Palliative Care

2020 ◽  
Vol 38 (9) ◽  
pp. 885-904 ◽  
Author(s):  
Gary Rodin ◽  
Ekaterina An ◽  
Joanna Shnall ◽  
Carmine Malfitano
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Advanced Cancer ◽  
Best Practice ◽  
Advanced Disease ◽  
Clinical Care ◽  
Psychosocial Interventions ◽  
Psychological Interventions ◽  
Psychotherapeutic Interventions ◽  
Quantitative Studies

A growing body of research demonstrates the feasibility and efficacy of psychological interventions for adult patients with advanced cancer. Findings from quantitative studies of psychotherapeutic interventions with primary psychological outcomes for such patients are reviewed here and recommendations for best practice are made. We consider these interventions according to three broad phases in which they are most commonly applied: soon after diagnosis of advanced cancer, when living with the disease, and at or near the end of life. Cumulative evidence from well-designed studies demonstrates the efficacy of psychosocial interventions for patients with advanced disease to relieve and prevent depression, anxiety, and distress related to dying and death, as well as to enhance the sense of meaning and preparation for end of life. Individual and couple-based interventions have been proven to be most feasible, and the development and use of tailored and validated measures has enhanced the rigor of research and clinical care. Palliative care nurses and physicians can be trained to deliver many such interventions, but a core of psychosocial clinicians, including social workers, psychologists, and psychiatrists, is usually required to train other health professionals in their delivery and to ensure their quality. Few of the interventions for which there is evidence of effectiveness have been routinely incorporated into oncology or palliative care. Advocacy on the basis of this evidence is required to build psychosocial resources in cancer treatment settings and to ensure that psychological care receives the same priority as other aspects of palliative care in oncology.

scholarly journals Family caregiver emotional distress in advanced cancer: the DME-C scale psychometric properties

2020 ◽  
pp. bmjspcare-2020-002608
Author(s):  
Joaquín T Limonero ◽  
Jorge Maté-Méndez ◽  
María José Gómez-Romero ◽  
Dolors Mateo-Ortega ◽  
Jesús González-Barboteo ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
End Of Life ◽  
Family Caregivers ◽  
Advanced Cancer ◽  
Emotional Distress ◽  
Family Caregiver ◽  
Screening Tools ◽  
Anxiety And Depression ◽  
The Family ◽  
End Stage

BackgroundFamily caregivers of patients with advanced illness at end of life often report high levels of emotional distress. To address this emotional distress is necessary to have adequate and reliable screening tools.AimThis study analyses the psychometric properties and clinical utility of the Family Caregiver Emotional Detection Scale for caregivers of patients with end-stage cancer (DME-C, Spanish acronym) who are receiving palliative care (PC).DesignMulticentre, cross-sectional study.Settings/participantsFamily caregivers of patients with advanced cancer at end of life receiving palliative treatment were interviewed to explore their emotional distress through the DME-C scale and other instruments measuring anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), distress thermometer (DT) and overload (B), as well as a clinical psychological assessment (CPA).Results138 family caregivers, 85 (61.6%) female and 53 (38.4%) male, with an average age of 59.69±13.3 participated in the study. The reliability of the scale, as measured by Cronbach’s alpha, was 0.76, and its stability over time was 0.734. Positive, significant correlations were found between the DME-C and the scores for anxiety and depression registered on the HADS scale, as well as with the total result of this latter scale and the results for B, the DT and the CPA. A statistical analysis of the receiver-operating characteristic curves showed that the scale has a sensitivity and specificity of 75%, and that the cut-off point for the detection of emotional distress was a score ≥11. Fifty-four per cent of the caregivers displayed emotional distress according to this scale.ConclusionsThe DME-C displays good psychometric properties. It is simple, short, reliable and easy to administer. We believe that the instrument is useful for the detection of emotional distress in the family caregivers of hospitalised patients suffering from end-stage illnesses and receiving PC.

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