Fatigue

2021 ◽  
pp. 685-697
Author(s):  
Sriram Yennurajalingam ◽  
Eduardo Bruera
Keyword(s):  
Palliative Care ◽  
Sleep Disturbances ◽  
Common Factors ◽  
Symptomatic Treatment ◽  
Shortness Of Breath ◽  
Initial Management ◽  
Pain Anxiety ◽  
Underlying Causes ◽  
Recent Activity ◽  
Anxiety Depression

Fatigue is the most frequent, complex, multidimensional, and debilitating symptom in patients with advanced life-limiting diseases. In cancer patients, it is defined as ‘distressing persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning’. In the majority of patients receiving palliative care, the aetiology of fatigue is multifactorial. The most common factors associated with fatigue include anorexia/cachexia, pain, anxiety, depression, shortness of breath, sleep disturbances, anaemia, and inflammation. Routine screening for fatigue is essential for optimal assessment of fatigue. Initial management should aim towards identification and treatment of the reversible/underlying causes However, if there are no reversible causes identified or if the fatigue is not responsive to specific treatments, symptomatic treatment should be considered.

Fatigue and asthenia

2015 ◽  
Author(s):  
Sriram Yennurajalingam ◽  
Eduardo Bruera
Keyword(s):  
Sleep Disturbances ◽  
Symptomatic Treatment ◽  
Future Research ◽  
Optimal Management ◽  
Pharmacological Agents ◽  
Factors Associated ◽  
Short Course ◽  
Underlying Causes ◽  
Individualized Management ◽  
Anxiety Depression

Fatigue is the most frequent, complex, multidimensional, and debilitating symptom in patients with advanced medical conditions. In the majority of palliative care patients, the aetiology of fatigue is multifactorial and the most common factors associated with fatigue include anorexia/cachexia, anxiety, depression, shortness of breath, sleep disturbances, anaemia, and inflammation. Routine screening for fatigue is essential for optimal assessment of fatigue and history and investigations should always be individualized. Management should initially aim towards identification and treatment of the reversible/underlying causes; however, if there are no reversible causes identified or if the fatigue is not responsive to specific treatments, symptomatic treatment should be considered. For optimal management the multidimensional components of fatigue should be assessed and future research is needed on the use of non-pharmacological treatment such as physical activity, counselling, and/or pharmacological agents such as a trial of psychostimulants or short course of corticosteroids.

Do newly diagnosed cancer patients require palliative care? An audit at a regional cancer center in India.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 65-65
Author(s):  
Sushmita Ghoshal Chakrabarti ◽  
Raviteja Miriyala ◽  
Arun Elangovan ◽  
Bhavana RAI
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Statistical Correlation ◽  
Holistic Care ◽  
Cancer Center ◽  
Newly Diagnosed ◽  
Pain Anxiety ◽  
The Difference ◽  
Loss Of Appetite ◽  
Anxiety Depression

65 Background: The present study was planned to record the distressing symptoms of newly diagnosed cancer patients and to evaluate how the symptoms were addressed by the treating oncologists. Methods: All newly diagnosed cancer patients referred to the department of Radiotherapy during the month of May 2014 were asked to fill a questionnaire after taking their consent. The ESAS-r questionnaire was used to assess the frequency and intensity of distressing symptoms. The case records of these patients were then reviewed to compare the frequency and intensity documented by the treating physician. The difference in the two sets of symptoms documented were statistically analysed by non-parametric tests using SPSS. Results: Eighty-nine patients participated in this study out of which only 19 could fill the questionnaire on their own. Anxiety was the commonest symptom (97.8%) followed by depression (89.9%), tiredness (89.9%) and pain (86.5%). The treating physicians recorded pain in 83.1% while the other symptoms were either not documented or grossly under reported. Anxiety was documented in 3/87 patients but depression was not documented in any. Tiredness was documented in 12/80 patients, loss of appetite in 54/77 patients mentioning them in the questionnaire. Significant statistical correlation could be seen between the presence of pain, anxiety, depression, tiredness and loss of appetite in the patients. Conclusions: The study reveals that the distressing symptoms experienced by newly diagnosed cancer patients are grossly under reported and inadequately addressed by treating oncologists. Sensitizing the oncologists and incorporating palliative care principles early in the management of cancer patients could improve their holistic care.

Outcomes of Music Therapy Interventions on Symptom Management in Palliative Medicine Patients

2017 ◽  
Vol 35 (2) ◽  
pp. 250-257 ◽  
Author(s):  
Lisa M. Gallagher ◽  
Ruth Lagman ◽  
Lisa Rybicki
Keyword(s):  
Music Therapy ◽  
Symptom Management ◽  
Palliative Medicine ◽  
Shortness Of Breath ◽  
Pain Anxiety ◽  
Effective Interventions ◽  
Patient Reported ◽  
Anxiety Depression ◽  
The Impact ◽  
Therapy Sessions

Purpose: Evidence has demonstrated the positive effects of music therapy on symptom management for palliative medicine patients. Previous studies have addressed patient needs, with limited discussion involving the relationship between interventions utilized to improve symptoms. The purpose of this study was to understand the impact of music therapy sessions; identify common music therapy goals and interventions and assess their effect; and investigate the effects of gender, age, and type of cancer on symptoms in patients who experienced music therapy. Methods: This was a retrospective study of data collected during music therapy sessions. Patients scored their symptoms (pain, anxiety, depression, shortness of breath, and mood) before and after sessions. Data collected from over 1500 patients included symptom evaluation, goals, interventions, music used, patient/family reactions, and narratives. Results: Among 293 patients who met all study inclusion criteria, significant improvement in pain, anxiety, depression, shortness of breath, mood, facial expression, and vocalization scores was noted. In addition, 96% of patients had positive responses to participating in music therapy. Vocal and emotional were the 2 most effective interventions in improving symptoms. All 5 patient-reported symptoms improved when the therapist focused on these symptoms as goals. Age, gender, and diagnosis had no impact on symptom improvement. Conclusions: This study demonstrated the importance of music therapy for addressing symptoms and behaviors of palliative medicine patients. Statistically and clinically significant effects were noted. The most effective interventions were identified. More research needs to be conducted to better understand the benefits of music therapy for palliative medicine patients.

Reiki therapy for pain, anxiety and quality of life

2019 ◽  
pp. bmjspcare-2019-001775 ◽  
Author(s):  
Maxime Billot ◽  
Maeva Daycard ◽  
Chantal Wood ◽  
Achille Tchalla
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Alternative Therapies ◽  
Pain Anxiety ◽  
Complementary And Alternative Therapies ◽  
Positive Effects ◽  
Current Article ◽  
Energy Therapy ◽  
Anxiety Depression

The use of complementary and alternative therapies is growing year after year, and Reiki therapy takes a place of choice. Reiki therapy, classed as a biofield energy therapy, raises the question of validity when applied to patients, especially in palliative care. The purpose of this review is to highlight the effects of Reiki therapy on pain, anxiety/depression and quality of life of patients, specifically in palliative care. The current article indicates that Reiki therapy is useful for relieving pain, decreasing anxiety/depression and improving quality of life in several conditions. Due to the small number of studies in palliative care, we were unable to clearly identify the benefits of Reiki therapy, but preliminary results tend to show some positive effects of Reiki therapy for the end-of-life population. These results should encourage teams working in palliative care to conduct more studies to determine the benefits of Reiki therapy on pain, anxiety/depression and quality of life in palliative care.

Effect of Music on Pain in Cancer Patients in Palliative Care Service: A Randomized Controlled Study

2021 ◽  
pp. 003022282110598
Author(s):  
Gönül Düzgün ◽  
Ayfer Karadakovan
Keyword(s):  
Palliative Care ◽  
Music Therapy ◽  
Cancer Patients ◽  
Functional Capacity ◽  
Classical Music ◽  
Care Service ◽  
Palliative Care Service ◽  
Palliative Care Unit ◽  
Pain Anxiety ◽  
Randomized Controlled

This study aimed to investigate the effect of music on pain, anxiety, comfort, and functional capacity of cancer patients who received care in a palliative care unit. The population of this randomized controlled trial consisted of cancer patients hospitalized in the palliative care service between July 2018 and July 2019. The study included 60 patients (30 interventions/30 controls). The patients in the intervention group were given a total of six music sessions, 10 minutes each with the Turkish classical music in maqams of their choice (Hejaz or Rast accompanied by an expert tambour (drum) player). There was a significant difference between the mean total pain scores, anxiety, comfort, and functional capacity scores of the patients in the intervention and control groups before and after music therapy. Music therapy decreased the level of pain. It is demonstrated that Turkish classical music therapy improved the pain, anxiety, comfort, and functional capacity in the palliative care unit.

scholarly journals Takotsubo Cardiomyopathy and Psychiatric Illness: Redefining the Relationship

2016 ◽  
Vol 5 ◽  
Author(s):  
Hannah Masoud
Keyword(s):  
Emergency Department ◽  
Takotsubo Cardiomyopathy ◽  
Psychiatric Illness ◽  
Panic Attacks ◽  
Shortness Of Breath ◽  
Model Of Care ◽  
Coronary Syndrome ◽  
Relationship Of ◽  
Anxiety Depression ◽  
The Relationship

Physicians who encounter patients in the emergency department with chest pain, palpitations, or shortness of breath may often find it difficult to differentiate diagnosis of panic attacks from acute coronary syndrome or Takotsubo Cardiomyopathy. Redefining and understanding the pathophysiological relationship of psychiatric illness including anxiety, depression, or panic attacks and Takotsubo Cardiomyopathy may help clinicians implement a more effective and beneficial model of care for this affliction that is being found to be increasingly more common in today’s age.

scholarly journals The Use of Massage Therapy for Reducing Pain, Anxiety, and Depression in Oncological Palliative Care Patients: A Narrative Review of the Literature

ISRN Nursing ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Maria Falkensteiner ◽  
Franco Mantovan ◽  
Irene Müller ◽  
Christa Them
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Complementary Medicine ◽  
Massage Therapy ◽  
Narrative Review ◽  
Anxiety And Depression ◽  
Literature Analysis ◽  
Review Of The Literature ◽  
Pain Anxiety

A considerable number of cancer patients use complementary medicine therapies in order to alleviate different symptoms such as pain, anxiety, and depression, occurring in connection with cancer. This paper explores the question to what extent massage therapies are able to reduce the amount of pain, anxiety, and depression. For this purpose, a systematic literature analysis was carried out in the electronic databases and specialist journals. There is already evidence that massage therapies can influence the symptoms of pain, anxiety, and depression in a positive way.

scholarly journals Physical therapy modalities for treating fibromyalgia

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 2030 ◽  
Author(s):  
Fernanda Mendonça Araújo ◽  
Josimari Melo DeSantana
Keyword(s):  
Physical Therapy ◽  
Cognitive Dysfunction ◽  
Musculoskeletal Pain ◽  
Sleep Disturbances ◽  
Physical Therapy Modalities ◽  
Alternative Therapies ◽  
Chronic Musculoskeletal Pain ◽  
Gastrointestinal Disorders ◽  
Psychosomatic Symptoms ◽  
Anxiety Depression

Fibromyalgia is a syndrome characterized by generalized chronic musculoskeletal pain, hyperalgesia in specific points, and psychosomatic symptoms, such as fatigue, sleep disturbances (waking unrefreshed), anxiety, depression, cognitive dysfunction, headache, and gastrointestinal disorders. Investigations with non-pharmacological therapies, focused on physical therapy, have increased in recent years as alternative therapies for the treatment of fibromyalgia. The purpose of this review is to summarize the main physical therapy modalities used to treat fibromyalgia.

scholarly journals Neuropsychiatric Adverse Events During 12 Months of Treatment with Efavirenz in a Treatment-Naïve HIV-Infected Population in China: A Prospective Cohort Study

2020 ◽  
Author(s):  
Lili Dai ◽  
Sen Wang ◽  
Ying Shao ◽  
Yali Wang ◽  
Jiangzhu Ye ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Adverse Events ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Sleep Disturbances ◽  
Neuropsychiatric Disorders ◽  
Factors Associated ◽  
Anxiety Depression

Abstract Background: Efavirenz (EFV) is a widely used antiretroviral therapy (ART), but side effect risks of neuropsychiatric adverse events (NPAEs) have not been investigated in Chinese populations receiving rapid ART. Methods: This prospective cohort study assessed HIV-infected patients initiating antiretroviral treatment with EFV to determine prevalence of and factors associated with NPAEs over a 12-month follow-up period using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Results: A total of 546 patients were enrolled. Prevalence of anxiety, depression, and sleep disturbances at baseline were 30.4%, 22.7%, and 68.1%, respectively. Six patients discontinued treatment due to drug related NPAEs. Treatment was associated with improvements in HADS-A, HADS-D, and PSQI scores over the 12-month follow-up, and the frequencies of patients with anxiety, depression, and sleep disturbances significantly decreased after 12 months. Abnormal baseline HADS-A, HADS-D, and PSQI scores and other factors, including high school education or lower, unemployment, divorce, and WHO III/IV stages, were associated with severe neuropsychiatric disorders over the 12 months. Conclusions: These findings suggested EFV-based first-line antiretroviral therapy was well-tolerated and associated with improvements in HADS-A, HADS-D, and PSQI scores. Certain risk factors associated with neuropsychiatric disorders may be useful in identifying HIV-infected patients at higher NPAE risk.

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