Management issues in chronic pain following cancer therapy

2015 ◽  
Author(s):  
Martin Chasen ◽  
Gordon Giddings
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Control ◽  
Interdisciplinary Team ◽  
Long Term Effects ◽  
Team Members ◽  
Patients With Cancer ◽  
Management Issues

With improved surveillance, diagnoses, and treatment of patients with cancer, an increased life expectancy, and specifically an increased number of ‘cancer cured’ patients, is noted. However, the long-term effects of the disease and treatment have a bearing on obtaining optimal physical, psychological, and cognitive functioning for cancer survivors. Pain impacts on all dimensions of quality of life and is one of the most distressing symptoms for patients. Patients often under-recognize pain and are unsure if optimum pain control is achievable. In addition, members of the interdisciplinary team often fail to assess the patient’s pain adequately, due to a lack of knowledge of the principles of pain relief and side effect management. Treatment requires an interprofessional approach that details a comprehensive assessment, with ongoing reassessment, utilizing both pharmacological and non-pharmacological measures. Empowerment of the cancer survivor, respect for survivors’ individuality and collaboration among team members are key elements of any successful strategy to optimize a patient’s quality of life.

scholarly journals Post-Covid-19 Syndrome: Improvements in Health-Related Quality of Life Following Psychology-Led Interdisciplinary Virtual Rehabilitation

2021 ◽  
Vol 12 ◽  
pp. 215013192110676
Author(s):  
Sari Harenwall ◽  
Suzanne Heywood-Everett ◽  
Rebecca Henderson ◽  
Sherri Godsell ◽  
Sarah Jordan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Interdisciplinary Team ◽  
Care Staff ◽  
Health Related Quality ◽  
Long Term Effects ◽  
Virtual Rehabilitation ◽  
Related Quality ◽  
Health Related

Coronavirus disease 2019 (COVID-19) is increasingly recognized as having significant long-term impact on physical and mental health. The Primary Care Wellbeing Service (PCWBS) in Bradford District Care NHS Foundation Trust (BDCFT) is a psychology-led specialist interdisciplinary team of health professionals specializing in persistent physical symptoms (PPS) and Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) with an emphasis on holistic integrated care. The PCWBS quickly recognized the risk of the long-term effects of COVID-19, particularly for social, health and care staff, and developed a 7-week virtual rehabilitation course which was piloted in October 2020. The “ Recovering from COVID” course takes a whole system, biopsychosocial approach to understanding COVID-19 and post-viral fatigue (PVF) and is delivered by an interdisciplinary team consisting of a clinical psychologist, physiotherapist, occupational therapist, dietitian, speech and language therapist, assistant psychologist, and a personal support navigator with support from a team administrator. The course focuses on understanding PVF, sleep optimization, nutrition, swallowing, activity management, energy conservation, stress management, breathing optimization, managing setbacks, and signposting to appropriate resources and services. Since the pilot, PCWBS has delivered 7 courses to support over 200 people suffering from post-COVID-19 syndrome. One hundred and forty-nine individuals that enrolled on the “ Recovering from COVID” course completed the EQ-5D-5L to assess Health-related quality of life (HRQoL) across 5 dimensions, including problems with mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Subsequently, 76 individuals completed these measures at the end of the rehabilitation course showing that patient ratings were significantly improved. In response to the NIHR recommendation for rapid evaluation of different service models for supporting people with post-COVID-19 syndrome, this data offers hope that rehabilitation is effective in reversing some of the problems faced by people living with the long-term effects of COVID-19.

Chronic pain, functionality and quality of life in cancer survivors

2020 ◽  
pp. 204946372097273
Author(s):  
João Poço Gonçalves ◽  
Dalila Veiga ◽  
António Araújo
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Neuropathic Pain ◽  
Cancer Survivors ◽  
Long Term Effects ◽  
Average Life ◽  
Average Life Span ◽  
Oncological Disease

The increasing number of cancer survivors associated to a longer average life-span after diagnosis of an oncological disease facilitates the observation of deleterious long-term effects of both oncological disease and its treatment. Among these effects, chronic pain emerges as one of the most prevalent and, with its onset, there is a decrease in these patients’ functionality and quality of life. The main focus in oncological disease treatment has been tumour eradication and average life expectancy extension after diagnosis, neglecting these deleterious long-term effects. This study aims at assessing the prevalence and characteristics of chronic pain in cancer survivors as well as pain interference in their quality of life and functionality. The study selected cancer survivors (n = 85) after dismissal from oncology service to assess the presence and characteristics of chronic pain, their health-related quality of life (HRQoL) and pain-related disability through a combination of different questionnaires. Chronic pain prevalence was 23.5%. In total, 85% of patients reported neuropathic pain descriptors and 45% presented diagnostic criteria for neuropathic pain. Of these patients, 45% were followed-up for pain surveillance and 35% underwent analgesic medication. There was a median pain disability index of 20.50 (14.50–35.00) and an average HRQoL of 0.5338 in chronic pain patients and 0.8872 in patients without pain. We found that chronic pain was the main negative predictor of HRQoL and was associated with decreased functionality. This study also concluded that these patients often were not offered the appropriate long-term medical follow-up. These findings highlight a need to raise awareness among health professionals to the importance of timely diagnosis and treatment of pain and its impact on HRQoL and functionality of long-term cancer survivors as well as the need to change clinical practice in order to improve healthcare provided to these patients.

scholarly journals Long-term Impact of Adenotonsillectomy on the Quality of Life of Children with Sleep-disordered breathing

2020 ◽  
Author(s):  
Juliana Alves Sousa Caixeta ◽  
Jessica Caixeta Silva Sampaio ◽  
Vanessa Vaz Costa ◽  
Isadora Milhomem Bruno da Silveira ◽  
Carolina Ribeiro Fernandes de Oliveira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Long Term Effects ◽  
Obstructive Sleep ◽  
Long Term Impact ◽  
Disordered Breathing

Abstract Introduction Adenotonsillectomy is the first-line treatment for obstructive sleep apnea secondary to adenotonsillar hypertrophy in children. The physical benefits of this surgery are well known as well as its impact on the quality of life (QoL), mainly according to short-term evaluations. However, the long-term effects of this surgery are still unclear. Objective To evaluate the long-term impact of adenotonsillectomy on the QoL of children with sleep-disordered breathing (SDB). Method This was a prospective non-controlled study. Children between 3 and 13 years of age with symptoms of SDB for whom adenotonsillectomy had been indicated were included. Children with comorbities were excluded. Quality of life was evaluated using the obstructive sleep apnea questionnaire (OSA-18), which was completed prior to, 10 days, 6 months, 12 months and, at least, 18 months after the procedure. For statistical analysis, p-values lower than 0.05 were defined as statistically significant. Results A total of 31 patients were enrolled in the study. The average age was 5.2 years, and 16 patients were male. The OSA-18 scores improved after the procedure in all domains, and this result was maintained until the last evaluation, done 22 ± 3 months after the procedure. Improvement in each domain was not superior to achieved in other domains. No correlation was found between tonsil or adenoid size and OSA-18 scores. Conclusion This is the largest prospective study that evaluated the long-term effects of the surgery on the QoL of children with SDB using the OSA-18. Our results show adenotonsillectomy has a positive impact in children's QoL.

scholarly journals Yoga therapy to reduce fatigue in cancer: effects of reminder e-mails and long-term efficacy

2021 ◽  
Author(s):  
Teresa Zetzl ◽  
Andre Pittig ◽  
Agnes Renner ◽  
Birgitt van Oorschot ◽  
Elisabeth Jentschke
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Mediation Model ◽  
Long Term Effects ◽  
Long Term Outcomes ◽  
Cognitive Fatigue ◽  
Yoga Therapy ◽  
Life Data

Abstract Objective To examine the efficacy of reminder e-mails to continue yoga therapy on practice frequency and fatigue in cancer patients and long-term effects of yoga on fatigue, depression, and quality of life. Methodology One hundred two cancer patients who completed an 8-week yoga therapy were randomly allocated to two groups: reminder (N = 51) vs. no-reminder group (N = 51). After completing yoga therapy, the reminder group received weekly e-mails for 24 weeks, which reminded them of practicing yoga, whereas the no-reminder group did not. Primary outcomes were fatigue and practice frequency, and long-term outcomes were fatigue, depression, and quality of life. Data were assessed using questionnaires after yoga therapy (T1) and 6 months after completing yoga therapy (T2). Result A significantly stronger reduction of general (p = 0.038, d = 0.42) and emotional fatigue (p = 0.004, d = 0.59) and a higher increase of practice frequency (p = 0.015, d = 0.52) between T1 and T2 were found for the reminder group compared to the no-reminder group. In the mediation model, practice frequency as a mediator partially explained the changes in emotional fatigue (indirect effect B =  − 0.10). Long-term effects of yoga therapy regarding fatigue, depression, and quality of life were found (F > 7.46, p < 0.001, d > 0.54). Conclusion Weekly reminder e-mails after yoga therapy can positively affect general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher physical or cognitive fatigue improvement, suggesting other factors that mediate efficacy on physical or cognitive fatigue, such as mindfulness or side effects of therapy.

Long-Term Effects of Doxazosin, Finasteride and Combination Therapy on Quality of Life in Men with Benign Prostatic Hyperplasia

2013 ◽  
Vol 190 (1) ◽  
pp. 187-193 ◽  
Author(s):  
Chyng-Wen Fwu ◽  
Paul W. Eggers ◽  
Steven A. Kaplan ◽  
Ziya Kirkali ◽  
Jeannette Y. Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Prostatic Hyperplasia ◽  
Long Term Effects

Long-term effects of bilateral subthalamic nucleus stimulation on health-related quality of life in advanced Parkinson's disease

2006 ◽  
Vol 21 (6) ◽  
pp. 746-753 ◽  
Author(s):  
Andrew Siderowf ◽  
Jurg L. Jaggi ◽  
Sharon X. Xie ◽  
Catherine Loveland-Jones ◽  
Lewis Leng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Subthalamic Nucleus ◽  
Health Related Quality ◽  
Long Term Effects ◽  
Advanced Parkinson’S Disease ◽  
Subthalamic Nucleus Stimulation ◽  
Related Quality ◽  
Health Related

scholarly journals Physical occupational exposures during working life and quality of life after labour market exit: results from the GAZEL study

2016 ◽  
Author(s):  
Loretta G. Platts ◽  
Gopalakrishnan Netuveli ◽  
Elizabeth Webb ◽  
Marie Zins ◽  
Marcel Goldberg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Working Conditions ◽  
Occupational Exposures ◽  
Working Life ◽  
Life Course Perspective ◽  
Physical And Mental Health ◽  
Long Term Effects ◽  
Physical Danger

Objective: To investigate variations in quality of life at older ages, we take a life course perspective to analyse long-term effects of physical working conditions upon quality of life after retirement. In doing so, we study to what extent these associations are explained by individuals’ health at older ages. Method: We use administrative data and self-administered questionnaire responses from the French GAZEL cohort. Quality of life was assessed with CASP-19 in 2009 and related to three types of physical working conditions during previous working life: (1) ergonomic strain, (2) physical danger and (3) exposures to chemicals. Health was assessed in 2007 with the SF-36 Health Survey. Multiple regressions were calculated in retired men only, controlling for important confounders including social position. Results: In contrast to men, few women were exposed to strenuous and dangerous working conditions in this cohort and were not included in subsequent analyses. Negative effects on retired men's quality of life were found for the physical occupational exposures of ergonomic strain and physical danger, but not for chemical exposures. Effects were attenuated after the introduction of physical and mental health to the models, indicating an indirect effect of physical working conditions upon quality of life via health. Conclusion: Adverse physical working conditions have long-term consequences for health and quality of life at older ages. Improvements to physical working conditions may improve individuals’ quality of life over the long term.

scholarly journals Opioid Analgesia: Perspectives on Right Use and Utility

2007 ◽  
Vol 3;10 (5;3) ◽  
pp. 479-491 ◽  
Author(s):  
Jane C. Ballantyne
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Side Effects ◽  
Clinical Decision Making ◽  
Analgesic Efficacy ◽  
Clinical Decision ◽  
Opioid Analgesia ◽  
Opioid Treatment

The ability of opioids to effectively and safely control acute and cancer pain has been one of several arguments used to support extending opioid treatment to patients with chronic pain, against a backdrop of considerable caution that has been based upon fears of addiction. Of course, opioids may cause addiction, but the “principle of balance” may justify that “…efforts to address abuse should not interfere with legitimate medical practice and patient care.” Yet, situations are increasingly encountered in which opioid-maintained patients are refractory to analgesia during periods of pain, or even during the course of chronic treatment. The real question is whether analgesic efficacy of opioids can be maintained over time. Overall, the evidence supporting long-term analgesic efficacy is weak. The putative mechanisms for failed opioid analgesia may be related to tolerance or opioid-induced hyperalgesia. Advances in basic sciences may help in understanding these phenomena, but the question of whether long-term opioid treatment can improve patients’ function or quality of life remains a broader issue. Opioid side effects are well known, but with chronic use, most (except constipation) subside. Still, side effects can negatively affect the outcomes and continuity of therapy. This paper addresses 1) what evidence supports the long-term utility of opioids for chronic pain; 2) how side effects may alter quality of life; 3) the nature of addiction and why it is different in pain patients, and 4) on what grounds could pain medication be denied? These questions are discussed in light of patients’ rights, and warrant balancing particular responsibilities with risks. These are framed within the Hippocratic tradition of “producing good for the patient and protecting from harm,” so as to enable 1) more informed clinical decision making, and 2) progress towards right use and utility of opioid treatment for chronic pain. Key Words: Opioids, chronic pain, addiction, side effects, utility, ethics

Enhancing Quality of Life of Families Who Use Adult Day Services: Short- and Long-Term Effects of the Adult Day Services Plus Program

2006 ◽  
Vol 46 (5) ◽  
pp. 630-639 ◽  
Author(s):  
L. N. Gitlin ◽  
K. Reever ◽  
M. P. Dennis ◽  
E. Mathieu ◽  
W. W. Hauck
Keyword(s):  
Quality Of Life ◽  
Long Term Effects ◽  
Adult Day Services ◽  
Short And Long Term ◽  
Day Services
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