Strategy of Coping With End-Stage Disease and Cancer-Related Fatigue in Terminally Ill Patients

2013 ◽  
Vol 31 (7) ◽  
pp. 771-776 ◽  
Author(s):  
Aleksandra Modlińska ◽  
Bożena Kowalik ◽  
Tomasz Buss ◽  
Justyna Janiszewska ◽  
Monika Lichodziejewska-Niemierko
Keyword(s):  
Terminally Ill ◽  
Terminally Ill Patients ◽  
Cancer Related Fatigue ◽  
Stage Disease ◽  
End Stage

Investigation of Optimal Time for Starting Betamethasone Using Fatigue Scores and Prognostic Nutritional Index in Terminally Ill Patients With Cancer-Related Fatigue

2016 ◽  
Vol 34 (5) ◽  
pp. 449-455 ◽  
Author(s):  
Nanako Koyama ◽  
Chikako Matsumura ◽  
Hiroaki Morii ◽  
Chiaki Hasegawa ◽  
Daiki Hira ◽  
...  
Keyword(s):  
Survival Time ◽  
Terminally Ill ◽  
Prognostic Nutritional Index ◽  
Optimal Time ◽  
Clinical Validity ◽  
Patients With Cancer ◽  
Terminally Ill Patients ◽  
Cancer Related Fatigue ◽  
Nutritional Index ◽  
The Relationship

Background: Corticosteroids are frequently used to treat cancer-related fatigue (CRF), but it is yet to be established as standard care, and few reports have defined the appropriate time to start treatment. Objectives: We investigated the optimal time for starting betamethasone and evaluated the clinical validity of using the prognostic nutritional index (PNI) for this purpose. Methods: Data were retrospectively collected for patients with terminal cancer receiving betamethasone for palliative care. Fatigue strength was evaluated by the daily occurrence of fatigue, using proportion of adequate fatigue, AF(%), defined as the average of the daily score for all treatment days, AF(%)all, the initial 5 days, AF(%)initi5, or the last 5 days, AF(%)last5. We examined (1) the relationship between survival time and adequate fatigue for CRF and (2) the correlation between survival time and PNI (based on serum albumin and lymphocytes). Results: Data from 24 patients were included. The AF(%)all was approximately 50% at 42 days before death and gradually decreased as the survival time shortened ( R2 =.41, P <.001). There was a clear positive correlation between AF(%)all and AF(%)initi5 ( R2 =.84, P <.001). At 42 days before death, PNI was approximately 30 and significantly correlated with the survival time ( R2 = .873, P <.001). Conclusion: The adequate fatigue appears to be dependent on survival time, and PNI might be useful for identifying patients that will benefit from betamethasone use. It is hoped that these results will contribute to individualized pharmacotherapy of terminally ill patients with CRF.

scholarly journals Peaceful End of Life Theory: A Critical Analysis of Its Use to Improve Nursing Practice

2021 ◽  
Vol 4 (3) ◽  
pp. 412-417
Author(s):  
Schadrack Ngabonziza ◽  
Marie Chantal Murekatete ◽  
Gerard Nyiringango ◽  
Sandra Marie Grace Musabwasoni
Keyword(s):  
End Of Life ◽  
Nursing Practice ◽  
Healthcare Providers ◽  
Terminally Ill ◽  
Practice Research ◽  
Nursing Interventions ◽  
Theory Analysis ◽  
Terminally Ill Patients ◽  
Research And Education ◽  
End Stage

BackgroundProvision of empathetic palliative care in agreement with patient’s favorites is an indispensable attitude of healthcare providers. A Peaceful End of Life Theory was designed by Rulandand Moore (1998),to provide theoretical framework for nurses who care for patients at end stage of their life.MethodsChinn and Kramer theory analysis guideline was used to analyse this theory to suggest its improvement.ResultsFive major concepts and sub-concepts are identified.This theory informs the nursing profession on the relieving interventions at the end of life. It provides a guidance to supportively manage terminally ill patients in collaboration with their families.ConclusionThis theory is important to guide nursing practice,research, and education. However, there is a lack of an instrument to measure the desired outcomes, some subconcepts do not cleary specify the nursing interventions, and it lacks the spiritual comfort to the terminally ill patients who believe in eternal life.Rwanda J Med Health Sci 2021;4(3):412-417

Terminally Ill Patients and Desire for Death

1986 ◽  
Author(s):  
J. H. Brown ◽  
P. Henteleff ◽  
S. Barakat ◽  
C. J. Rowe
Keyword(s):  
Terminally Ill ◽  
Terminally Ill Patients ◽  
Desire For Death

scholarly journals The role of EORTC QLQ-C15-PAL scores and inflammatory biomarkers in predicting survival in terminally ill patients with cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nanako Koyama ◽  
Chikako Matsumura ◽  
Yoshihiro Shitashimizu ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Cox Regression ◽  
Terminally Ill ◽  
Inflammatory Biomarkers ◽  
Survival Curves ◽  
Patients With Cancer ◽  
Terminally Ill Patients ◽  
Patient Reported ◽  
Eortc Qlq

Abstract Background The clinical use of patient-reported outcomes as compared to inflammatory biomarkers for predicting cancer survival remains a challenge in palliative care settings. We evaluated the role of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative scores (EORTC QLQ-C15-PAL) and the inflammatory biomarkers C-reactive protein (CRP), albumin (Alb), and neutrophil-lymphocyte ratio (NLR) for survival prediction in patients with advanced cancer. Methods This was an observational study in terminally ill patients with cancer hospitalized in a palliative care unit between June 2018 and December 2019. Patients’ data collected at the time of hospitalization were analyzed. Cox regression was performed to examine significant factors influencing survival. A receiver operating characteristic (ROC) analysis was performed to estimate cut-off values for predicting survival within 3 weeks, and a log-rank test was performed to compare survival curves between groups divided by the cut-off values. Results Totally, 130 patients participated in the study. Cox regression suggested that the QLQ-C15-PAL dyspnea and fatigue scores and levels of CRP, Alb, and NLR were significantly associated with survival time, and cut-off values were 66.67, 66.67, 3.0 mg/dL, 2.5 g/dL, and 8.2, respectively. The areas under ROC curves of these variables were 0.6–0.7. There were statistically significant differences in the survival curves between groups categorized using each of these cut-off values (p < .05 for all cases). Conclusion Our findings suggest that the assessment of not only objective indicators for the systemic inflammatory response but also patient-reported outcomes using EORTC QLQ-C15-PAL is beneficial for the prediction of short-term survival in terminally ill patients with cancer.

scholarly journals Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Péter J. Hegyi ◽  
Alexandra Soós ◽  
Emese Tóth ◽  
Attila Ébert ◽  
Viktória Venglovecz ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Morphological Changes ◽  
International Study ◽  
Study Data ◽  
Cross Sectional ◽  
Clinical Biomarkers ◽  
Stage Disease ◽  
Significant Difference ◽  
End Stage

AbstractChronic pancreatitis (CP) is an end-stage disease with no specific therapy; therefore, an early diagnosis is of crucial importance. In this study, data from 1315 and 318 patients were analysed from acute pancreatitis (AP) and CP registries, respectively. The population from the AP registry was divided into AP (n = 983), recurrent AP (RAP, n = 270) and CP (n = 62) groups. The prevalence of CP in combination with AP, RAP2, RAP3, RAP4 and RAP5 + was 0%, 1%, 16%, 50% and 47%, respectively, suggesting that three or more episodes of AP is a strong risk factor for CP. Laboratory, imaging and clinical biomarkers highlighted that patients with RAP3 + do not show a significant difference between RAPs and CP. Data from CP registries showed 98% of patients had at least one AP and the average number of episodes was four. We mimicked the human RAPs in a mouse model and found that three or more episodes of AP cause early chronic-like morphological changes in the pancreas. We concluded that three or more attacks of AP with no morphological changes to the pancreas could be considered as early CP (ECP).The new diagnostic criteria for ECP allow the majority of CP patients to be diagnosed earlier. They can be used in hospitals with no additional costs in healthcare.

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