scholarly journals To hydrate or not to hydrate? The effect of hydration on survival, symptoms and quality of dying among terminally ill cancer patients

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chien-Yi Wu ◽  
Ping-Jen Chen ◽  
Tzu-Lin Ho ◽  
Wen-Yuan Lin ◽  
Shao-Yi Cheng
Keyword(s):  
Cancer Patients ◽  
Proportional Hazards Model ◽  
Clinical Symptoms ◽  
Terminally Ill ◽  
Good Death ◽  
Artificial Nutrition ◽  
Symptom Improvement ◽  
Terminally Ill Cancer Patients ◽  
Quality Of Dying

Abstract Background Artificial nutrition and hydration do not prolong survival or improve clinical symptoms of terminally ill cancer patients. Nonetheless, little is known about the effect of artificial hydration (AH) alone on patients’ survival, symptoms or quality of dying. This study explored the relationship between AH and survival, symptoms and quality of dying among terminally ill cancer patients. Methods A pilot prospective, observational study was conducted in the palliative care units of three tertiary hospitals in Taiwan between October 2016 and December 2017. A total of 100 patients were included and classified into the hydration and non-hydration group using 400 mL of fluid per day as the cut-off point. The quality of dying was measured by the Good Death Scale (GDS). Multivariate analyses using Cox’s proportional hazards model were used to assess the survival status of patients, the Wilcoxon rank-sum test for within-group analyses and the Mann-Whitney U test for between-groups analyses to evaluate changes in symptoms between day 0 and 7 in both groups. Logistic regression analysis was used to assess the predictors of a good death. Results There were no differences in survival (p = 0.337) or symptom improvement between the hydration and non-hydration group, however, patients with AH had higher GDS scores. Conclusions AH did not prolong survival nor significantly improve dehydration symptoms of terminally ill cancer patients but it may influence the quality of dying. Communication with patients and their families on the effect of AH may help them better prepared for the end-of-life experience.

scholarly journals Inpatient Hospice Palliative Care Unit and Palliative Consultation Service Enhance Comprehensive Quality of Life Outcomes in Terminally Ill Cancer Patients: A Prospective Longitudinal Study

2021 ◽  
Vol 18 (17) ◽  
pp. 8992
Author(s):  
Li-Fang Chang ◽  
Li-Fen Wu ◽  
Chi-Kang Lin ◽  
Ching-Liang Ho ◽  
Yu-Chun Hung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Hospice Care ◽  
Terminally Ill ◽  
Consultation Service ◽  
Prospective Longitudinal Study ◽  
Terminally Ill Cancer Patients ◽  
Prospective Longitudinal ◽  
Hospice Palliative Care

This study aimed to explore the effectiveness of an inpatient hospice palliative care unit (PCU) and palliative consultation service (PCS) on comprehensive quality of life outcome (CoQoLo) among terminally ill cancer patients. This was a prospective longitudinal study. Terminally ill cancer patients who met the inclusion criteria and received PCU or PCS in a northern Taiwanese medical center were recruited. The CoQoLo Inventory was used to measure CoQoLo level pre- and seven days following hospice care between August 2018 and October 2019. A total of 90 patients completed the study. No significant differences were found in CoQoLo levels between the PCU and PCS groups pre- and seven days following care. However, the CoQoLo level of patients significantly improved seven days following care in both PCU and PCS groups, compared with pre-hospice care. Patients’ age, religious belief, marital status, closeness with family, palliative prognostic index (PPI), and symptom severity were significant concerning CoQoLo levels after adjusting for patients’ baseline characteristics. PCU and PCS showed no difference in CoQoLo levels, but both of them can improve CoQoLo among terminally ill cancer patients. These patients could receive PCU or PCS to achieve a good CoQoLo at the end-of-life stage.

scholarly journals Characteristics of Breakthrough Pain and Its Impact on Quality of Life in Terminally Ill Cancer Patients

2019 ◽  
Vol 18 ◽  
pp. 153473541985909 ◽  
Author(s):  
Silvia Gonella ◽  
Riccardo Sperlinga ◽  
Veronica Sciannameo ◽  
Valerio Dimonte ◽  
Sara Campagna
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Negative Impact ◽  
Breakthrough Pain ◽  
Short Form ◽  
Terminally Ill ◽  
Severe Problem ◽  
Terminally Ill Cancer Patients ◽  
Time To Peak

Purpose. This study aimed to characterize breakthrough pain (BTP) and investigate its impact on quality-of-life (QoL) in terminally-ill cancer patients. Similarities and differences between high and low predictable BTP were also tested. Methods. Secondary analysis of a multicenter longitudinal observational study included 92 patients at their end-of-life. BTP was assessed with a short form of the Italian version of the Alberta Breakthrough Pain Assessment Tool. QoL was assessed with the Palliative Outcome Scale (0-40). Patients were stratified by self-reported BTP predictability into unpredictable BTP (never or rarely able to predict BTP) and predictable BTP (sometimes to always able to predict BTP). Results. In all, 665 BTP episodes were recorded (median 0.86 episodes/day). A median duration of 30 minutes and a median peak intensity score of 7 out of 10 were reported. Time to peak was <10 minutes, 10 to 30 minutes, and ≥30 minutes in 267 (41.1%), 259 (39.9%), and 30 (4.6%) of the episodes, respectively. Onset of relief occurred after a median of 30 minutes. Time to peak ( P < .001) and duration ( P = .046) of BTP was shorter in patients with predictable pain ( n = 31), who usually were younger than those with unpredictable pain ( P = .03). The mean (SD) QoL score was 14.6 (4.6). No difference in QoL between patients with predictable and unpredictable BTP was found ( P = .49). Conclusions. In terminally-ill cancer patients, BTP is a severe problem with a negative impact on QoL and has different characteristics according to its predictability.

Last days: A study of the quality of life of terminally ill cancer patients

1986 ◽  
Vol 39 (1) ◽  
pp. 47-62 ◽  
Author(s):  
John N. Morris ◽  
Samy Suissa ◽  
Sylvia Sherwood ◽  
Susan M. Wright ◽  
David Greer
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Terminally Ill Cancer Patients

The Family in Hospital-Based Home Care with Special Reference to Terminally Ill Cancer Patients

1993 ◽  
Vol 9 (1) ◽  
pp. 5-13 ◽  
Author(s):  
Barbro Beck-Friis ◽  
Peter Strang
Keyword(s):  
Home Care ◽  
Cancer Patients ◽  
Symptom Control ◽  
Terminally Ill ◽  
Next Of Kin ◽  
Terminally Ill Cancer Patients ◽  
Terminally Ill Patients ◽  
Economic Support ◽  
The Family

Eighty-seven next of kin, 80 spouses and seven adult children, were the primary caregivers of terminally ill patients (87% cancer patients) cared for at the hospital-based home care (HBHC) unit of Motala Hospital during 1989–1990. All of the patients died in their homes. Next of kin were asked to complete self-questionnaires and to give written comments on their experiences and their perception of how the patient had felt about 13 aspects of home care provided by the HBHC staff. The response rate was 94%. In nine out of 13 areas, such as adequate information at the time of referral about the HBHC, security, support, immediate extra help when needed, high quality of nursing, and care and pain control, 86%–97% of next of kin were very satisfied (7–9 on a 9-point scale); whereas information provided about the disease, economic support, and support given after death were very satisfactory according to 72%, 58%, and 80% of relatives, respectively. Gender and time from diagnosis to death did not seem to affect responses. Next of kin of cancer patients were generally more satisfied than next of kin of other terminally ill patients. A total time of care of more than 60 days (median time) was associated with significantly more positive responses. Older spouses were significantly more satisfied with the HBHC than younger ones; despite this, 99% of all next of kin would choose HBHC again in a similar situation. It is concluded that very satisfactory terminal home care can be achieved, but it presupposes effective, prompt support and symptom control, 24 hours per day, and that both patient and family wish to participate in the HBHC.

Psychometric testing of the Spiritual Well-Being Scale–Mandarin version in Taiwanese cancer patients

2016 ◽  
Vol 15 (3) ◽  
pp. 336-347 ◽  
Author(s):  
Woung-Ru Tang ◽  
Chen-Yi Kao
Keyword(s):  
Quality Of Life ◽  
Factor Analysis ◽  
Psychometric Properties ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Well Being ◽  
Life Questionnaire ◽  
Terminally Ill Cancer Patients ◽  
Spiritual Well Being

AbstractObjective:The spiritual well-being of terminally ill cancer patients is an important indicator of the quality of their lives and of the quality of hospice care, but no validated tools are available for assessing this indicator in Taiwan.Method:The present cross-sectional study validated the Spiritual Well-Being Scale–Mandarin version (SWBS–M) by testing its psychometric properties in 243 cancer patients from five teaching hospitals throughout Taiwan. Construct validity was tested by factor analysis and hypothesis testing. Patients' spiritual well-being and quality of life were assessed using the SWBS–M and the McGill Quality of Life Questionnaire (MQoL), respectively.Results:Overall, the SWBS–M had an internal consistency/reliability of 0.89. Exploratory factor analysis showed that the SWBS–M had an underlying two-factor structure, explaining 46.94% of the variance. SWBS–M scores correlated moderately with MQoL scores (r = 0.48, p < 0.01). Terminally ill cancer patients' spiritual well-being was inversely related to their average pain level during the previous 24 hours (r = –0.183, p = 0.006). Cancer patients' spiritual well-being also differed significantly with their experience of pain (t = –3.67, p < 0.001); terminally ill cancer patients with pain during the previous 24 hours had a lower sense of spiritual well-being than those without pain.Significance of results:Our findings support a two-factor model for the SWBS–M in terminally ill Taiwanese cancer patients. We recommend testing the psychometric properties of the SWBS–M in different patient populations to verify its factorial structure in other Asian countries.

Sign in / Sign up

Export Citation Format

Share Document