Factors associated with fatigue in children with cancer at the end of life

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8574-8574
Author(s):  
C. K. Ullrich ◽  
J. M. Hilden ◽  
J. W. Sheaffer ◽  
C. L. Moore ◽  
C. B. Berde ◽  
...  

8574 Background: Fatigue is prevalent in children with cancer but is poorly understood. Improved understanding of this symptom will inform development of interventions aimed at alleviating it. Methods: Cross-sectional survey conducted between 1997–2001 of 144 parents of children who died of cancer cared for at Dana-Farber Cancer Institute/Children’s Hospital Boston and Children’s Hospital and Clinics, St Paul and Minneapolis (response rate 65%). Parents reported the child’s experience of symptoms in the last month of life and associated suffering, and patient characteristics. Determinants of suffering from, and treatment of fatigue were explored with univariate analyses adjusting for physician and time since death. A logistic regression model was built to determine factors associated with suffering from fatigue, with a threshold for entry of P<.05, and accounting for physician clustering. Results: Almost all children experienced fatigue and 50% suffered significantly from it (a great deal/a lot versus some/a little/none at all). Only 15% received treatment, and of them, 79% were not successfully treated. Univariate analyses revealed significant associations between suffering from fatigue and suffering from pain, dyspnea, anorexia, diarrhea, and nausea/vomiting, as well sadness, anemia and successful treatment of pain (P<.05). Treatment of fatigue was associated with side effects from treatment of pain (OR 3.9, P=.008) and treatment of dyspnea (OR 3.9, P=.02). In the multivariate analysis of suffering from fatigue, successful treatment of pain remained significant (OR 4.2, P=.009). Conclusions: Suffering from fatigue is common in children with cancer at the end of life and efforts to palliate it are limited. Significant fatigue is highly associated with other symptoms and their treatments. Increased attention to treatment-related fatigue and evaluation of interventions such as stimulants may be effective in ameliorating fatigue in children with advanced cancer. No significant financial relationships to disclose.

2007 ◽  
Vol 25 (11) ◽  
pp. 1357-1362 ◽  
Author(s):  
Jennifer W. Mack ◽  
E. Francis Cook ◽  
Joanne Wolfe ◽  
Holcombe E. Grier ◽  
Paul D. Cleary ◽  
...  

Purpose Patients often overestimate their chances of surviving cancer. Factors that contribute to accurate understanding of prognosis are not known. We assessed understanding of likelihood of cure and functional outcome among parents of children with cancer and sought to identify factors that place parents at risk for overly optimistic beliefs about prognosis. Patients and Methods We conducted a cross-sectional survey of 194 parents of children with cancer (response rate, 70%) who were treated at the Dana-Farber Cancer Institute and Children's Hospital in Boston, MA, and the children's physicians. Parent and physician expectations for likelihood of cure and functional outcome were compared. In 152 accurate or optimistic parents, we determined factors associated with accurate understanding of likelihood of cure compared with optimism. Results The majority of parents (61%) were more optimistic than physicians about the likelihood of cure. Parents' beliefs about other outcomes of cancer treatment were similar (quality-of-life impairment, P = .70) or more pessimistic (physical impairment, P = .01; intellectual impairment, P = .01) than physicians' beliefs. Parents and physicians were more likely to agree about chances of cure when physicians had confidence in knowledge of prognosis (odds ratio [OR] = 2.55, P = .004) and allowed parents to take their preferred decision-making role (OR = 1.89, P = .019). Conclusion Parents of children with cancer are overly optimistic about chances of cure but not about other outcomes of cancer therapy. Parents tend to be overly optimistic about cure when physicians have little confidence and when the decision-making process does not meet parents' preferences. These findings suggest that physicians are partly responsible for parents' unrealistic expectations about cure.


2021 ◽  
Vol 62 (4) ◽  
Author(s):  
Nguyen Van Dung ◽  
Nguyen Thi Thinh ◽  
Pham Van Phu

A cross-sectional survey on 523 pairs of mother and suffered from acute respiratory infections child6-23 months old treated at the Maternity and Children’s Hospital of Ha Nam provine in 2016-2018to assess the nutritional status of children and describe some mother’s child-feeding practices. Theresults showed that: The rates of stunting and wasting of children were high: 21.2% and 11.1%(respectively); the rate of underweight was 14.0%. The rates of mothers who breastfeed their babieslate after the first hour after birth and of mothers who give complementary foods too early or too late(before 6 months or after 8 months of age) were quite high: 62.5% and 53.0% (respectively); the rateof mothers squeezed colostrum before first breastfeeding was 24.3%. Children who were started oncomplementary feeding at the wrong time compared with those who were fed at the right time hadhigher rates of stunting: 24.2% and 18.8% (respectively) (OR=1, 4; 95%CI 0.9-2.3) but no statisticallysignificant difference (p=0.1075); the rate of underweight malnutrition was also higher: 19.5% and7.8% (respectively) statistically significant difference (OR=2.9; 95%CI 1.6-5.3; p=0.0001).


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 777-778
Author(s):  
Yan Luo ◽  
Lewis Lee ◽  
Hyunjin Noh ◽  
Hee Lee

Abstract The intention to communicate end-of-life wishes and its related factors among adults in the southern rural region of the US has not been studied. This study aims to: (1) assess the intention to communicate end-of-life wishes among rural residents living in the Black Belt Region; (2) controlling for demographics and social determinants of health (SDH), examine the relationship between awareness of hospice care and the intention to communicate end-of-life wishes. A convenient sample living in rural Alabama was collected to complete a cross-sectional survey (N=182, age=18-91). Univariate analyses were conducted to assess participants’ intention to communicate end-of-life wishes, demographic characteristics, and SDH. Binary logistic regressions were used to examine the relationship between awareness of hospice care and the intention to communicate end-of-life wishes while controlling for demographics and SDH. The majority of participants were willing to communicate end-of-life wishes to their family (77.5%) or doctors (72.5%). Participants who were aware of hospice care were more likely to be willing to communicate end-of-life wishes to both their families (OR=10.08, p&lt;0.01) and doctors (OR=7.20, p&lt;0.05). Moreover, participants who were older were less likely to communicate end-of-life wishes to their doctors while participants with higher social isolation scores had lower intention to communicate end-of-life wishes to their families (OR=0.53, p&lt;0.05). This is the first study assessing the intention of communicating end-of-life wishes among residents living in the Black Belt Region. This study demonstrated that awareness of hospice care is positively associated with the intention to communicate end-of-life wishes to both families and doctors.


BMJ Open ◽  
2014 ◽  
Vol 4 (3) ◽  
pp. e004398 ◽  
Author(s):  
Sadiqa Kendi ◽  
Mark R Zonfrillo ◽  
Karen Seaver Hill ◽  
Kristy B Arbogast ◽  
Michael A Gittelman

2015 ◽  
Vol 5 (1) ◽  
pp. 18-26 ◽  
Author(s):  
S. J. Friedrichsdorf ◽  
A. Postier ◽  
D. Eull ◽  
C. Weidner ◽  
L. Foster ◽  
...  

Author(s):  
Soufiane El Moussaoui ◽  
Kamal Kaoutar ◽  
Ahmed Chetoui ◽  
Abdeslam El Kardoudi ◽  
Fatiha Chigr ◽  
...  

BACKGROUND: Exclusive breastfeeding is the best form of nutrition for infants during the first 6 months of life. Nevertheless, the practice of breastfeeding is currently declining throughout the world. OBJECTIVE: The objective of this study was to assess the prevalence of exclusive breastfeeding (EBF) practice and its associated factors among mothers living in Marrakesh province, Morocco. METHODS: The data were collected using an interviewer administered questionnaire. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with exclusive breastfeeding practice. RESULTS: Prevalence of exclusive breastfeeding was 50.2%. Mothers with age more than 30 years, residing in rural area, receiving counseling related breastfeeding during antenatal follow up and having knowledge about duration of breastfeeding were more likely to practice exclusive breastfeeding than their counterparts. CONCLUSION: Although the prevalence of breastfeeding in Marrakesh was higher than the last national survey report but it is still insufficient. These findings have to stress authorities and deciders to sensitize mothers and future mothers to increase exclusive breastfeeding practice notably through the involvement of health professionals.


Author(s):  
James Alton Croker ◽  
Julie Bobitt ◽  
Sara Sanders ◽  
Kanika Arora ◽  
Keith Mueller ◽  
...  

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.


Author(s):  
Yoko Iwaki ◽  
Santosh Kumar Rauniyar ◽  
Shuhei Nomura ◽  
Michael C. Huang

Tuberculosis (TB) has still remained a serious global health threat in low- and middle-income countries in recent years. As of 2021, Nepal is one of the high TB burden countries, with an increasing prevalence of cases. This study evaluates factors associated with TB awareness in Nepal. This study uses data from the Nepal Demographic and Health Survey, a cross-sectional survey carried out from June 2016 to January 2017. Multilevel logistic regression is performed to examine the association of demographic and socioeconomic factors with TB awareness. Our findings show a high level of TB awareness in all seven provinces of Nepal. Province 5 has the highest level of awareness (98.1%) among all provinces, followed by provinces 3 and 4, while province 6 has the lowest awareness level (93.2%) compared to others. Socioeconomic factors such as wealth, education and owning a mobile phone are significantly associated with TB awareness. Socioeconomic determinants are influential factors associated with TB awareness in Nepal. The wide variation in the proportion of awareness at a regional level emphasizes the importance of formulating tailored strategies to increase TB awareness. For instance, the use of mobile phones could be an effective strategy to promote TB awareness at a regional level. This study provides valuable evidence to support further research on the contribution of information and communication technology (ICT) usage to improving TB awareness in Nepal.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tun Min Bo ◽  
Yohei Hama ◽  
Norihisa Akiba ◽  
Shunsuke Minakuchi

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