Factors associated with quality of life in a cohort of patients with palliative advanced cancer from a developing country: Relevance of perception of cancer curability.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 93-93
Author(s):  
Pedro Emilio Perez-Cruz ◽  
Paola Langer ◽  
Cecilia Carrasco Escarate ◽  
Pilar Bonati ◽  
Bogomila Batic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Developing Countries ◽  
Developing Country ◽  
Advanced Cancer ◽  
Public Hospital ◽  
Symptom Burden ◽  
Factors Associated ◽  
Symptom Intensity

93 Background: Improving quality of life (QOL) is a key goal in palliative care for patients with advanced cancer. Most studies about QOL in palliative care patients have been performed in the developed world. However, little is known about the factors that influence patients QOL in developing countries. The aim of this study is to describe factors associated with QOL in a cohort of patients with advanced cancer who were enrolled in the outpatient clinic public hospital in Santiago, Chile. Methods: Patients with advanced cancer admitted to the National Program of Palliative Care at a public Hospital in Santiago, Chile were prospectively enrolled in a study to assess QOL longitudinally. QOL was assessed with the EORTC-QLQ-PAL 15 questionnaire. Demographics, symptom intensity, depression and anxiety were assessed. Descriptive statistics and regression analysis were performed. Information about cancer curability and perception of personal health were also included. Results: In this preliminary report, the first 37 patients were included. Baseline characteristics were: mean patient age was 64, 21 (57%) females, 14 (38%) had GI cancer, 7 (19%) lung cancer, 4 (11%) breast cancer and 12 (22%) other. Mean (SD) QOL was 63 (34) in a 0 to 100 scale. QOL was not associated with age, gender, functionality, depression, anxiety, spiritual pain or financial distress. QOL was negatively associated with total symptom burden (coef -.53, p = .48), and positively associated with believing that cancer was curable (coef 33.3, p = .003). In a multivariate analysis, QOL was independently associated with both lower overall symptom burden (coef -.55, p = .38) and believing that cancer was curable (coef 28.6, p = .009). Conclusions: In palliative care patients with advanced cancer from a developing country, QOL was associated with lower overall symptom burden and with believing that cancer was curable. Further studies are needed to explore whether clarifying prognostic information about cancer curability in developing countries may impact patients’ QOL.

Nurse-Led Palliative Care for Advanced Cancer Patients (DRAFT)

2018 ◽  
Author(s):  
Emily J. Martin ◽  
Eric J. Roeland
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Controlled Trial ◽  
Control Group ◽  
Advanced Cancer Patients ◽  
Intention To Treat ◽  
Symptom Intensity

This chapter summarizes the Bakitas et al. 2009 Project ENABLE II randomized controlled trial, which examined how a nurse-led palliative care intervention, provided concurrently with usual oncologic care, impacted quality of life, symptom intensity, mood, and resource use among advanced cancer patients. Longitudinal intention-to-treat analyses showed greater quality of life and less depressed mood in patients who received palliative care as compared with the control group. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

Factors Associated with Higher Symptom Burden and Lower Quality of Life Among Older Adults with Advanced Cancer (RP507)

2020 ◽  
Vol 60 (1) ◽  
pp. 232-233
Author(s):  
Yael Schenker ◽  
Andrew Althouse ◽  
Margaret Rosenzweig ◽  
Douglas White ◽  
Edward Chu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Advanced Cancer ◽  
Symptom Burden ◽  
Factors Associated

scholarly journals Quality of life of cancer patients at palliative care units in developing countries: systematic review of the published literature

2020 ◽  
Author(s):  
Dwi Gayatri ◽  
Ljupcho Efremov ◽  
Eva Johanna Kantelhardt ◽  
Rafael Mikolajczyk
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Developing Countries ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Experimental Studies ◽  
Spiritual Support ◽  
Advanced Cancer Patients

Abstract Purpose This systematic review aims to summarize factors that influence the quality of life (QOL) of advanced cancer patients in palliative care (PC) in developing countries. Understanding this context in developing countries milieu is necessary; however, this outcome is rarely reported. Methods Following the PRISMA guidelines, the electronic databases MEDLINE, Embase, CINAHL, and Web of Science were systematically searched using the search terms: QOL, cancer, PC, and names of all developing countries. Studies with less than ten subjects, qualitative or pilot studies, reviews, conference abstracts, and that reported validation of QOL questionnaires were excluded. Results Fifty-five studies from 15 developing countries in the African (n = 5), Latin America and the Caribbean (n = 10), and Asian (n = 40) region were included in the narrative synthesis. 65.4% were cross-sectional, 27.3% were cohort studies, 7.3% were RCTs or quasi-experimental studies. Around 30 QOL factors were studied with 20 different types of QOL instruments. Advanced cancer patients who were older, married/ever married, participated in additional care within PC, used complementary and alternative medicine (CAM), and practiced spirituality/religiosity showed higher QOL score. Low educational level and high depression were associated with a lower QOL. Conclusion Various factors affect QOL among cancer patients in PC. Patients valued the use of CAMs; however, the quality and safety aspects should be properly addressed. Important factors that influenced the QOL score were social and spiritual support. While there is a general need to develop PC strategies further, recognizing patients’ needs should be prioritized in national cancer programs.

scholarly journals Integrated outpatient palliative care for patients with advanced cancer: A systematic review and meta-analysis

2018 ◽  
Vol 33 (2) ◽  
pp. 123-134 ◽  
Author(s):  
Jessica J Fulton ◽  
Thomas W LeBlanc ◽  
Toni M Cutson ◽  
Kathryn N Porter Starr ◽  
Arif Kamal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Healthcare Utilization ◽  
Advanced Cancer ◽  
Meta Analysis ◽  
Symptom Burden ◽  
Short Term ◽  
Randomized Controlled ◽  
Oncology Care

Background: Despite increasing emphasis on integration of palliative care with disease-directed care for advanced cancer, the nature of this integration and its effects on patient and caregiver outcomes are not well-understood. Aim: We evaluated the effects of integrated outpatient palliative and oncology care for advanced cancer on patient and caregiver outcomes. Design: Following a standard protocol (PROSPERO: CRD42017057541), investigators independently screened reports to identify randomized controlled trials or quasi-experimental studies that evaluated the effect of integrated outpatient palliative and oncology care interventions on quality of life, survival, and healthcare utilization among adults with advanced cancer. Data were synthesized using random-effects meta-analyses, supplemented with qualitative methods when necessary. Data sources: English-language peer-reviewed publications in PubMed, CINAHL, and Cochrane Central through November 2016. We subsequently updated our PubMed search through July 2018. Results: Eight randomized-controlled and two cluster-randomized trials were included. Most patients had multiple advanced cancers, with median time from diagnosis or recurrence to enrollment ranging from 8 to 12 weeks. All interventions included a multidisciplinary team, were classified as “moderately integrated,” and addressed physical and psychological symptoms. In a meta-analysis, short-term quality of life improved, symptom burden improved, and all-cause mortality decreased. Qualitative analyses revealed no association between integration elements, palliative care intervention elements, and intervention impact. Utilization and caregiver outcomes were often not reported. Conclusions: Moderately integrated palliative and oncology outpatient interventions had positive effects on short-term quality of life, symptom burden, and survival. Evidence for effects on healthcare utilization and caregiver outcomes remains sparse.

scholarly journals Impact on caregiver burden of a patient-focused palliative care intervention for patients with advanced cancer

2010 ◽  
Vol 8 (4) ◽  
pp. 395-404 ◽  
Author(s):  
Ross E. O'Hara ◽  
Jay G. Hull ◽  
Kathleen D. Lyons ◽  
Marie Bakitas ◽  
Mark T. Hegel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Usual Care ◽  
Advanced Cancer ◽  
Caregiver Burden ◽  
Depressed Mood ◽  
Care Intervention ◽  
Symptom Intensity ◽  
Objective Burden

AbstractObjective:Caregivers of patients with advanced cancer experience physical and emotional strain that can raise their own risk for morbidity and mortality. This analysis was performed to determine whether ENABLE II, a patient-focused palliative care intervention that increased patients' quality of life, reduced symptom intensity, and lowered depressed mood compared to usual care, would affect caregiver burden.Method:Caregivers of patients with advanced cancer from the parent study completed a caregiver burden scale and patients completed quality of life, symptom intensity, and depressed mood measures. Data were collected at baseline, 1 month, and every 3 months thereafter until patient death or the study ended. Decedents' caregivers were asked to complete an after-death interview regarding the quality of care that the patient received.Results:There were no significant differences in caregiver burden between intervention and usual care conditions. Follow-up analyses showed that higher caregiver objective burden and stress burden were related to lower patient quality of life, higher symptom intensity, and higher depressed mood. Caregivers who perceived that patients had unmet needs at end of life reported higher objective burden, and those who perceived that patients were not treated with respect reported higher demand burden.Significance of results:The results indicate that a successful patient-focused intervention did not have a similar beneficial effect on caregiver burden. Future interventions should focus on caregivers as well as patients, with particular attention to caregivers' perceptions of patient care, and seek to change both negative and positive effects of informal caregiving.

The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis

2021 ◽  
pp. 026921632199472
Author(s):  
Natalia Salamanca-Balen ◽  
Thomas V Merluzzi ◽  
Man Chen
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Meta Analysis ◽  
Symptom Burden ◽  
Well Being ◽  
Medium Effect ◽  
Spiritual Well Being ◽  
Quasi Experimental

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.

scholarly journals Shifting Palliative Care Paradigm in Primary Care From Better Death to Better End-of-Life : A Swiss Pilot Study

2021 ◽  
Author(s):  
Johanna Sommer ◽  
Christopher Chung ◽  
Dagmar M. Haller ◽  
Sophie Pautex
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Palliative Care ◽  
Pilot Study ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Communication Skills ◽  
Advanced Cancer Patients

Abstract Background: Patients suffering from advanced cancer often loose contact with their primary care physician (PCP) during oncologic treatment and palliative care is introduced very late.The aim of this pilot study was to test the feasibility and procedures for a randomized trial of an intervention to teach PCPs a palliative care approach and communication skills to improve advanced cancer patients’ quality of life. Methods: Observational pilot study in 5 steps. 1) Recruitment of PCPs. 2) Intervention: training on palliative care competencies and communication skills addressing end-of-life issues.3) Recruitment of advanced cancer patients by PCPs. 4) Patients follow-up by PCPs, and assessment of their quality of life by a research assistant 5) Feedback from PCPs using a semi-structured focus group and three individual interviews with qualitative deductive theme analysis.Results: 8 PCPs were trained. PCPs failed to recruit patients for fear of imposing additional loads on their patients. PCPs changed their approach of advanced cancer patients. They became more conscious of their role and responsibility during oncologic treatments and felt empowered to take a more active role picking up patient’s cues and addressing advance directives. They developed interprofessional collaborations for advance care planning. Overall, they discovered the role to help patients to make decisions for a better end-of-life.Conclusions: PCPs failed to recruit advanced cancer patients, but reported a change in paradigm about palliative care. They moved from a focus on helping patients to die better, to a new role helping patients to define the conditions for a better end-of-life.Trial registration : The ethics committee of the canton of Geneva approved the study (2018-00077 Pilot Study) in accordance with the Declaration of Helsinki

Financial Hardship and Quality of Life Among Patients With Advanced Cancer Receiving Outpatient Palliative Care

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sarah M. Belcher ◽  
Haerim Lee ◽  
Janet Nguyen ◽  
Kimberly Curseen ◽  
Ashima Lal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Advanced Cancer ◽  
Financial Hardship

Telemedically Augmented Palliative Care

2014 ◽  
pp. 185-201
Author(s):  
Romina Nemecek ◽  
Patrick Huber ◽  
Sophie Schur ◽  
Eva Masel ◽  
Stefanie Porkert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Family Caregivers ◽  
Hospital Admissions ◽  
Intervention Group ◽  
Symptom Burden ◽  
Well Being ◽  
Control Group ◽  
User Friendly

Patients with advanced cancer have a substantial symptom burden, which deteriorates their quality of life. Palliative care improves well-being of patients and their family caregivers. Within the scope of a controlled pilot study, a user-friendly telepresence system is developed, which enables patients and family caregivers to send a direct request to a palliative care team. Additionally, a specially tailored database is developed, which contains up to date patient information. Twenty patients with advanced non-small cell lung cancer are consecutively assigned in a control and an intervention group. The intervention group receives the telemedically augmented care, whereas the control group receives standard care. The primary goal of this chapter is to determine the usability and feasibility; the secondary goal is the assessment of the intervention's impact on quality of life and the number of unscheduled hospital admissions. To sum up, telemedically supported ambulatory palliative care may synergistically help to improve safety and quality of life.

scholarly journals Chemotherapy use and quality of life in cancer patients at the end of life: an integrative review

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Elham Akhlaghi ◽  
Rebecca H. Lehto ◽  
Mohsen Torabikhah ◽  
Hamid Sharif Nia ◽  
Ahmad Taheri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Palliative Chemotherapy ◽  
Palliative Therapy ◽  
Related Quality ◽  
Health Related

Abstract Background When curative treatments are no longer available for cancer patients, the aim of treatment is palliative. The emphasis of palliative care is on optimizing quality of life and provided support for patients nearing end of life. However, chemotherapy is often offered as a palliative therapy for patients with advanced cancer nearing death. The purpose of this review was to evaluate the state of the science relative to use of palliative chemotherapy and maintenance of quality of life in patients with advanced cancer who were at end of life. Materials and methods Published research from January 2010 to December 2019 was reviewed using PRISMA guidelines using PubMed, Proquest, ISI web of science, Science Direct, and Scopus databases. MeSH keywords including quality of life, health related quality of life, cancer chemotherapy, drug therapy, end of life care, palliative care, palliative therapy, and palliative treatment. Findings 13 studies were evaluated based on inclusion criteria. Most of these studies identified that reduced quality of life was associated with receipt of palliative chemotherapy in patients with advanced cancer at the end of life. Conclusion Studies have primarily been conducted in European and American countries. Cultural background of patients may impact quality of life at end of life. More research is needed in developing countries including Mideastern and Asian countries.

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