Quality of life after morphine treatment in patients with advanced and terminal cancer.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 54-54
Author(s):  
Tammy Alonso

54 Background: Life quality evaluation is the main indicator of the impact of palliative care, which has the objective of diminished suffering. It includes symptoms control and the satisfactions of patients and relatives. Opioids constitute a milestone in pain treatment. Present work is aimed to evaluate the secondary effects in oncological patients with bad prognosis treated with morphine at the Palliative Care Unit (PCU) of the National institute of Oncology and Radiobiology. Methods: The sample includes 72 cancer patients that arrive to the Palliative Care Unit of the National Institute of Oncology and Radiobiology of Cuba, from May 2015 to May 2016. It was characterized in terms of the demographic and clinical parameters. Severity of symptoms was evaluated using the Visual Analogue Scale (VAS). Pain was evaluated using Analogue Visual Scale. Morphine was administered subcutaneously. Incidence of adverse effects related to morphine administration and accuracy of moderate to severe pain was measured. Results: The age range was from 41 to 50 and females predominate. Gynecological cancers were the most frequent pathology. Most frequent adverse effects related to morphine administration were: constipation (35%), nauseas and vomiting (25%) and somnolence (22%). Despite of morphine myths that terrify many physicians and make them use this drug at the end of analgesic scale, in the present work was used in patients in clinical stage III (58.6 % of the 63.8 % survivors) with an effective pain control. Life quality, that includes mood, functional capacity, social interaction and recurrent symptoms, was improved. Conclusions: The use of morphine for pain relief in stage III oncological patients increases the quality of life of patients and relatives for a longer period of time.

2021 ◽  
Author(s):  
Laoridi Aouridi-Héritier ◽  
Sophie Alonzo ◽  
Pascale Fabbro-Peray ◽  
Marion Guinamard ◽  
Sylvie Blanchard ◽  
...  

Abstract Title: The impact of Clown Therapy in a Palliative Care Unit (PCU); a pilot studyBackground: Although several studies on clown therapy have demonstrated benefits for children and the elderly, few studies exist on its impact on quality of life in adult terminal patients.We devised this monocentric, prospective, descriptive pilot study, covering both quantitative and qualitative aspects, to test the hypothesis that “clowning” in the PCU would help to improve the quality of life of patients, and benefit those accompanying them and their carers.Methods: 30 terminal patients [age range 63-79, 19 women, 11 men] from the palliative care unit at Nîmes University Hospital were included in the study from 31/03/2016 to 08/11/2016. All had given written informed consent. 2 clowns visited the patients and their companions, inviting them to take part in 15 to 30-minute improvised role-plays to prepare them for the inevitable separation. Primary outcome measures for the impact of the clowns’ interventions were: The Edmonton Symptom Assessment System evaluating patients’ physical symptoms and the McGill Quality of Life Questionnaire assessing patients’ quality of life. The secondary outcome measure was Alceste textual data analysis software to analyse semi-structured interviews held with patients, their companions and carers. Results: However long the clown’s intervention, the ESAS scores indicated a significant improvement in nausea (p=0.0248) and dyspnea (p=0.0476). Scores for depression (p=0.0160) also showed an improvement. A slight difference in the scores for anxiety (p=0.0900) and drowsiness (p=0.0812) was also observed. 2 days after the clowns’ intervention, the Mc Gill scores revealed a significantly greater physical quality of life (p=0.0044) and a very slight increase in the patients’ overall quality of life (p=0.0807). Results of the lexical analysis with Alceste revealed benefits for all those involved and gave an indication for better patient management at the PCU. Conclusions: This pilot study demonstrating the impact of “clowning” on various physical and mental symptoms in adult patients indicates the benefits of such interventions for patients, their companions and carers. Although the usefulness of clowns for children with life-threatening diseases is clear, the results obtained with our study clearly indicate the benefits of these interventions in adult, end-of-life patients. Further studies would be required to confirm these findings.Date of first registration : 20/11/2015Trial registration: ClinicalTrials.gov ID: NCT02610452This research was registered under the following reference : IDRCB 2015-A00719-40 and approved by the local committee for the protection of persons, CPP Sud-Méditerranée III-Nîmes on November 6th, 2015 under the reference 2015.06.03.


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Nesreen Fathi Mahmoud ◽  
Huda Zahran ◽  
Sherif Abdelmonam

Abstract Background This study focuses on the self-perception of the voice in the elderly as assessed by the Voice-Related Quality of Life (V-RQOL) questionnaire. This work aimed to compare differences in the voice-related quality of life outcomes between (1) elderly with and without voice disorders, (2) female and male elderly with voice disorders, and (3) different types of voice disorders, and to explore the correlation between the V-RQOL and perceptual analysis done by the clinician. Forty-three dysphonic and 44 non-dysphonic elderly filled out the Voice-Related Quality of Life (V-RQOL) protocol that analyzes the impact of dysphonia on life quality. Vocal perceptual assessment of each subject with dysphonia was made by three voice therapists, followed by a flexible nasofibrolaryngoscope. Results A significant statistical difference was found between the means of total V-RQOL scores and its subdomains for each group (dysphonic and non-dysphonic). No significant differences were found between male and female elderly with dysphonia. The statistical analysis showed a significant correlation with the vocal assessment made by the clinicians and the V-RQOL self-assessment made by the subjects. Conclusions This study provides valuable information regarding the risk factors that contribute to vocal quality in the elderly population. Our results revealed that different types of voice disorders are common among the elderly population with significant negative effects on quality of life. It was observed that the poorest score on the V-RQOL was for functional voice disorders, followed by neoplastic lesions, whereas MAPLs had the best score on the V-RQOL.


Author(s):  
Adele Bianco

The topic of this article is quality of life and ageing process specially focused on today young generations and their coming retirement situation. The main idea is that quality of life is increasing, that means longer, safer and better living condition; consequently positive ageing processes mean also reforming retirement sector. The hypothesis carried out in this paper is an alternative one. Despite of the positive trends, we describe how three main factor of nowadays life are, on the contrary, turning into worse condition the future of young generations and their coming life situation. Firstly we consider the socio-economic aspects, the impact on health and the implications connected with precarious work. Secondly we consider pollution and its effects on health, life quality and life expectation. Thirdly we pay attention about climate and environmental change and their effect on health, life quality and expectation. In conclusion, the retirement future of today young generations may be very different (worse) than expected. The paper in based on WHO, IPCC and European Agency for Safety and Health at Work data and reports.Key words: Young generations; Coming quality of life; Population ageing and future of retirement question.Parole chiave: Giovani generazioni; Qualitŕ della vita; Invecchiamento della popolazione e pensioni.


2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Cory Ingram

In palliative care we have the privilege to care for seriously ill people and their families. Some people value capturing their life story or illness journey on film. I have been fortunate to have been invited into the lives of many people close the end of life for a heartfelt conversation.On an interactive iPad incorporated in the poster, the recorded narrative of patients and one bereft spouse the poster audience will experience the lived experience of people close to the end of life as they reflect on their lives. The narratives will demonstrate how each lived with a new found improved quality of life in the face of increasing symptoms, declining functioning and the approaching end of life; otherwise known as healing. Topics of healing and quality of life, patient-centered care, dignity, human development, spirituality and love will be the focus of their stories. The stories lay bare the very practical, emotional, existential, and personal experience central to our provision of whole person care through palliative care. The poster audience will experience a renewed sense of the impact of a dedicated approach to whole person care as experienced through those on the receiving end.


Author(s):  
Faizan Younus Shah ◽  
Ifrah Shafat Kitab ◽  
Aaqib Aslam Shah ◽  
Faisal Younis Shah ◽  
Mohd Younus Shah ◽  
...  

Background: Psoriasis affects nearly 1% of the world population. It can be a source of significant morbidity and psychological stress to the patient but is not lethal under ordinary circumstances. Patients suffering from the disease feel a lack of empathy on part of care-givers, family members, healthcare professionals as well as society in general. Dermatology life quality index (DLQI) is a questionnaire-based assessment of health related quality of life in patients suffering from skin disorders and has been seen to correlate well with the impact of the disease on a patient. This study was done to understand the impact of psoriasis on the overall well-being of patients using DLQI as the tool of assessment.Methods: The study included 40 cases of psoriasis that were assessed for the severity of the disease based on percentage body surface area involvement. The impact of disease severity and other factors on the quality of life of the patient was assessed using DLQI.Results: Out of 35 patients with BSA involvement <50% (mild and moderate disease), 28.6% (n=10/35) showed a very large or extremely large effect on the quality of life while no patient with a BSA involvement >50% (severe and very severe disease) reported the same. A small, moderate or no effect on the DLQI was seen in 71.4% (n=25/35) of cases from the mild and moderate disease group while 100% (n=5/5) of cases from severe and very severe disease group reported a similar effect. Thus, DLQI was not directly related to the extent of BSA involvement and was dependent on other factors as well.Conclusion: Age had a correlation with the effect of the disease on the quality of life of psoriasis cases. Patients who were younger were more likely to report stress and anxiety related to the recurrences seen with the disease. Patients with lesions on sites that are socially exposed like face, hands, scalp, etc. were more likely to feel embarrassed about their condition. Younger age, female gender, lesions on exposed sites and recently diagnosed patients (<12 months) were factors which had a significant impact on the health-related quality of life of patients. The severity of disease and extent of involvement were not always directly related to extent of impact on the quality of life.


2015 ◽  
Vol 19 (6) ◽  
pp. 546-554 ◽  
Author(s):  
K. Heelan ◽  
S. L. Hitzig ◽  
S. Knowles ◽  
A. M. Drucker ◽  
N. Mittmann ◽  
...  

Background: Little is known about quality of life and work productivity in autoimmune bullous dermatoses (AIBDs). Objective: To determine the impact of AIBDs on quality of life and work productivity. Methods: An observational cross-sectional study took place between February and May 2013 at an AIBD tertiary referral centre. Ninety-four patients were included. All participants completed the Dermatology Life Quality Index and the Work Productivity and Activity Impairment–Specific Health Problem questionnaires. Results: Responders to treatment had less impairment ( P < .001) than nonresponders. Patients with severe AIBD had significantly more impairment that those with mild ( P < .001) and moderate ( P = .002) AIBD. Greater impairment was associated with higher percentage of work missed. Those with a higher Dermatology Life Quality Index score had greater work impairment and overall activity impairment ( P = .041, P = .024). Nonresponders had increased impairment while working ( P < .001), overall work impairment ( P < .001), and activity impairment ( P < .001). Severely affected patients had worse impairment in all Work Productivity and Activity Impairment Questionnaire domains. Conclusions: AIBD has the potential to be a large burden on ability to work and quality of life. Larger studies are needed to clarify how these domains change over time and whether or not they improve with treatment.


2012 ◽  
Vol 87 (6) ◽  
pp. 862-869 ◽  
Author(s):  
Eleni Tasoula ◽  
Stamatis Gregoriou ◽  
John Chalikias ◽  
Dimitris Lazarou ◽  
Ifigenia Danopoulou ◽  
...  

BACKGROUND: Acne vulgaris can severely affect social and psychological functioning. OBJECTIVE: The aim of this study was to investigate the impact of acne vulgaris and its severity on Quality of Life of young adolescents in Greece. METHODS: We conducted a questionnaire based survey among 1560 adolescent between the ages of 11 and 19 years old and 1531 of these were completed. Adolescents with acne filled all the questions including the Children Dermatology Life Quality Index. Adolescents without acne filled the questions about age, family history of acne, stress and smoking. Data were analyzed with Pearson Chi Square test. RESULTS: Acne prevalence was 51.2% affecting both sexes equally. Self reported mild acne was present in 71.2% and moderate-severe acne in 28.8% of the study population. The mean age of the study population was 15.77y. The median score of Children Dermatology Life Quality Index was 4.02. The impact of acne on quality of life is associated with the severity of the acne (p<0.0001). Patients with moderate/severe acne experience greater psychosocial and emotional impairment (p<0.0001). Body image is modified proportionally to the severity of acne (p<0.0001). Symptoms and treatment of acne are factors that also influence their quality of life. Girls and boys are equally affected. Stress and heredity are correlated with acne and its severity (p<0.0001). We didn't find any correlation between smoking and acne. CONCLUSION: Acne affects Quality of Life of young adolescents in Greece. The impact is proportional to the severity of acne. More severe acne is associated with greater effect on quality of life with implications for self esteem, body image and relationships with others.


2017 ◽  
Vol 54 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Émerson Soares PONTES ◽  
Ana Karênina de Freitas Jordão do AMARAL ◽  
Flávia Luiza Costa do RÊGO ◽  
Elma Heitmann Mares AZEVEDO ◽  
Priscila Oliveira Costa SILVA

ABSTRACT BACKGROUND The elderly population faces many difficulties as a result of the aging process. Conceptualize and evaluate their life quality is a challenge, being hard to characterize the impact on daily activities and on functional capacity. The stroke is one of the most disabling neurological diseases, becoming a public health problem. As an aggravating result, there is dysphagia, a disorder that compromises the progression of the food from the mouth to the stomach, causing clinical complications to the individual. OBJECTIVE Characterize the life quality of the elderly swallowing affected by stroke. METHODS Cross-sectional study conducted at the University Hospital, attended by 35 elderly with stroke, being 19 women and 16 men, with age between 60 and 90 years old, that self-reported satisfactory overall clinical picture. It was applied the Quality of Life Swallowing protocol. The data were statistically analyzed, by means of ANOVA tests, Spearman correlation, t test, with significance level of 5%. RESULTS The mean age was 69.5 years; as for the scores obtained by the 35 participants in the 11 domains of the protocol, it was observed a change in score indicating severe to moderate impact in quality of life related to self-reported swallowing (31.8% to 59.5%); the domain that most interfered was the feeding time (31.8%). CONCLUSION Elderly affected by stroke that present dysphagia has low scores in quality of life related to swallowing.


Author(s):  
Andrew Bradshaw ◽  
Samantha Greenwood ◽  
Lynne Yeadon ◽  
Kate Eagle

2015 ◽  
Vol 11 (3) ◽  
pp. 216-220 ◽  
Author(s):  
S Agrawal ◽  
A Rijal ◽  
S Bhattarai

Background Patch testing has previously been shown to influence the quality of life, although a very few studies have shown if this is dependent on the result of the patch tests. Objective To assess the impact of patch testing on the quality of life (QOL) in patients with hand eczema (HE). Methods A total of 50 patients diagnosed of hand eczema at the time of patch testing, aged 16 years and above participated in this study. Detailed demographic information and diagnosis of hand eczema were collected on the day of the patch test. After six weeks, the patients were asked about the hand eczema, knowledge of their allergies and change in their life style to avoid the relevant allergens demonstrated on the patch test. Dermatology Life Quality Index (DLQI) was used to measure the QOL on both occasions. Results The patch test positivity was found in 68% of patients to one or more allergens. The sum score of DLQI at baseline was 12.16 ± 5.58 with median 12.0. HE had most impact on symptoms and feelings. Patients with both positive patch test (mean baseline= 11.94± 5.88; mean at six weeks=2.81± 2.01; P<0.001) and negative patch test (mean baseline=12.63± 5.03; mean at 6 weeks=5.4± 3.56; P=0.001) showed significant improvement in DLQI scores, however it was more improved in patients with positive patch test than in patients with negative patch test. Conclusions Hand eczema had an appreciable impact on the QOL. Patch testing had been beneficial to most patients in improving patient quality of life considerably. DOI: http://dx.doi.org/10.3126/kumj.v11i3.12506 Kathmandu Univ Med J 2013; 43(3):216-220


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