Eating-related distress in patients with advanced cancer cachexia and family members: A survey in palliative and supportive care settings.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 163-163
Author(s):  
Koji Amano

163 Background: Few studies have investigated nutrition impact symptoms and eating-related distress among advanced cancer patients and their family members. This is an anonymous questionnaire survey to explore the severity of nutrition impact symptoms and the prevalence of eating-related distress among advanced cancer patients and their family members in palliative and supportive care settings. Methods: The questionnaires for patients and their family members have been preliminarily developed by the authors. We have chosen 16 common symptoms of advanced cancer, i.e., 9 symptoms of the ESAS-r and 7 symptoms of the PG-SGA. Each questionnaire concerning eating-related distress consists of 12 items. Results: A total of 140 out of 147 patients responded (95.2%). They were classified into two groups: 1) Non-cachexia/Pre-cachexia (n = 57) and 2) Cachexia/Refractory cachexia (n = 83). The top 3 out of 16 symptoms in all patients were feeling of well-being, lack of appetite, and tiredness. Significant differences between the two groups were observed in 5 symptoms: pain (p = 0.005), nausea (p = 0.005), diarrhea (p = 0.001), abnormal taste (p = 0.017), and difficulty swallowing (p = 0.002), respectively. Concerning eating-related distress, significant differences between the two patient groups were observed in all items except for 2, and those between the two family member groups were observed in all items. The mean numbers of items in which patients/family members answered positively were significantly higher in Cachexia/Refractory cachexia group (p < 0.001, respectively). Conclusions: Advanced cancer patients with cachexia have greater nutrition impact symptoms than those without cachexia, and patients with cachexia and their family members have higher eating-related distress than those without cachexia.

2018 ◽  
Vol 27 (8) ◽  
pp. 2869-2876 ◽  
Author(s):  
Koji Amano ◽  
Tatsuya Morita ◽  
Saori Koshimoto ◽  
Teruaki Uno ◽  
Hirofumi Katayama ◽  
...  

2004 ◽  
Vol 2 (3) ◽  
pp. 243-253 ◽  
Author(s):  
CHERYL L. NEKOLAICHUK ◽  
EDUARDO BRUERA

Objective:The purpose of this study was to gather validity evidence for an innovative experience of hope scale, theHope Differential-Short (HDS), and evaluate its clinical utility for assessing hope in advanced cancer patients.Methods:A consecutive sampling approach was used to recruit 96 patients from an inpatient tertiary palliative care unit and three hospice settings. Each participant completed an in-person survey interview, consisting of the following measures: HDS (nine items), Herth Hope Index (HHI), hope visual analog scale (Hope-VAS) and Edmonton Symptom Assessment System (ESAS).Results:Using factor analytic procedures, a two-factor structure for the HDS was identified, consisting ofauthentic spirit(Factor I) andcomfort(Factor II). The HDS factors had good overall internal consistency (α = 0.83), with Factor I (α = 0.83) being higher than Factor II (α = 0.69). The two factors positively correlated with the HHI, Hope-VAS, and one of the ESAS visual analog scales, well-being (range: 0.38 to 0.64) and negatively correlated with depression and anxiety, as measured by the ESAS (range: −0.25 to −0.42).Significance of results:This is the first validation study of the HDS in advanced cancer patients. Its promising psychometric properties and brief patient-oriented nature provide a solid initial foundation for its future use as a clinical assessment measure in oncology and palliative care. Additional studies are warranted to gather further validity evidence for the HDS before its routine use in clinical practice.


Author(s):  
William Breitbart ◽  
Wendy G. Lichtenthal ◽  
Allison J. Applebaum ◽  
Melissa Masterson

Among the advanced cancer population, existential concerns are major issues that promote significant distress. For patients who are facing death, meaning and the preservation of meaning are not only clinically and existentially important but also central concepts to a therapeutic intervention. Based on Viktor Frankl’s logotherapy and the principles of existential psychology and philosophy, “meaning-centered psychotherapy” was developed to help patients with advanced cancer sustain or enhance a sense of meaning, peace, and purpose in their lives. This chapter provides an overview of work developing and testing individual meaning-centered psychotherapy (IMCP). It provides an overview of the session content in the IMCP intervention. It also presents findings from clinical trials, which support the efficacy of IMCP as an intervention to increase a sense of meaning, spiritual well-being, and hope while decreasing end-of-life despair. Furthermore, it presents difficult scenarios that may arise when delivering IMCP for clinicians interested in this work.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9640-9640
Author(s):  
M. de la Cruz ◽  
D. Hui ◽  
H. A. Parsons ◽  
P. Lynn ◽  
C. Parker ◽  
...  

9640 Background: We have previously reported significant placebo response in randomized controlled treatment trials for cancer related fatigue (CRF). We conducted a retrospective study to determine the frequency and predictors of response to placebo and nocebo effect in patients with CRF. Methods: We reviewed patients that received placebo in two previous randomized clinical trials conducted by our group and determined the proportion of patients who demonstrated clinical response to fatigue using an increase (ΔFACIT-F score) > 7 from baseline to day 8, and those with nocebo response as those who reported side effects. Baseline patient characteristics and symptoms recorded from the Edmonton Symptom Assessment Scale (ESAS) were analyzed to determine their association with placebo and nocebo effects. Results: A total of 105 advanced cancer patients received placebo. 59 (56%) patients responded to placebo (median Δ FACIT-F score of 22). Worse baseline anxiety and well-being subscale score (univariate) and well-being (multivariate, MR) were significantly associated with placebo response. Common side effects reported were insomnia (79%), anorexia (53%), nausea (38%) and restlessness (34%). MR analysis showed that worse baseline (ESAS) sleep, appetite, nausea, and restless are associated with increased reporting of these side effects ( Table ). Conclusions: Nearly half of advanced cancer patients enrolled in the fatigue trials responded to placebo. Worse physical well-being score was associated with placebo response. Patients experiencing specific symptoms at baseline were more likely to report these as side effects of the medication. These findings should be considered in fatigue clinical trial design. [Table: see text] No significant financial relationships to disclose.


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