Clinician Roles in Symptoms and Signs Improvement among Advanced Cancer Patients

2020 ◽  
Author(s):  
Jae Ho Chung ◽  
Sun Hyun Kim ◽  
Sang-Yeon Suh ◽  
Shao-Yi Cheng ◽  
Masanori Mori ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Hospice Care ◽  
Terminally Ill ◽  
Palliative Care Service ◽  
Care Physician ◽  
Care Group ◽  
Respiratory Secretion ◽  
Terminally Ill Cancer Patients ◽  
Physician Group ◽  
Symptoms And Signs

Abstract Background: We, study and research how to improve terminally ill cancer patients’ symptoms and signs to ease their pain. Furthermore we also seek how the dedicated palliative care service effects on the cancer patients’ results.Methods: We analyzed 334 physician-diagnosed terminally ill cancer patients and categorized them into non-dedicated hospice care group of 234 and dedicated hospice care group of 100.Results: Symptoms improvement of dyspnea, fatigue, drowsiness, and dry mouth during the first week of admission were respectively 298 (89.2%), 25 (7.5%), 204 (61.1%), 76 (22.8%). Signs improvement of myoclonus, respiratory secretion, leg edema, and ascites between admission and a week after were 5 (1.5%), 41 (12.3%), 47 (14.1%), 12 (3.6%). Significant differences between dedicated hospice care physician group and non-dedicated hospice care physician group were shown in drowsiness (67.5% vs 46 %, p < 0.001) and respiratory secretion (15% vs 6%, p < 0.028).Conclusions:In conclusion, terminally ill cancer patients who received palliative or hospice service showed significant improvement in symptoms and illness signs. Moreover, family doctors (dedicated hospice physician group) performed better than oncologist (non-dedicated physician group).

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.

Caregiver burden and bereavement among family caregivers who lost terminally ill cancer patients

2019 ◽  
Vol 17 (5) ◽  
pp. 515-522
Author(s):  
Yong Tang
Keyword(s):  
Content Analysis ◽  
Cancer Patients ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
Hospice Care ◽  
Southern China ◽  
Terminally Ill ◽  
Truth Telling ◽  
Terminally Ill Cancer Patients ◽  
Attitudes Toward Death

AbstractObjectiveFamily caregivers (FCs) in China provide hospice care to terminally ill cancer patients; however, few studies have been conducted in China on caregiver burden and bereavement experiences as a process that continues over time. The purpose of this study was to identify the main elements of caring and bereavement experiences for FCs caring for patients diagnosed with terminal cancer.MethodTwenty in-depth qualitative semistructured interviews were conducted with FCs providing care in a hospice unit in Shenzhen, Southern China. Interview transcripts were analyzed via thematic content analysis.ResultA framework based on the following eight principal themes was developed through content analysis of our FC interviews: symptoms of the illness, the truth-telling process, attitudes toward death, the “color” of death, social and professional support, the moment of death, and grief and loss.Significance of resultsThe analysis showed that caregiving may positively or negatively influence the bereavement process.

Determinants of the place of death among terminally ill cancer patients under home hospice care in Japan

2003 ◽  
Vol 17 (5) ◽  
pp. 445-453 ◽  
Author(s):  
Sakiko Fukui ◽  
Hiromi Kawagoe ◽  
Sakai Masako ◽  
Nishikido Noriko ◽  
Nagae Hiroko ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Hospice Care ◽  
Terminally Ill ◽  
Place Of Death ◽  
Terminally Ill Cancer Patients ◽  
Home Hospice Care

Predictive Factors for the Development of Dyspnea Within 7 Days After Admission Among Terminally Ill Cancer Patients

2021 ◽  
pp. 104990912110288
Author(s):  
Ryo Matsunuma ◽  
Takashi Yamaguchi ◽  
Masanori Mori ◽  
Tomoo Ikari ◽  
Kozue Suzuki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Predictive Factors ◽  
Performance Status ◽  
Univariate Analysis ◽  
Terminally Ill ◽  
Primary Lung Cancer ◽  
Poor Performance Status ◽  
Terminally Ill Cancer Patients ◽  
Development Group

Background: Predictive factors for the development of dyspnea have not been reported among terminally ill cancer patients. Objective: This current study aimed to identify the predictive factors attributed to the development of dyspnea within 7 days after admission among patients with cancer. Methods: This was a secondary analysis of a multicenter prospective observational study on the dying process among patients admitted in inpatient hospices/palliative care units. Patients were divided into 2 groups: those who developed dyspnea (development group) and those who did not (non-development group). To determine independent predictive factors, univariate and multivariate analyses using the logistic regression model were performed. Results: From January 2017 to December 2017, 1159 patients were included in this analysis. Univariate analysis showed that male participants, those with primary lung cancer, ascites, and Karnofsky Performance Status score (KPS) of ≤40, smokers, and benzodiazepine users were significantly higher in the development group. Multivariate analysis revealed that primary lung cancer (odds ratio [OR]: 2.80, 95% confidence interval [95% CI]: 1.47-5.31; p = 0.002), KPS score (≤40) (OR: 1.84, 95% CI: 1.02-3.31; p = 0.044), and presence of ascites (OR: 2.34, 95% CI: 1.36-4.02; p = 0.002) were independent predictive factors for the development of dyspnea. Conclusions: Lung cancer, poor performance status, and ascites may be predictive factors for the development of dyspnea among terminally ill cancer patients. However, further studies should be performed to validate these findings.

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.

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