Improving the quality of life of terminally ill oncological patients: the example of palliative care at Hospice Villa Speranza

2013 ◽  
Vol 9 (6) ◽  
pp. 771-776 ◽  
Author(s):  
Adriana Turriziani ◽  
Gennaro Attanasio ◽  
Santina Cogliandolo ◽  
Francesco Scarcella ◽  
Luisa Sangalli ◽  
...  
2013 ◽  
Vol 21 (3) ◽  
Author(s):  
Cornelia Meffert ◽  
Gerhild Becker

SummaryRecent statistics reveal a substantial and even growing need for palliative care in present-day society. Providing adequate pain therapy remains a largely unsolved problem, mainly because of the small number of clinical studies in palliative medicine. Hence, clinical research is urgently needed – and therefore suitable tools to measure outcomes must be developed. Contrary to typical clinical studies, the usual outcome parameters such as decreased mortality and/or morbidity are unsuitable. Future research should focus on developing an instrument which allows to measure quality of life as the central outcome criterion of clinical studies in palliative medicine.


Author(s):  
William S. Breitbart

In addition to the diagnosis and treatment of psychiatric disorders in palliative care settings, pain and other troublesome physical symptoms must also be aggressively treated in efforts aimed at the enhancement of the patient’s quality of life. These symptoms must be assessed by the psycho-oncologist concerned with the assessment and treatment of affective and other syndromes in the terminally ill population. This chapter provides a brief overview of the prevalence, assessment, and management of the commonly encountered, distressing physical symptoms such as pain, insomnia, and nausea among patients with advanced cancer.


2018 ◽  
Vol 28 (2) ◽  
pp. 603-611
Author(s):  
Tsvetka Boycheva ◽  
Mariya Dimitrova

In recent decades, there has been a growing public interest in palliative care. This is dictated by the ever increasing number of people who need it. With advances in medical science and the development of new technologies, life expectancy has increased, but at the same time, the number of years spent in illness and suffering has increased. Still, death is not defeated, but pain and suffering can be relieved, and the quality of life of the terminally ill and their families can be improved. Palliative care is overwhelming. They target the patient and his family. They meet the psychic, social, spiritual and cultural needs of the patient, provide training and support to relatives. The family is a social institution that ensures the biological and social continuity of the human race. There is a correlation between it and health. Today it is impossible to function and develop properly without providing optimal health to its members. Diseases of a family member adversely affect his or her functions. Reproductive, economic and psycho-emotional function is impaired. A home is a place where one lives fully and most people prefer their care to be done at home. The needs of patients in need of palliative care are specific. Apart from a health problem, they also have spiritual, social and mental needs. The most frequent care of these patients is taken by a relative or a family member. In most cases, they lack the necessary skills, resources and time. This clearly shows that the quality of life of these patients and their families is not guaranteed. The purpose of this study is to find out what influence has the care of terminally ill on his family. The subject of the study is 602 persons, close to terminally ill in 30 medical institutions in the country. Within a six-month period from 01.11.2017 to 30.04.2018. With the help of a direct individual survey, how the care of the terminally ill is reflected in his family was identified. Statistical methods for data processing and analysis were used. Results: The family is experiencing great stress when there is a severely sick patient in it. The lifestyle of the whole family is changing. Negative emotions accumulate and social contacts are disturbed. Economic and social difficulties, lack of time and lack of knowledge and skills are major problems in families with patients in need of palliative care. Respondents want to participate in training for the care of the sick, need professional help and support to ensure a better quality of life for their close and normal family functioning.


Surgical Palliative Care is a synoptic presentation about the treatment of suffering and the promotion of quality of life for seriously or terminally ill patients under surgical care. The contributors include surgeons of different specialties who are leaders in the new specialty of surgical palliative care. Surgical palliative care encompasses supportive care for patients and families with serious illness that includes disease-directed treatment and supportive care for patients and families with terminal illness not seeking disease-directed treatment. The book commences with chapters covering the historical, conceptual and moral framework for surgical palliative care followed by chapters that follow the trajectory of the patient/family encounter with surgical care, from the time of presentation and proceeding to intraoperative and post-operative periods. The unique problems of several surgical subspecialties such as trauma and burns, thoracic surgery, and the transplantation are addressed in individual chapters.


Author(s):  
Chikako Matsumura ◽  
Nanako Koyama ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
Takehisa Nomura ◽  
...  

Background: Few studies evaluated whether health care professionals accurately assess several symptoms for patients with cancer in palliative care units. We determined the agreement level for several symptoms related to quality of life (QOL) between patient-reported QOL assessment and health care professional-assessed symptoms based on the Support Team Assessment Schedule (STAS). Method: An observational study was performed with terminally ill patients with cancer hospitalized in the palliative care unit between June 2018 and December 2019. Patients and health care professionals independently assessed 7 symptoms at the time of hospitalization and after 1 week. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL). In examining the proportions of exact agreement, “exact agreement” referred to the pairs of the scores (QLQ-C15-PAL vs STAS) being (1 vs 0), (2 vs 1), (3 vs 2 or 3), or (4 vs 4). The relationships of physical functioning between QLQ-C15-PAL and Palliative Performance Scale (PPS) were examined. Results: Of 130 patients, approximately 60% had PPS scores from 40 to 60. The highest mean score on QLQ-C15-PAL was for fatigue (63.8). The exact agreement on symptoms between patients and health care professionals ranged from 15.4% (fatigue) to 57.7% (nausea and vomiting). The mean of the transformed QLQ-C15-PAL and proportions of exact agreement were negatively correlated ( R 2 = 0.949, P < .05). The physical function scores in QLQ-C15-PAL for each PPS group showed no differences. Conclusion: We expect patient-reported outcomes including QLQ-C15-PAL to be added to health care professionals’ assessment of serious symptoms such as fatigue in terminally ill patients with cancer.


2021 ◽  
Vol 4 (6) ◽  
pp. 23965-23976
Author(s):  
Amanda Ferreira Alves ◽  
Bruna Lorena Soares Cavalcante Sousa ◽  
Káren Andresa Mendes Da Silva ◽  
José Bruno Macedo Castelo Branco ◽  
Gylvana de Sousa Carvalho ◽  
...  

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.


Author(s):  
Manuel Mejías-Estévez ◽  
Rocio Dominguez Álvarez ◽  
Ignacio Jauregi Lobera

Psychosomatic medicine (MP) and palliative care are disciplines with history and both are based in the scientific world. Although the psychosomatic diagnosis is exclusionary, it can help palliative care to be more effective. The influence of the psychosomatic in the palliative exists. According to all the bibliography available in the electronic databases, psychosomatic medicine is a biopsychosocial model related to both physical and psychosocial factors, which helps improve the care of patients with advanced cancer in palliative care (improved survival, quality of life, reduces the burden on caregivers). It helps analyze and address psychiatric disorders, as well as in the control of complex symptoms such as life-threatening anxiety, depression or delirium. Therefore, both medical disciplines are related from the beginning and help to the quality of life of terminally ill patients.


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