scholarly journals Impact of early palliative care on survival in advanced-stage cancer patients: An institution-based retrospective cross-sectional study

2019 ◽  
Vol 4 (4) ◽  
pp. 151-155
Author(s):  
NIKETA THAKUR ◽  
Sushmita Ghoshal

Background: While treating patients with the advanced disease it becomes very challenging for the clinicians to decide as to when the active treatment is justified and when should palliative care be introduced in patient's treatment. American Society of Clinical Oncology (ASCO) suggested that patients with advanced cancer, regardless of patient or outpatient, should receive dedicated palliative care services, early in the disease course, simultaneous with active treatment. Similar recommendations have been proposed by the European Society of Medical Oncology (ESMO). Keeping in view this background, we aimed to do this study. Aim: To study the impact of the introduction of early palliative care into routine oncological management on patient's survival.Methods: This retrospective cross-sectional study is based on hospital data for patients who died in the hospice between the year 2017 and 2018. The complete information including age, gender, date of death, diagnosis, procedures, and medical interventions, as well as the date of documentation, was obtained of each patient.Results: A total of 27 patients were enrolled in this study. The mean age at presentation was 50.3 years. 11 (40.7%) patients received oncological treatment integrated with palliative care in the last month of life. The median duration of survival from diagnosis till death was 7 months in the patients who received only palliative care and 10 months in patients who received integrated onco-palliative care in the last month of life (P=0.452). 14 (51.8%) patients received early palliative care. The median survival of the patients who received early palliative care and of those who were offered palliative care towards the end of life was 8.5 months and 7 months respectively (P=0.040).Conclusion: Based on our results, we strongly believe that early palliative care when integrated into standard oncological treatment in advance stage cancer patients can prolong patient's survival.

2020 ◽  
Author(s):  
Qingyi Xu ◽  
Shuhua Jia ◽  
Maiko Fukasawa ◽  
Lin Lin ◽  
Jun Na ◽  
...  

Abstract Background: Epidemiological studies have shown elevated suicide risk in cancer patients compare with the general population. This study was performed to examine the association between physical symptoms and suicidal ideation among Chinese hospitalized cancer patients and test the modifying effect of health self-efficacy on this association. Methods: A cross-sectional study was conducted among 544 cancer patients from oncology settings in two general hospitals in northeast China via face-to-face interviews. Suicidal ideation was measured by using four items from the Yale Evaluation of Suicidality scale, dichotomized into a positive and negative score. Multivariable logistic regression was applied to examine the impact of physical symptoms, health self-efficacy and their interactions on suicidal ideation.Results: We found a suicidal ideation rate of 26.3% in patients following cancer diagnosis. Logistic regression showed that insomnia (aOR=1.84, 95% CI 1.13 to 3.00, p =0.015), lack of appetite (aOR=2.14, 95% CI 1.26 to 3.64, p =0.005) were positively associated with suicidal ideation, low health self-efficacy showed a marginally significant exaggerating effect on the association between pain and suicidal ideation (aOR = 2.77, 95% CI 0.99 to 7.74, p =0.053), even after controlling for significant socio-demographic, clinical characteristics and depression. Conclusions: These findings demonstrate the associations between insomnia、lack of appetite and suicidal ideation and highlight the potential moderating role of health self-efficacy in the identification and prevention of suicide among cancer patients.


2014 ◽  
Vol 48 (2) ◽  
pp. 278-284 ◽  
Author(s):  
Daniela de Araújo Lamino ◽  
Ruth Natalia Teresa Turrini ◽  
Katharine Kolcaba

Cross-sectional study, carried out at the outpatient clinic of an oncology hospital. Data were collected from 88 caregivers of cancer patients using the Caregiver General Comfort Questionnaire (GCQ) to assess the caregivers’ comfort. The caregivers’ GCQ score mean was 203.9; better comfort scores was associated with age, care time and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. 203.9; better comfort scores were associated with age of the caregiver and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. Caregivers, who didn’t have a paid job or leisure’s activities showed a worse GCQ. The GCQ scale can help to identify factors that interfere in caregivers’ comfort, as well as needs that can be modified through health professionals’ interventions.



BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Amélie Harle ◽  
Alex Molassiotis ◽  
Oliver Buffin ◽  
Jack Burnham ◽  
Jaclyn Smith ◽  
...  

Abstract Background There is absence of literature related to cough prevalence and its characteristics in lung cancer patients, with information deriving only from broader symptoms occurrence studies. The aims of this study were to provide a snapshot of the prevalence of all-cause-cough in lung cancer patients and to characterise cough in terms of its impact and severity. Methods A cross-sectional study recruiting consecutive lung cancer patients over a pre-defined period of time and using cough-specific validated tools in a tertiary referral centre in the UK, including a cough severity VAS and the Manchester Cough in Lung Cancer scale (MCLCS). Results Data was collected from 202 patients. All-cause cough prevalence was 57% (through VAS) both in the screened (N = 223) and research (N = 202) population or 67% (through the MCLCS), and cough severity was moderate at a mean of 32 mm (in a 100 mm VAS). Age, sex, smoking status, lung cancer histology, stage and comorbidities were not associated with cough prevalence. The only variable associated with lower cough reports was being ‘on anticancer treatment’; fewer patients on treatment reported a cough (40%) compared to those off treatment (54%) (p = 0.04). The impact of cough (as measured by MCLCS) was also significant (mean score = 22). About 18% of patients felt moderate/severe distress from their cough and about 15% often or always reported disturbed sleep due to coughing. Half the patients felt their cough warranted treatment. Conclusions Cough is a common symptom in lung cancer with considerable impact on patients’ lives. Cough presence and severity should regularly be assessed in clinical practice. There is an urgent need to focus on developing more potent antitussive treatments and improve the management of this complex and distressing symptom.


2020 ◽  
pp. bmjspcare-2020-002528
Author(s):  
Cristina Lasmarías ◽  
Lourdes Guanter ◽  
Pamela Turrillas ◽  
Judith Peñafiel ◽  
Xavier Gómez-Batiste

ObjectiveTo assess the impact after 20 years of a Master’s degree in palliative care (MsPC) on the participants’ educational outcomes in terms of educational needs satisfaction, motivation, applicability and professional development (PD) in the palliative care (PC) field.MethodsA cross-sectional study was conducted between October 2016 and February 2017. Participants were students of the MsPC from 13 editions. An ad hoc survey comprising closed-end questions was provided. Variables such as sociodemographic and learning outcomes, based on Kirkpatrick’s model, were included.ResultsRespondents were 76.6% women, and 60% were between 30 and 50 years of age. Over half of participants were physicians (57.4%), with >15 years of experience (52%). 77% (n=152) reported previous work experience (PWE) in PC, and 23% (n=45) had no PWE. After completing the MsPC, 49% of those without PWE were hired to work in a PC unit, while 84,2% with PWE continued work in a PC-related position. 51.6% professionals with PWE were currently working in other PC areas, such as training or research. High scores were observed on expectations, training needs, motivation in professional practice, PD, applicability and satisfaction, in both groups. Data have shown statistically significant differences on the perceived value of the MsPC to obtain work in the PC field (p=0.006).ConclusionsThis MsPC training programme improves educational outcomes, and promotes PD, regardless of PWE in PC. Interdisciplinary training for all professionals who care for PC individuals is required. To ensure the quality of education in PC programmes, a systematic process of continuous evaluation is needed.


2020 ◽  
Author(s):  
Qingyi Xu ◽  
Shuhua Jia ◽  
Maiko Fukasawa ◽  
Lin Lin ◽  
Jun Na ◽  
...  

Abstract Background: To examine the association between physical symptoms and suicidal ideation among Chinese hospitalized cancer patients post-diagnosis, and test the modifying effect of health self-efficacy on this association. Methods: A cross-sectional study was conducted among 544 cancer patients from oncology setting in two general hospitals in northeastern China. Suicidal ideation data was collected by face-to-face interview using the Yale Evaluation of Suicidality scale (YES). Patients also rated on the McGill Quality of Life Questionnaire (MQOL), the Hamilton Depression Rating scale (HAMD-17) and the Strategies Used by People to Promote Health scale (SUPPH). Multivariable logistic regression was applied to examine the impact of physical symptoms, health self-efficacy and their interactions on suicidal ideation. Results: We found a suicidal ideation rate of 26.3% in patients following cancer diagnosis. Logistic regression showed that insomnia (aOR=1.84, 95% CI 1.13 to 3.00, p =0.015), lack of appetite (aOR=2.14, 95% CI 1.26 to 3.64, p =0.005) were significantly associated with suicidal ideation, low health self-efficacy showed a marginally significant exaggerating effect on the association between pain and suicidal ideation (aOR = 2.77, 95% CI 0.99 to 7.74, p =0.053), even after controlling socio-demographic, clinical characteristics and depression. Conclusions: Insomnia, loss of appetite, even after adjusting depression, are associated with suicidal ideation, health self-efficacy play a moderating role on pain and suicidal ideation among Chinese cancer patients. Paying attention to these physical symptoms and promoting the sense of health self-efficacy could be useful for suicide intervention.


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