Avaliação da qualidade de vida de pacientes oncológicos sob cuidados paliativos frente às intervenções de fisioterapia / Evaluation of the quality of life of oncological patients under palliative care in front of physiotherapy interventions

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.

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Spotlight: Palliative Care-Improving the Quality of Life Through the End of Life

PsycEXTRA Dataset ◽

10.1037/e310982005-003 ◽

2005 ◽

Author(s):

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

End Of Life

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Palliative Care: Improving quality of life on the way to death

PsycEXTRA Dataset ◽

10.1037/e606322007-001 ◽

2004 ◽

Author(s):

Marcia Doniger

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

The Way

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Palliative Care and Quality of Life in Idiopathic Pulmonary Fibrosis

Case Medical Research ◽

10.31525/ct1-nct03981406 ◽

2019 ◽

Author(s):

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis

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Health and Quality of Life in Oncological Patients: Management of Bone Pathology in the Italian Citbl (Cancer Treatment Induced Bone Loss) Population

Case Medical Research ◽

10.31525/ct1-nct04055805 ◽

2019 ◽

Author(s):

Keyword(s):

Quality Of Life ◽

Bone Loss ◽

Cancer Treatment ◽

Bone Pathology ◽

Oncological Patients

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Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness

BMJ Open ◽

10.1136/bmjopen-2018-025692 ◽

2019 ◽

Vol 9 (1) ◽

pp. e025692 ◽

Cited By ~ 3

Author(s):

Corita R Grudzen ◽

Deborah J Shim ◽

Abigail M Schmucker ◽

Jeanne Cho ◽

Keith S Goldfeld

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Palliative Care ◽

Randomised Controlled Trial ◽

Case Management ◽

Controlled Trial ◽

Chronic Obstructive ◽

Randomised Controlled ◽

End Stage

IntroductionEmergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysisThis is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and disseminationInstitutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03325985; Pre-results.

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The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis

Palliative Medicine ◽

10.1177/0269216321994728 ◽

2021 ◽

pp. 026921632199472

Author(s):

Natalia Salamanca-Balen ◽

Thomas V Merluzzi ◽

Man Chen

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Palliative Care ◽

Meta Analysis ◽

Symptom Burden ◽

Well Being ◽

Medium Effect ◽

Spiritual Well Being ◽

Quasi Experimental

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.

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Palliative Care in Patients With High-Grade Gliomas in the Neurological Intensive Care Unit

The Neurohospitalist ◽

10.1177/1941874419869714 ◽

2019 ◽

Vol 10 (3) ◽

pp. 163-167

Author(s):

Jon Rosenberg ◽

Allie Massaro ◽

James Siegler ◽

Stacey Sloate ◽

Matthew Mendlik ◽

...

Keyword(s):

Quality Of Life ◽

Intensive Care Unit ◽

Palliative Care ◽

High Grade ◽

Neurological Intensive Care Unit ◽

Code Status ◽

Neurological Intensive Care ◽

Palliative Care Consultation ◽

Care Consultation

Background: Palliative care improves quality of life in patients with malignancy; however, it may be underutilized in patients with high-grade gliomas (HGGs). We examined the practices regarding palliative care consultation (PCC) in treating patients with HGGs in the neurological intensive care unit (NICU) of an academic medical center. Methods: We conducted a retrospective cohort study of patients admitted to the NICU from 2011 to 2016 with a previously confirmed histopathological diagnosis of HGG. The primary outcome was the incidence of an inpatient PCC. We also evaluated the impact of PCC on patient care by examining its association with prespecified secondary outcomes of code status amendment to do not resuscitate (DNR), discharge disposition, 30-day mortality, and 30-day readmission rate, length of stay, and place of death. Results: Ninety (36% female) patients with HGGs were identified. Palliative care consultation was obtained in 16 (18%) patients. Palliative care consultation was associated with a greater odds of code status amendment to DNR (odds ratio [OR]: 18.15, 95% confidence interval [CI]: 5.01-65.73), which remained significant after adjustment for confounders (OR: 27.20, 95% CI: 5.49-134.84), a greater odds of discharge to hospice (OR: 24.93, 95% CI: 6.48-95.88), and 30-day mortality (OR: 6.40, 95% CI: 1.96-20.94). Conclusion: In this retrospective study of patients with HGGs admitted to a university-based NICU, PCC was seen in a minority of the sample. Palliative care consultation was associated with code status change to DNR and hospice utilization. Further study is required to determine whether these findings are generalizable and whether interventions that increase PCC utilization are associated with improved quality of life and resource allocation for patients with HGGs.

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