EXPERIENCE IN PALLIATIVE CARE FOR CANCER PATIENTS IN A HOSPICE "CITY HOSPITAL No. 20", ST. PETERSBURG

2021 ◽  
pp. 158-164
Author(s):  
Владимир Александрович Кошлаков
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cancer Patients ◽  
Emotional Disorders ◽  
Well Being ◽  
Scientific Article ◽  
Main Task ◽  
City Hospital ◽  
Number Of Patients

В научной статье отражен многолетний опыт оказания паллиативной помощи онкологическим больным, находившимся в условиях хосписа. Главной задачей, которую ставили перед собой специалисты отделения, являлась обеспечение лучшего, насколько это возможно, качества жизни пациента с тягостными симптомами. В реальности, определить число пациентов, имеющих потребность в паллиативной помощи, с соблюдением всех ее принципов, очень трудно. Авторы статьи пытаются отразить различные подходы в оказании паллиативной помощи пациентам, находящимся в условиях стационарного отделения. Принципы оказания паллиативной помощи онкологическим больным имеют схожее направления, что и для пациентов с другими патологическим процессами, но все же основой процесса является устранение или просто максимальное облегчение симптомов, ухудшающих качество жизни онкобольного, а не просто терапия основного заболевания. Используемые схемы оказания комплексной медикаментозной помощи позволили снизить частоту проявления анемии, усилить лимфодренаж, уменьшить степень выраженности пролежней и в целом - компенсировать качество жизни онкологических больных с тягостными симптомами, что проявлялось улучшением физического и социального благополучия, а также отсутствием эмоциональных расстройств у пациентов. Комплексные подходы в паллиативной помощи позволяют специалистам наиболее полноценно реализовывать поставленные перед ними задачи. Полученный многолетний опыт работы специалистами хосписа может быть использован в профильных лечебных учреждениях The scientific article reflects the long-term experience of providing palliative care to cancer patients who were in a hospice. The main task that the specialists of the department set for themselves was to ensure the best, as far as possible, quality of life for the patient with painful symptoms. In reality, it is very difficult to determine the number of patients with a need for palliative care, observing all its principles. The authors of the article try to reflect the different approaches in the provision of palliative care to patients in an inpatient department. The principles of providing palliative care to cancer patients are similar to those for patients with other pathological processes, but still the basis of the process is the elimination or simply maximum relief of symptoms that worsen the quality of life of a cancer patient, and not just therapy of the underlying disease. The schemes used for the provision of complex medical care made it possible to reduce the incidence of anemia, enhance lymphatic drainage, reduce the severity of pressure ulcers and, in general, compensate for the quality of life of cancer patients with painful symptoms, which was manifested by an improvement in physical and social well-being, as well as the absence of emotional disorders in patients. Comprehensive approaches to palliative care allow specialists to fully implement their tasks. The many years of experience gained by hospice specialists can be used in specialized medical institutions

scholarly journals Perception of cancer patients in palliative care about quality of life

2018 ◽  
Vol 71 (4) ◽  
pp. 1998-2004 ◽  
Author(s):  
Silmara Meneguin ◽  
Ticiane Dionísio de Sousa Matos ◽  
Maria de Lourdes da Silva Marques Ferreira
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cancer Patients ◽  
Quantitative Research ◽  
Public Hospital ◽  
Disease Process ◽  
Well Being ◽  
Relief Of Suffering ◽  
Improvement Method

ABSTRACT Objective: To understand the perception of cancer patients in palliative care about quality of life and identify propositions for its improvement. Method: This is a quantitative research carried out with 96 patients in palliative care, admitted in a public hospital from March 2015 to February 2015. The interviews were transcribed and analyzed by the methodology Discourse of the Collective Subject. Results: Quality of life was tied to meanings of health, well-being, happiness and spirituality; however, family and financial problems also had an impact on the perception of the construct. Interventions aimed at the relief of suffering, possibility of return to work and resolution of problems had suggestions for improvement. Conclusion: The results indicate that the concept of quality of life is subjective, tied to personal values and influenced by the repercussions of the health-disease process. In addition, they can guide actions based on interdisciplinary assistance aimed at the real needs of these patients.

Features and methods of assessing health-related quality of life and cognitive functions in patients with glial tumors

2020 ◽  
pp. 47-56
Author(s):  
Vera Arsenyeva ◽  
Boris Martynov ◽  
Gennadiy Bulyshchenko ◽  
Dmitriy Svistov ◽  
Boris Gaydar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Functions ◽  
Well Being ◽  
Health Related Quality ◽  
Number Of Patients ◽  
Related Quality ◽  
Health Related ◽  
Eortc Qlq ◽  
Patients With Epilepsy

Gliomas make up about 8 cases per 100,000 population and the number of patients with this disease is only increasing. There can be not only various types of neurological deficits among the symptoms, but also personal and emotional changes, that seriously affects the quality of life. The modern model of health care includes not only recovery of the patient’s physical functions, but also his or her psychosocial well-being. In particular, the assessment and study of the characteristics of health-related quality of life, as well as cognitive functions in patients with gliomas, is increasingly recognized as an important criterion when considering the effectiveness of treatment. To date, the features of health related quality of life and cognitive functions of patients with epilepsy and acute cerebral circulation disorders have been studied sufficiently, and, as a result, techniques have been developed that accurately assess the QOL and CF in patients with these diseases. These are QOLIE-31 and QOLIE-AD-48 questionnaires for patients with epilepsy. This is the National Institutes of Health Stroke Scale (NIHSS), Orgogozo stroke scale (OSS), World Federation of Neurological Surgeons (WFNS) scale for the clinical assessment of subarachnoid hemorrhage (SAH) for patients with acute cerebrovascular accident. At the same time, there are no generally accepted methods for assessing quality of life and neurocognitive functions that are sensitive to changes in the condition of patients with gliomas in the early postoperative period by the time of discharge from the hospital. As a result, there is no systematic information on the dynamics of the quality of life of such patients, their neurocognitive functioning. The purpose of this article was to study the literature on QOL and CF in patients affected by neurological and neurosurgical disorders for the further selection of optimal methods for assessing dynamics of the condition of patients with glial brain tumors before and after surgery. At the moment, such requirements are only partially met by the EORTC QLQ-C30 questionnaire and its application EORTC QLQ-BN20.

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

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.

scholarly journals Comparison of the Quality of Life of Patients with Breast or Colon Cancer with an Arm Vein Port (TIVAD) Versus a Peripherally Inserted Central Catheter (PICC)

2021 ◽  
Vol 28 (2) ◽  
pp. 1495-1506
Author(s):  
Brent Burbridge ◽  
Hyun Lim ◽  
Lynn Dwernychuk ◽  
Ha Le ◽  
Tehmina Asif ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Well Being ◽  
Venous Access ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Access Device ◽  
The Mean ◽  
Venous Access Device

Introduction: Venous access is a crucial element in chemotherapy delivery. It remains unclear whether cancer patients prefer a port to a peripherally inserted central catheter (PICC). Our study aimed to assess cancer patients’ satisfaction with their venous access device and to compare the quality of life (QoL) of subjects with a PICC to those with a port. Methods: In this prospective cohort study, EORTC QLQ-C30, and a locally developed quality of life survey (QLAVD), designed to assess satisfaction with venous access devices, were administered to breast or colorectal cancer patients over a one-year period following the device insertion. Mixed effects models were used to assess changes on mean scores at different time points. Results: A total of 101 patients were recruited over a three-year period, (PICC group, n = 50; port group, n = 51). Survey response rates for months one and three were 72% and 48%, respectively. Overall, no significant differences were noted between the two groups in relation to EORTC QOL. At three months, the mean pain scores were 3.5 ± 2.3 for the port and 1.3 ± 0.75 for PICC (<0.001). The mean score for a negative effect of the venous access device on psychosocial well-being was 6.0 ± 4.1 for PICC and 3.0 ± 2.7 for the port (p = 0.005). Complications related to PICCs occurred in 38% patients versus 41% with a port (p > 0.24). Conclusions: Although subjects with a port experienced more pain during the device insertion or access for chemotherapy, it had a smaller negative impact on psychosocial scores than the PICC. No significant differences in complications rates were observed between the two devices.

L'Impatto Della Patologia Neoplastica Sullo Stato di Benessere Del Paziente

1998 ◽  
Vol 84 (1_suppl1) ◽  
pp. S20-S23
Author(s):  
Enrico Cortesi ◽  
E. Ballatori ◽  
P. Casali ◽  
E. Cortesi ◽  
M. Costantini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Family Relationship ◽  
Well Being ◽  
Health Facilities ◽  
Common Interest ◽  
Careful Study ◽  
Medical Environment ◽  
Disease Information

The peculiar characteristics of the italian neoplastic patients, as far as their knowledge concerning the disease (information, prognosis, therapeutic options, etc) and the different cultural, environmental and health realities, place different problems on the routine application of the quality of life questionnaires wich were constructed and edited in North European or North American Countries, even if correctly translated and validated in Italy. The QVonc (Quality of Life in Oncology) Project started five years ago from the common interest of medical oncologists who felt the need to make a careful study on some aspects regarding the evaluation of italian patient's quality of life. A multidisciplinary working group, comprehensive of statisticians, epidemiologists, psychologists, nurses and methodologists, was then put together. During the last three years the Group produced a deep analysis of the different aspects and determinants of the italian patient's quality of life, mainly about their disease and medical environment perception. A prospective research was started in 1995 with the aims of identifying the contents of quality of life, using a sample of cancer patients as “experts” and of measuring the relevance of selected contents in different subgroups of patients. In the first study the quality of life dimensions were analysed as perceived from 248 neoplastic patients, uniformely and randomly distributed for pathology and place of residence in Italy, through an open questionnaire and interviews conducted by our psychologists. Some peculiar aspects of the quality of life perception in italian patients were evidenced: relationship with the family, with the medical team and health facilities, economic problems and occupational difficulties. The study confirmed that the information on the contents of quality of life can be derived only studying people suffering the specific disease and cast a doubt on the available QL instruments currently used. The second study evaluated the quality of life perception in 6939 consecutive cancer patients referred in the second week of July 1996 to 79 Italian medical oncology/radiotherapy Institutions. Patients were asked to fill out a questionnaire concerning the importance of 46 domains of QL, each one scored on 4 levels (not at all, a little, much and very much). Domains were derived from a previous content analysis of 268 pts answers to 4 questions related to their own QL: “in your experience, what is QL?”, “what is a bad QL?”, “what is a good QL?”, “Did the diagnosis and treatment received modify your QL?”. 6939 patients entered the study; of these, 820 (11.8%) did not fill out the questionnaire due to various reasons. Among the 6,119 evaluable pts, the most frequent cancers were: breast (2,328), colo-rectal (968), lung (517), lymphoma (351), gastric (225). The most frequently chosen domains (much or very much) were related to health facilities or communication between patient-physician/nurse. Family relationship and general well being were also found important, while from the negative perspective the presence of the disease and the related anxiety were the most relevant problems. In conclusion, when choosing or constructing QL instruments, at least for Italian cancer pts, factors such as health facilities and pt ‘- physician/nurse relationship should be more adequately considered. Most currently used QL questionnaires are probably lacking in this regard.

scholarly journals Shifting Palliative Care Paradigm in Primary Care From Better Death to Better End-of-Life : A Swiss Pilot Study

2021 ◽  
Author(s):  
Johanna Sommer ◽  
Christopher Chung ◽  
Dagmar M. Haller ◽  
Sophie Pautex
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Palliative Care ◽  
Pilot Study ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Communication Skills ◽  
Advanced Cancer Patients

Abstract Background: Patients suffering from advanced cancer often loose contact with their primary care physician (PCP) during oncologic treatment and palliative care is introduced very late.The aim of this pilot study was to test the feasibility and procedures for a randomized trial of an intervention to teach PCPs a palliative care approach and communication skills to improve advanced cancer patients’ quality of life. Methods: Observational pilot study in 5 steps. 1) Recruitment of PCPs. 2) Intervention: training on palliative care competencies and communication skills addressing end-of-life issues.3) Recruitment of advanced cancer patients by PCPs. 4) Patients follow-up by PCPs, and assessment of their quality of life by a research assistant 5) Feedback from PCPs using a semi-structured focus group and three individual interviews with qualitative deductive theme analysis.Results: 8 PCPs were trained. PCPs failed to recruit patients for fear of imposing additional loads on their patients. PCPs changed their approach of advanced cancer patients. They became more conscious of their role and responsibility during oncologic treatments and felt empowered to take a more active role picking up patient’s cues and addressing advance directives. They developed interprofessional collaborations for advance care planning. Overall, they discovered the role to help patients to make decisions for a better end-of-life.Conclusions: PCPs failed to recruit advanced cancer patients, but reported a change in paradigm about palliative care. They moved from a focus on helping patients to die better, to a new role helping patients to define the conditions for a better end-of-life.Trial registration : The ethics committee of the canton of Geneva approved the study (2018-00077 Pilot Study) in accordance with the Declaration of Helsinki

scholarly journals Key Factors Contributing to Quality of Life for Breast Cancer Patients in Latvia: Supplementing Quantitative Surveys with Qualitative Interviews

2012 ◽  
Vol 12 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Agnese Dzērvīte ◽  
Maruta Pranka ◽  
Tana Lace ◽  
Ritma Rungule ◽  
Edvins Miklasevics ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
Qualitative Interviews ◽  
Treatment Strategies ◽  
Well Being ◽  
University Hospital ◽  
Breast Cancer Patients ◽  
Key Factors

Summary Introduction. Health related quality of life is a much debated topic in medicine with much quantitative and qualitative research contributing to the understanding of how to improve the lives of patients, yet little has been published in relation to the quality of life of Latvian breast cancer patients. Aim of the Study. To gather base measurements of subjective and objective quality of life factors for breast cancer patients in Latvia and discover which key factors contribute most to quality of life of Latvian breast cancer patients at the start of treatment. Materials and Methods. This paper presents data collected from April 2010 to June 2011 at the Pauls Stradins Clinical University hospital on key factors influencing quality of life for breast cancer patients: health and physical well-being; state of surroundings and environment; social support and functionality; financial state, employment and leisure. Quantitative survey material has been supplemented with insight from qualitative in-depth interviews to better explain the objective and subjective implications for breast cancer patients’ quality of life. Results. Interviewed breast cancer patients rated their quality of life as being average or good at the beginning of treatment. Negative factors contributing to lowered quality of life were mainly linked to patient financial, social and emotional state at the first weeks of treatment and correspond to previous research done in Latvia on quality of life issues. Conclusions. Further follow-up surveys will contribute to the evaluation of breast cancer patients’ needs while undergoing treatment to further improve treatment strategies, especially if validated quality of life measurement surveys were to be implemented in Latvian hospitals.

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