scholarly journals Dignity and its influencing factors in patients with cancer in North China: a cross-sectional study

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
L. Wang ◽  
Y. Wei ◽  
L. Xue ◽  
Q. Guo ◽  
W. Liu
Keyword(s):  
Cancer Patients ◽  
North China ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Symptom Burden ◽  
Patients With Cancer ◽  
Stage Disease ◽  
Loss Of Dignity ◽  
Relevant Factors

Background Patients with cancer experience various levels of loss of dignity. Exploring levels of loss of dignity and the factors that influence such losses for patients with cancer is rare, but important in palliative care in China.Methods Participants were cancer patients with early and advanced cancer recruited from a tertiary cancer hospital in North China. Patients were surveyed to assess their level of loss of dignity and potentially relevant factors. Data were collected using the Patient Dignity Inventory, the MD Anderson Symptom Inventory–Chinese, the distress thermometer, the Hospital Anxiety and Depression Scale, and the 30-question core Quality of Life Questionnaire from the European Organisation for Research and Treatment of Cancer, and were analyzed using quantitative methods.Results The study included 202 cancer patients, 143 of whom experienced mild loss of dignity (71%); 37, moderate loss of dignity (18%); and 10, severe loss of dignity (5%). The problems with dignity were slightly different in patients with early-stage disease than in those with advanced-stage disease. Loss of dignity in the patients was significantly correlated with psychological distress, symptom burden, and quality of life (p < 0.05). Logistic regression showed that age, Karnofsky performance status, anxiety, and symptom burden were significant predictors of loss of dignity.Conclusions Most patients with early and advanced cancer experienced some level of loss of dignity. Loss of dignity was more likely for patients of younger age, high Karnofsky performance status, high symptom burden, and anxiety. Understanding the dignity of cancer patients and potentially relevant factors is of great value for implementing comprehensive palliative care in China.

scholarly journals The Quality of Palliative Sedation in End-Stage Disease: Audit From a Department of Oncology and Haematology

2021 ◽  
Author(s):  
Saviola Alessia ◽  
Schipilliti Francesca Matilde ◽  
Isca Chrystel ◽  
Massimiliano Salati ◽  
Daniele Dini ◽  
...  
Keyword(s):  
Karnofsky Performance Status ◽  
Performance Status ◽  
Critical Role ◽  
Palliative Sedation ◽  
University Hospital ◽  
Refractory Symptoms ◽  
Stage Disease ◽  
End Stage ◽  
The Impact

Abstract PurposePalliative sedation (PS) plays a critical role to give suffering relief from refractory symptoms at the end of life. Our audit aimed to assess and improve quality of PS at the Department of Oncology and Hematology of University Hospital of Modena, to verify the adherence to international guidelines, the cooperation among members of care team, focusing with attention on family’s perception of this delicate situation. MethodsFrom December 2016 to June 2019, data of patients undergoing PS in the Department were collected by an electronic folder tool, “Sedation Tool” (ST), that recorded clinical and PS informations, D-PaP, Rudkin Score and family’s perception. Results245 patients were enrolled. 82% had a Karnofsky Performance Status 10-20%. The most common cancer types were lung and gastro-intestinal carcinomas (27% and 21% respectively). Refractory symptoms observed were confusion and agitation (76%), dyspnea (39%), pain (15%), delirium (10%), psychological distress (5%). Midazolam was the drug of choice for PS. Most of patients had Rudkin score 5 after 24 hours and 33% had terminal event within a period of 24 hours from the beginning of PS. During PS most of Patient’s relatives reported peacefulness (65%), agitation/impatience in 6% of cases, concern for suffering (16%). ConclusionPS is used in case of worsening general conditions at the end-stage disease to relieve refractory symptoms with dignity. The ST can become a simple instrument to evaluate and improve PS quality, providing more attention on the impact of PS on relatives to then possibly develop new supportive procedures for patients and their families.

Lung Cancer

2021 ◽  
pp. 162-168
Author(s):  
Marianne Davies
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Psychological Distress ◽  
Cancer Patients ◽  
Late Stage ◽  
Symptom Burden ◽  
Lung Cancer Patients ◽  
Stage Disease ◽  
Late Stage Disease

Lung cancer is the leading cause of cancer-related deaths worldwide. Most patients are diagnosed with late-stage disease. Ninety percent of lung cancer cases can be attributed to tobacco smoking. Smoking cessation efforts have led to reductions in cancer-related deaths. Early screening can help to diagnose patients at earlier stages with improved outcomes. Lung cancer patients suffer the highest symptom burden and psychological distress above other cancers. Symptom burden is due to late-stage disease and treatment side effects. Psychological distress, anxiety, and depression are influenced by internal and external stigma. These lead to the negative impact on quality of life for lung cancer patients as well as family caregivers. Lung cancer–specific tools have been developed to assist in the screening and identification of distress, stigma, and quality-of-life metrics for lung cancer patients. Several organizations have formed to support the educational and psychological needs of lung cancer patients. Early assessment of symptom and psychological distress and integration of palliative care services can improve the quality of life of patients with lung cancer.

scholarly journals Depression and end-of-life care for patients with cancer

2011 ◽  
Vol 13 (1) ◽  
pp. 101-108 ◽  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Symptom Burden ◽  
Physical Symptoms ◽  
Patients With Cancer ◽  
Vulnerable Patients ◽  
Treatment Of Depression ◽  
Care Approach ◽  
Hastened Death

Patients with cancer and depression experience more physical symptoms, have poorer quality of life, and are more likely to have suicidal thoughts or a desire for hastened death than are cancer patients who are not depressed. Despite the ubiquity of depressive symptoms in cancer patients at the end of life, critical questions remain unanswered with respect to etiopathogenesis, diagnosis, and treatment of depression in these vulnerable patients. The pharmacotherapy of depression in patients with advanced cancer should be guided by a palliative care approach focused on symptom reduction, irrespective of whether the patient meets diagnostic criteria for major depression. Earlier and more intensive supportive care for patients with cancer reduces symptom burden and may prolong life for patients with advanced disease. Symptom-oriented clinical trials are needed to improve end-of-life cancer care.

scholarly journals Serum Vitamin Levels among Iraqi Cancer Patients Receiving Chemotherapy

2021 ◽  
Vol 9 (B) ◽  
pp. 231-234
Author(s):  
Mohammed Salim Abdulrahman ◽  
Hedef D. El-Yassin ◽  
Nada. A. S. Al-Alwan
Keyword(s):  
Cancer Patients ◽  
Performance Status ◽  
Serum Vitamin ◽  
Chemotherapeutic Agents ◽  
Term Outcome ◽  
Nutritional Elements ◽  
Patients With Cancer ◽  
Elisa Technique

BACKGROUND: Cancers are an abnormal irregular growth of cells. There is an interaction between cancer cells, immune cells, and neurotransmitters with nutritional elements and vitamins. With the administration of chemotherapeutic agents, many studies have highlighted the importance of these interactions and the role of chemotherapeutic drugs in augmenting or ameliorating such changes. Therefore, early detection of vitamins level changes is vital to improve patients’ short-term outcome and quality of life. AIM: The aim was assessment of serum vitamins level changes in patients with cancer pre- and post-chemotherapy. MATERIALS AND METHODS: A cohort study was carried out on newly diagnosed patients with cancer in Al-Amal National Radiation Oncology Hospital/Baghdad/Iraq during the period from January 2019 to July 2019. Assessments of the studied samples were conducted as a baseline before receiving chemotherapy and after the third cycle of chemotherapy. Weight, height and body mass index (BMI) were measured for each subject enrolled in the study. Serum level of the following vitamins: A, B1, B2, B3, B6, B12, folic acid, D, and E was measured using ELISA technique. RESULTS: One Hundred patients who were diagnosed with different types of cancer were enrolled in this study. Seventy seven (77%) females and twenty three (23%) males. Mean age was 50.15 years ranged between (18-75) years old, BMI range (16-42). Serum vitamin levels that have shown a significant decrease post chemotherapy as compared with baseline were: A (0.64 ± 0.23 vs 0.64 ± 0.23, P=0.0003), E (19.47 ± 4.714 vs 14.70 ± 5.354, P<0.0001), B12 (366.0 ± 95.94 vs 291.1 ± 102.6, P<0.001), B9 (16.13 ± 4.13 vs 16.13 ± 4.13, P<0.0001) whereas vitamins B6 and D which showed lower than normal baseline level underwent significant increase after chemotherapy yet remained below normal (vitamin B6 4.19 ± 1.94 vs 8.22 ± 5.39; vitamin D 21.11 ± 7.21 vs 26.55 ± 15.22). CONCLUSION: Our findings highlight the importance of updating and tailoring our regimens to suit the changes of the nutritional elements and parameters of performance status of cancer patients in terms of outcome and patient satisfaction.

scholarly journals Analysis of the Clinical Management and Quality of Life of Frail Patients with Cancer and Breakthrough Pain in Clinical Practice.

2021 ◽  
Author(s):  
Gemma Soler González ◽  
Juan Pérez Cajaraville ◽  
Silvia Forcano Sanjuan ◽  
José Luis Firvida Pérez ◽  
César Margarit Ferri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Clinical Management ◽  
Breakthrough Pain ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Patients With Cancer ◽  
Frail Patients ◽  
Gradual Onset

Abstract BackgroundThe purpose of this study was to analyse the clinical management and quality of life of frail patients with cancer, chronic pain and breakthrough pain (BTP) and to assess whether treatment was conditioned by their frailty status.Methods This was an observational study in adult frail patients with cancer, chronic background pain and BTP. Outcomes of interest collected include clinical and sociodemographic data, Karnofsky Performance Status, quality of life (EuroQoL-5D-5L), chronic pain and BTP characteristics, as well as treatments administered for their control.ResultsA total of 222 patients were included with a mean age of 68 years (range 24-91), 60.5% men, with a mean Karnofsky of 63.2%. The number of daily episodes of BTP was 3.8 (95% CI 3.3-4.3), with a duration of 34.6 minutes (95% CI 28.8-40.3), and 56.8% had a gradual onset. Opioids were administered to 88.3% of patients for the chronic pain, and to 83.8% for BTP. The treatment's daily doses administered for chronic pain and BTP did not differ from those usually recommended. Quality of life was significantly worst in frail patients with cancer than no frail patients and was related to performance status (p<0.001) and to the social-familial status (p=0.045). ConclusionsBTP in frail patients with cancer presents with more episodes, of a shorter duration and more gradual onset compared to other patients with BTP, and Quality of life was seriously affected. No relevant differences were seen in the doses or method of administration of treatments for chronic pain and BTP in frail patients with cancer as compared to the standard recommendations for non-frail patients. Trial registration: Not applicable to the study.

scholarly journals Palliative Care and COVID-19 Pandemic: Retrospective Study of Factors Associated With Infection and Death at an Oncological Palliative Care Reference Center

2021 ◽  
pp. 104990912098696
Author(s):  
Livia Costa de Oliveira ◽  
Karla Santos da Costa Rosa ◽  
Ana Luísa Durante ◽  
Luciana de Oliveira Ramadas Rodrigues ◽  
Daianny Arrais de Oliveira da Cunha ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Tumor Type ◽  
Advanced Cancer Patients ◽  
Factors Associated ◽  
Reactive Protein

Background: Advanced cancer patients are part of a group likely to be more susceptible to COVID-19. Aims: To describe the profile of advanced cancer inpatients to an exclusive Palliative Care Unit (PCU) with the diagnosis of COVID-19, and to evaluate the factors associated with death in these cases. Design: Retrospective cohort study with data from advanced cancer inpatients to an exclusive PCU, from March to July 2020, with severe acute respiratory syndrome. Diagnostic of COVID-19 and death were the dependent variables. Logistic regression analyses were performed, with the odds ratio (OR) and 95% confidence interval (CI). Results: One hundred fifty-five patients were selected. The mean age was 60.9 (±13.4) years old and the most prevalent tumor type was breast (30.3%). Eighty-three (53.5%) patients had a diagnostic confirmation of COVID-19. Having diabetes mellitus (OR: 2.2; 95% CI: 1.1-6.6) and having received chemotherapy in less than 30 days before admission (OR: 3.8; 95% CI: 1.2-12.2) were associated factors to diagnosis of COVID-19. Among those infected, 81.9% died and, patients with Karnofsky Performance Status (KPS) < 30% (OR: 14.8; 95% CI 2.7-21.6) and C-reactive protein (CRP) >21.6mg/L (OR: 9.3; 95% CI 1.1-27.8), had a greater chance of achieving this outcome. Conclusion: Advanced cancer patients who underwent chemotherapy in less than 30 days before admission and who had diabetes mellitus were more likely to develop Coronavirus 2019 disease. Among the confirmed cases, those hospitalized with worse KPS and bigger CRP were more likely to die.

Mood disorders and outcomes in lung cancer patients undergoing surgery: a brief summery

2020 ◽  
Author(s):  
Maria Salvina Signorelli ◽  
Teresa Surace ◽  
Marcello Migliore ◽  
Eugenio Aguglia
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Mood Disorders ◽  
Psychiatric Symptoms ◽  
Depression And Anxiety ◽  
Lung Cancer Patients ◽  
Patients With Cancer ◽  
Treatment Of Depression ◽  
The Impact

Cancer is a leading cause of death worldwide. Literature reports depression and anxiety are the most common psychiatric symptoms in cancer patients. Notably, lung cancer is associated with major depressive disorder in 5–13% of cases. The present article aims to give an overview regarding the impact of mood disorders on the outcomes of patients affected by lung cancer. Our review showed that pharmacological treatment and psychotherapy can be useful to improve the quality of life of patients with lung cancer. Moreover, the treatment of depression and anxiety can be associated with a reduced mortality. In conclusion, it is important to consider psychiatric care as important as other adjuvant oncologic therapies in patients with cancer.

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