Pain Relief as an Integral Part of the Palliative Care

BACKGROUND: Palliative therapy represents active care for patients whose illness has such nature that is not responding to the curative treatment. The palliative care aims to provide comfort and prevention from the suffering of the patients at the end of their life. Treatment of the pain presents an important integral part of palliative care.AIM: This article aims to discuss and answer to some of the analgesic regimes and therapeutic dilemmas.RESULTS: Pain control, in addition to the other treatments such as alleviation of psychological, sociological and spiritual problems, has a priority. The proper pain management can achieve a better quality of life for the patients and their families.CONCLUSION: It can be concluded that because of the different origin of the pain, the use of analgesic therapy should be individualised and adapted to the real need of every person. Finally, only a good organisation and institutionalisation of the palliative care in one society could permit better prevention of suffering at the end of the life.

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Perspectives From the Other Side: A Physician and Cancer Survivor

Journal of Oncology Practice ◽

10.1200/jop.2011.000365 ◽

2011 ◽

Vol 7 (6) ◽

pp. 348-350 ◽

Cited By ~ 1

Author(s):

Susan C. Stone

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Cancer Survivor ◽

Palliative Therapy ◽

The Other ◽

Comprehensive Care ◽

Care Model ◽

Comprehensive Care Model

ASCO has made great strides to integrate palliative care into the comprehensive care model. However, much work remains to ensure that all patients, whether receiving curative or palliative therapy, have a good quality of life.

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A Prospective Multicentre Study to Evaluate the Efficacy and Tolerability of Osmotic Release Oral System (Oros®) Hydromorphone in Opioid-Naive Cancer Patients: Results of the Korean South West Oncology Group Study

Pain Research and Management ◽

10.1155/2015/458389 ◽

2015 ◽

Vol 20 (6) ◽

pp. 293-299 ◽

Cited By ~ 3

Author(s):

Eun-Kee Song ◽

Hyunjeong Shim ◽

Hye-Suk Han ◽

DerSheng Sun ◽

Soon-Il Lee ◽

...

Keyword(s):

Quality Of Life ◽

Pain Relief ◽

Cancer Pain ◽

Pain Intensity ◽

Cancer Patients ◽

Pain Control ◽

Intensity Difference ◽

Front Line ◽

Long Acting

BACKGROUND: Osmotic release oral system (OROS®) hydromorphone is a potent, long-acting opioid analgesic, effective and safe for controlling cancer pain in patients who have received other strong opioids. To date, few studies have examined the efficacy of hydromorphone for pain relief in opioid-naive cancer patients.OBJECTIVES: A prospective, open-label, multicentre trial was conducted to determine the efficacy and tolerability of OROS hydromorphone as a single and front-line opioid therapy for patients experiencing moderate to severe cancer pain.METHODS: OROS hydromorphone was administered to patients who had not previously received strong, long-acting opioids. The baseline evaluation (visit 1) was followed by two evaluations (visits 2 and 3) performed two and 14 weeks later, respectively. The starting dose of OROS hydromorphone was 4 mg/day and was increased every two days when pain control was insufficient. Immediate-release hydromorphone was the only accepted alternative strong opioid for relief of breakthrough pain. The efficacy, safety and tolerability of OROS hydromorphone, including the effects on quality of life, and patients’ and investigators’ global impressions on pain relief were evaluated. The primary end point was pain intensity difference (PID) at visit 2 relative to visit 1 (expressed as %PID).RESULTS: A total of 107 patients were enrolled in the present study. An improvement in pain intensity of >50% (≥50% PID) was observed in 51.0% of the full analysis set and 58.6% of the per-protocol set. The mean pain score, measured using a numerical rating scale, was significantly reduced after two weeks of treatment, and most adverse events were manageable. Quality of life also improved, and >70% of patients and investigators were satisfied with the treatment.CONCLUSIONS: OROS hydromorphone provided effective pain relief and improved quality of life in opioid-naive cancer patients. As a single and front-line treatment, OROS hydromorphone delivered rapid pain control.

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Chemotherapy use and quality of life in cancer patients at the end of life: an integrative review

Health and Quality of Life Outcomes ◽

10.1186/s12955-020-01580-0 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Elham Akhlaghi ◽

Rebecca H. Lehto ◽

Mohsen Torabikhah ◽

Hamid Sharif Nia ◽

Ahmad Taheri ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

End Of Life ◽

Cancer Patients ◽

Advanced Cancer ◽

Palliative Chemotherapy ◽

Palliative Therapy ◽

Related Quality ◽

Health Related

Abstract Background When curative treatments are no longer available for cancer patients, the aim of treatment is palliative. The emphasis of palliative care is on optimizing quality of life and provided support for patients nearing end of life. However, chemotherapy is often offered as a palliative therapy for patients with advanced cancer nearing death. The purpose of this review was to evaluate the state of the science relative to use of palliative chemotherapy and maintenance of quality of life in patients with advanced cancer who were at end of life. Materials and methods Published research from January 2010 to December 2019 was reviewed using PRISMA guidelines using PubMed, Proquest, ISI web of science, Science Direct, and Scopus databases. MeSH keywords including quality of life, health related quality of life, cancer chemotherapy, drug therapy, end of life care, palliative care, palliative therapy, and palliative treatment. Findings 13 studies were evaluated based on inclusion criteria. Most of these studies identified that reduced quality of life was associated with receipt of palliative chemotherapy in patients with advanced cancer at the end of life. Conclusion Studies have primarily been conducted in European and American countries. Cultural background of patients may impact quality of life at end of life. More research is needed in developing countries including Mideastern and Asian countries.

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Assessment of pain control, quality of life, and predictors of success after gamma knife surgery for the treatment of trigeminal neuralgia

Neurosurgical FOCUS ◽

10.3171/foc.2005.18.5.9 ◽

2005 ◽

Vol 18 (5) ◽

pp. 1-7 ◽

Cited By ~ 29

Author(s):

Ajay Jawahar ◽

Rishi Wadhwa ◽

Caglar Berk ◽

Gloria Caldito ◽

Allyson Delaune ◽

...

Keyword(s):

Quality Of Life ◽

Patient Satisfaction ◽

Pain Relief ◽

Trigeminal Neuralgia ◽

Gamma Knife ◽

Pain Control ◽

Gamma Knife Surgery ◽

Patient Satisfaction Score

Object There are various surgical treatment alternatives for trigeminal neuralgia (TN), but there is no single scale that can be used uniformly to assess and compare one type of intervention with the others. In this study the objectives were to determine factors associated with pain control, pain-free survival, residual pain, and recurrence after gamma knife surgery (GKS) treatment for TN, and to correlate the patients' self-reported quality of life (QOL) and satisfaction with the aforementioned factors. Methods Between the years 2000 and 2004, the authors treated 81 patients with medically refractory TN by using GKS. Fifty-two patients responded to a questionnaire regarding pain control, activities of daily living, QOL, and patient satisfaction. The median follow-up duration was 16.5 months. Twenty-two patients (42.3%) had complete pain relief, 14 (26.9%) had partial but satisfactory pain relief, and in 16 patients (30.8%) the treatment failed. Seven patients (13.5%) reported a recurrence during the follow-up period, and 25 (48.1%) reported a significant (> 50%) decrease in their pain within the 1st month posttreatment. The mean decrease in the total dose of pain medication was 75%. Patients' self-reported QOL scores improved 90% and the overall patient satisfaction score was 80%. Conclusions The authors found that GKS is a minimally invasive and effective procedure that yields a favorable outcome for patients with recurrent or refractory TN. It may also be offered as a first-line surgical modality for any patients with TN who are unsuited or unwilling to undergo microvascular decompression.

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Quality of Life of Patients with Advanced Cancer in Palliative Therapy and in Palliative Care

Aquichan ◽

10.5294/aqui.2019.19.3.7 ◽

2019 ◽

Vol 19 (3) ◽

pp. 1-14

Author(s):

Leonel dos Santos Silva ◽

Bruna Eloise Lenhani ◽

Dabna Hellen Tomim ◽

Paulo Ricardo Bittencourt Guimarães ◽

Luciana Puchalski Kalinke

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Palliative Therapy ◽

Symptom Assessment ◽

Assessment System ◽

Life Questionnaire ◽

Edmonton Symptom Assessment System ◽

Quality Of Life Questionnaire ◽

Chronic Illness Therapy

Objective: To assess the quality of life of patients with advanced cancer in palliative therapy and in palliative care. Materials and Methods: Quantitative, observational, cross-sectional, and analytic study conducted in a teaching hospital in Paraná, Brazil, from January to June 2018, with 126 patients: 107 in palliative therapy; 19 in exclusive palliative care. The questionnaires for data collection were: Quality of Life Questionnaire-Core 15-Palliative, Functional Assessment of Chronic Illness Therapy-Palliative Care 14, and Edmonton Symptom Assessment System. The Spearman non-parametric coefficient test was used for the analysis. Results: The overall quality of life in palliative therapy and in palliative care was, respectively, 71.54/59.65; when correlating the total score of quality of life of the Quality of Life Questionnaire-Core 15-Palliative with the Functional Assessment of Chronic Illness Therapy-Palliative Care 14 (p = 0.001), and the Edmonton Symptom Assessment System (p = 0.001), significant difference of better quality of life was observed in the palliative therapy. Conclusion: Patients in palliative therapy have good overall quality of life, while the palliative care group reports regular quality of life. The symptoms were milder in the palliative therapy and more intense and with greater significance in palliative care; hence, knowing the compromise of quality of life will help professionals in planning interventions with transdisciplinary approach for patients and for their families.

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Percutaneous Radiofrequency Hip Joint Denervation

10.5772/intechopen.96708 ◽

2021 ◽

Author(s):

Nieves Saiz-Sapena ◽

Vicente Vanaclocha-Vanaclocha ◽

José María Ortiz-Criado ◽

Leyre Vanaclocha

Keyword(s):

Quality Of Life ◽

Pain Relief ◽

Hip Joint ◽

Pain Control ◽

Joint Pain ◽

Pulsed Radiofrequency ◽

Total Hip ◽

Sensory Denervation ◽

Hip Arthroplasties

With an aging population, chronic osteoarthritic hip joint pain is becoming a major issue. Most patients with hip pain can control their pain with conservative measures but with a gradual reduction in their quality of life. When gradually reduced ambulation and pain become recalcitrant, total hip arthroplasty is the next step. For most patients, this is a good way to improve pain control and to recover some quality of life, but for a few this aggressive surgical procedure is not possible. Sometimes co-morbidities make total hip arthroplasties undesirable. At other times, the age of the patients recommends to wait for a while. In these cases, other options have to be explored. Percutaneous partial hip joint sensory denervation has become a notable option as it can provide acceptable rates of pain relief with minimal surgical aggressiveness. There are three modalities to perform it: thermal, cooled and pulsed radiofrequency.

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End-stage pulmonary disease

Emergencies in Respiratory Medicine ◽

10.1093/med/9780199202447.003.0016 ◽

2007 ◽

pp. 99-102

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Pulmonary Disease ◽

Physical Symptoms ◽

Curative Treatment ◽

Total Care ◽

End Stage ◽

Spiritual Problems

End-stage pulmonary disease 100 The WHO defines palliative care as the active total care of patients whose disease is not responsive to curative treatment. The goal of palliative care is achievement of best quality of life for patients and their families. It includes control of pain and other physical symptoms as well as care of psychological, social and spiritual problems....

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The Quality of Life of Palliative Care Staff: A Personal Construct Approach

OMEGA - Journal of Death and Dying ◽

10.2190/a7y9-0f7j-tlr2-9byn ◽

1994 ◽

Vol 28 (3) ◽

pp. 201-217 ◽

Cited By ~ 6

Author(s):

Linda L. Viney ◽

Beverly M. Walker ◽

Betsy Lilley ◽

Barbara Tooth ◽

Pam Bell ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Content Analysis ◽

Social Interactions ◽

The Other ◽

Care Staff ◽

Anxiety And Depression ◽

Personal Construct ◽

Interview Schedule

Palliative care staff were compared with staff from burn and neonatal units, and with mature age general nursing trainees at the end of their training. Hypotheses, based on a personal construct model of their quality of life, sources of anxiety, and types of social interactions were tested. These tests were conducted by applying content analysis scales to their responses to an open-ended request in their interview schedule. The palliative care staff did express better quality of life, in terms of significantly less anxiety and depression, as well as more good feelings than the other staff groups. They showed, as predicted, significantly more anxiety about death, but less shame and diffuse anxiety. They also reported more helping and loving interactions but fewer influencing or vaguely defined, but shared interactions. The implications of these findings for the model and for the support of palliative care staff are considered.

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