scholarly journals PALLIATIVE CARE RECOVERY OUTCOMES: NATURE OF RECOVERY OUTCOMES AMONG CANCER PATIENTS IN NAIROBI AND NYERI COUNTIES, KENYA

2021 ◽  
Vol 6 (2) ◽  
pp. 1-12
Author(s):  
Joyce Wang’ombe ◽  
Beatrice Kathungu

Purpose: This study sought to find out nature of recovery outcomes among cancer patients attending palliative care in Nairobi and Nyeri County Methodology: The study adopted a correlation research design. The target population were the cancer patients, attending treatment at the three palliative care units in Nairobi and Nyeri Counties. Systematic random sampling technique was used in the study to obtain a sample of 96 participants. Semi structured questionnaires were used to collect data. Data was analysed using both descriptive and inferential statistics, namely Pearson Moment Correlation Coefficient(r). Findings: Result showed that, majority of the respondents (65.5%) had a low level of recovery outcomes, while 32.1% had a high level of recovery outcomes. results indicate that the lowest score on recovery outcomes was 31, while the highest score was 74. The mean score was 47.0+9.465, which indicates that the recovery outcomes fell in the low range. These findings were not unusual considering that most of the patients were newly diagnosed with cancer and for some respondent’s metastasis had set in. Conclusion: The study concluded that the two most significant challenges encountered in palliative care were, patient experiencing isolation and lacking finances. Provision of financial support and increasing the number of counselling sessions were suggested as possible strategies for enhancing patient recovery outcomes Recommendation: This study recommended that the palliative care units staff should encourage participation of family members, friends and significant others in the cancer continuum, so as to provide psychological and social support to patients  Unique contribution to theory, practice and policy Patients under palliative care could adopt group psychotherapy, including cognitive-behavioural, informational, non-behavioral, social support, and using unusual treatments such as music and art therapy to curb cancer. More cancer related programs enhancing patients AQ should be put in place by the counsellors in order to increase the patients AQ in the palliative care units from moderate level to high level of AQ in order to boost recovery outcomes

2018 ◽  
Vol 4 (1) ◽  
pp. 1-7
Author(s):  
Meegoda MKDL ◽  
Fernando DMS ◽  
Sivayogan S ◽  
Atulomah NOS ◽  
Marasinghe RB

A qualitative study was conducted to describe views and life experiences of domiciliary care providers in meeting the palliative care needs of adult cancer patients at the National Cancer Institute, Maharagama, Sri Lanka. The target population for this study was Domiciliary Care Providers (DCPs) who were the family care givers of patients at National Institute of Cancer, Maharagam (NICM), Cancer Home (CH), Maharagama, Shantha Sevana Hospice (SSH) and Ceylinco Oncology Unit (COU), Colombo, Sri-Lanka. Purposive sampling technique was used to select participants for the study. In-depth interviews were conducted using validated semi-structured interviewer guide. Data saturation was reached after 15 in-depth interviews with DCPs. Trustworthiness of the study was maintained. Phenomenological-hermeneutic approach was followed to analyze qualitative data and thematic analysis was performed. Data analysis was done concurrently with data gathering. Being reassured, having more expectations, need psychosocial help and inadequate knowledge were the key themes identified. They expect knowledge improvement to provide better care. As patients’ level of satisfaction on domiciliary care provided by DCPs was high, improving their knowledge on palliative care may be a cost effective method of improving palliative care.


2021 ◽  
Vol 6 (1) ◽  
pp. 43-52
Author(s):  
Joyce Wang’ombe ◽  
Beatrice Kathungu

Purpose: This study sought to establish challenges among cancer patients that may influence recovery outcomes in palliative care units in Nairobi and Nyeri Counties. Methodology: The study adopted a correlation research design. The target population were the cancer patients, attending treatment at the three palliative care units in Nairobi and Nyeri Counties. Systematic random sampling technique was used in the study to obtain a sample of 96 participants. Semi structured questionnaires were used to collect data. Data was analyzed using both descriptive and inferential statistics, namely Pearson Moment Correlation Coefficient(r). Findings: Result showed that, majority of the respondents indicated participating in the programs available at the palliative care institutions, which included; group psychotherapy (91.7%), spiritual support (91.7%) and programs on coping skills (91.7). Others (22.6%) participated in programs such as performing chorals, knitting and board games. The results also showed that 82.1% and 78.6% of the respondents noted that they experienced challenges of being isolated and lacking finances respectively. 50% of the respondents had a challenge in coping with the condition, while 2.4% experienced challenges in adhering to drugs .These findings were not unusual considering that most of the patients were newly diagnosed with cancer and for some respondent’s metastasis had set in. Unique contribution to theory, practice and policy Patients facing challenges receiving palliative care could adopt group psychotherapy, including cognitive-behavioral, informational, non-behavioral, social support, and using unusual treatments such as music and art therapy to curb cancer. Administrators and medical staff in the palliative care units should create awareness and encourage the attending patients to source for a health insurance cover e.g.  National Health Insurance Fund (NHIF) to cater for the cancer disease both outpatient and incase of hospitalization. This will ease the financial burden of cancer on the patient, family and community.


2020 ◽  
Vol 6 ◽  
pp. 237796082098178
Author(s):  
Sumana Lama ◽  
Jintana Damkliang ◽  
Luppana Kitrungrote

Introduction Community integration is an essential component for rehabilitation among traumatic brain injury (TBI) survivors, which yields positive outcomes in terms of social activities, community participation, and productive work. A factor that usually facilitates community integration among TBI survivors is social support, whereas physical environment and fatigue are most often found as barriers. Objectives This study aimed to (1) describe the level of community integration, fatigue, physical environment, and social support of persons after TBI, and (2) examine the relationship between community integration and these three factors. Methods This is a descriptive correlational study. One hundred and twenty TBI survivors living in the communities of Province Number Three, Nepal were enrolled using the stratified sampling technique. The data were collected using the Community Integration Questionnaire, Modified Fatigue Impact Scale, Craig Hospital Inventory of Environmental Factors, and the Multidimensional Scale of Perceived Social Support. Descriptive statistics and Pearson’s correlation were used to analyze the data. Results Community integration, fatigue, and physical environment showed a moderate level, while social support revealed a high level. Fatigue was significantly correlated with overall community integration, whereas physical environment was found to correlate with two subscales of community integration, home integration and productive activities. Conclusion To enhance the level of community integration among TBI survivors, health care providers, in particular rehabilitation nurses and community nurses, should plan and implement strategies such as follow-up appointments or continued rehabilitation at home.


2021 ◽  
pp. 026921632198956
Author(s):  
Takahiro Higashibata ◽  
Takayuki Hisanaga ◽  
Shingo Hagiwara ◽  
Miho Shimokawa ◽  
Ritsuko Yabuki ◽  
...  

Background: Studies on the appropriate use of urinary catheters for cancer patients at the end of life are limited. Aim: To clarify the differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units. Design: Pre-planned secondary analysis of a multicenter, prospective cohort study; East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED). Setting/participants: This study enrolled consecutive advanced cancer patients admitted to palliative care units between January and December 2017. The final study group comprised 1212 patients from 21 institutions throughout Japan. Results: Out of the 1212 patients, 380 (31.4%; 95% confidence interval, 28.7%–34.0%) underwent urinary catheterization during their palliative care unit stay, and the prevalence of urinary catheterization in patients who died at palliative care units by institution ranged from 0.0% to 55.4%. When the 21 participating institutions were equally divided into three groups according to the institutional prevalence of catheterization, patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation were more likely to be catheterized in institutions with a high prevalence of catheterization than in those with a low or moderate prevalence ( p < 0.008, p = 0.008, and p < 0.008, respectively). Conclusion: This study revealed that the institutional prevalence of urinary catheterization in advanced cancer patients at palliative care units widely varied. Further studies are needed to establish the appropriate use of urinary catheters, especially in patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation.


2021 ◽  
Vol 9 (3) ◽  
pp. 5-9
Author(s):  
A Sangamithra ◽  
S Vishnu

This study exclusively focuses on accessing the level of perceived economic support and quality of life of cancer patients’ cost of cancer with coping up and drawing suggestions to achieve a high level of quality of life and addressing the issues of the day-to-day life problems. This study may help to understand the prevailing status of the person with cancer and help to find the level of perceived social support among the cancer patients. The study discovers the level of quality of life of the persons affected by cancer.


2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Nur Melizza ◽  
Anggraini Dwi Kurnia ◽  
Nur Lailatul Masruroh ◽  
Indrasari Dwi Yulianti

ABSTRACT Introduction: Many students have been accustomed to smoking, including those majoring at health sciences. Theoretically, they are supposed to be the ones who are actively aware of some possible health damages caused by smoking habit. Thus, people around them play an essential role in taking control of someone’s pattern through social support, especially over those who are highly motivated to quit smoking. Objective: This study aimed to identify smoking behavior, social support, and cessation motivation in smoking among health sciences’ students. Methods: This research was categorized as observational-descriptive one, with the use of accidental sampling technique to recruit as many as 63 students of faculty of health sciences who were defined as active smokers. The data, furthermore, were collected by means of a questionnaire. At last, a statistical-descriptive analysis was used to evaluate the data. Result: The result was most of the involved respondents were shown to have a moderate trend of smoking (65%). On the other hand, the majority of the respondents had been supported through some types of social support with relatively high percentage, to name appraisal support (indicating 71%), tangible support (indicating 87%), self-esteem support (indicating 97%), and belonging support (indicating 92%). Moreover, most of the respondents were equipped by the high level of quittance motivation from smoking, signifying 71%.  Discussion: This research had indicated that the level of smoking habit perceived by the respondents was moderate. In short, appraisal support was defined as high, tangible support low, self-esteem support high, and belonging support high. In addition, some of the respondents had demonstrated a high level of quittance motivation from smoking


2006 ◽  
Vol 4 (2) ◽  
pp. 179-188 ◽  
Author(s):  
KEIKO TAMURA ◽  
KAORI ICHIHARA ◽  
EIKO MAETAKI ◽  
KEIKO TAKAYAMA ◽  
KUMI TANISAWA ◽  
...  

Objective: This research explores the potential benefit of a spiritual pain assessment sheet to clinical practice. With spiritual pain defined as “pain caused by extinction of the being and meaning of the self,” the spiritual pain assessment sheet was developed by Hisayuki Murata from his conceptual framework reflecting the three dimensions of a human being as a being founded on temporality, a being in relationship, and a being with autonomy. The assessment sheet was developed from reviews of the literature and examinations from a philosophical perspective on the structure of spiritual pain.Methods: Patients admitted to palliative care units in Japan were interviewed using the assessment sheet. The responses were analyzed qualitatively. The usefulness of the assessment sheet and the burden placed on the patients by its use were also investigated.Results: The spiritual pain elucidated by the assessment sheet was the same as that revealed in the earlier research of Morita. The patients reported that they did not find the use of the assessment sheet a burden, and more than half reported that it was useful. The burden of the assessment sheet on the subjects was thus determined to be low. Positive feedback on the assessment sheet was also received from the nurses who conducted the patient interviews, who said the assessment sheet made it easier to talk with the patients about their spiritual pain.Significance of research: The research results indicate that the spiritual pain assessment sheet provided an appropriate assessment of spiritual pain among terminal cancer patients, showing that such a sheet could be used as an assessment tool in the future.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Nanako Nishiyama ◽  
Yoshinobu Matsuda ◽  
Noriko Fujiwara ◽  
Keisuke Ariyoshi ◽  
Shunsuke Oyamada ◽  
...  

Abstract Background Although rehabilitation is recommended for terminal cancer patients, the specific components and methods of such programs are poorly documented. No studies to date have examined the effectiveness of rehabilitation for terminal cancer patients. This study aims to evaluate the efficacy of a new intervention for rehabilitation therapists, using the Op-reha Guide (Guide to Optimal and Patient-Centred Rehabilitation Practice for Patients in Palliative Care Units [PCUs]) in rehabilitation practice. This guide consists of recommended actions and attitudes for rehabilitation therapists and aims to optimise therapists’ actions according to the patient’s needs and condition. It shares goals with terminal cancer patients to maintain their activities of daily living (ADL). Methods This study uses a multicentre, prospective, randomised controlled trial (RCT) design with two parallel groups in PCUs where specialised rehabilitation will be routinely performed for terminal cancer patients by rehabilitation therapists. Participants will be randomised (1:1) to intervention (the Op-reha Guide) and control groups (usual rehabilitation). We will then conduct an observational study in PCUs that do not perform specialised rehabilitation for terminal cancer patients; this will be considered the usual care group, and the efficacy of usual rehabilitation will be quantitatively evaluated. Inclusion criteria are hospitalisation in PCU, European Cooperative Oncology Group Performance Status of 2 or 3, and clinical estimation of life expectancy of 3 weeks or more. Patients with severe symptom burden will be excluded. We hypothesise that the Op-reha Guide will be more effective in maintaining the ADL of terminal cancer patients hospitalised in PCUs than usual rehabilitation. The primary endpoint is defined as the change in (total) modified Barthel Index from baseline to Day 22. Quality of life will be a secondary endpoint. In total, 135 patients will be recruited from 16 Japanese sites between July 2019 and December 2021. Discussion This will be the first trial to evaluate the efficacy of specialised rehabilitation for terminal cancer patients hospitalised in PCUs, and will contribute to the evidence on the efficacy of implementing rehabilitation for terminal cancer patients. Trial registration UMIN-CTR, UMIN000037298 R000042525 (date of registration 7 July 2019).


2020 ◽  
Vol 9 (6) ◽  
pp. 1960
Author(s):  
Maria Isabel Carrasco-Zafra ◽  
Rafael Gómez-García ◽  
Ricardo Ocaña-Riola ◽  
Maria Luisa Martín-Roselló ◽  
Encarnación Blanco-Reina

The current treatment approach for patients in palliative care (PC) requires a health model based on shared and individualised care, according to the degree of complexity encountered. The aims of this study were to describe the levels of complexity that may be present, to determine their most prevalent elements and to identify factors that may be related to palliative complexity in advanced-stage cancer patients. An observational retrospective study was performed of patients attended to at the Cudeca Hospice. Socio-demographic and clinical data were compiled, together with information on the patients’ functional and performance status (according to the Palliative Performance Scale (PPS)). The level of complexity was determined by the Diagnostic Instrument of Complexity in Palliative Care (IDC-Pal©) and classified as highly complex, complex or non-complex. The impact of the independent variables on PC complexity was assessed by multinomial logistic regression analysis. Of the 501 patients studied, 44.8% presented a situation classed as highly complex and another 44% were considered complex. The highly complex items most frequently observed were the absence or insufficiency of family support and/or caregivers (24.3%) and the presence of difficult-to-control symptoms (17.3%). The complex item most frequently observed was an abrupt change in the level of functional autonomy (47.6%). The main factor related to the presence of high vs. non-complexity was that of performance status (odds ratio (OR) = 10.68, 95% confidence interval (CI) = 2.81–40.52, for PPS values < 40%). However, age was inversely related to high complexity. This study confirms the high level of complexity present in patients referred to a PC centre. Determining the factors related to this complexity could help physicians identify situations calling for timely referral for specialised PC, such as a low PPS score.


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