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Alnajar M, Darawad M, Khater W, Alshahwan R, Mosleh S, Nofal B, Abdalrahim M. Exploring Palliative Care Needs Among Patients With Cancer and Non-Cancer Serious Chronic Diseases: A Comparison Study. Am J Hosp Palliat Care 2024:10499091241235920. [PMID: 38386721 DOI: 10.1177/10499091241235920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Palliative care (PC) is integral to improving the quality of life and mitigating suffering for individuals with serious illnesses. This interdisciplinary-led study aims to comprehensively evaluate the prevalence of distressing problems and unmet needs among both cancer and non-cancer chronic disease patients and explore their need for PC. METHODS A cross-sectional, comparative, and multicenter design was conducted, involving 458 patients from eight hospitals, utilizing a self-reported Problems and Needs in Palliative Care-sv questionnaire. RESULTS The study included 276 (60.3%) patients with cancer and 182 (39.7%) with non-cancer chronic diseases. Most were 45-64 years old (n = 216, 47.2%). Patients with cancer reported a higher prevalence of physical symptoms, notably pain (n = 240, 87%) and anorexia (n = 192, 69.6%), while non-cancer patients faced more social challenges, including issues in companion relationships (n = 77, 42.3%) and discussing their disease with life companion (n = 78, 42.9%). Unmet needs were prevalent in both groups, with cancer patients having an average of 75.6% (n = 120) unmet needs, predominantly in the information (n = 145, 91.75%) and spiritual domains (n = 123, 77.8%). Non-cancer patients emphasized financial (n = 71, 66.6%) and autonomy (n = 59, 55.0%) problems. Moreover, patients in both groups with severe Charlson Comorbidity Index scores demonstrated significantly higher PC needs across all health domains. CONCLUSION The study highlights the universal demand for comprehensive PC for patients with both cancer and non-cancer chronic diseases. The findings underscore the need for enhanced PC provision, especially for patients with multiple comorbidities. Further research is needed to comprehensively address psychological, social, and spiritual problems in both patient groups.
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Affiliation(s)
- Malek Alnajar
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Muhammad Darawad
- School of Nursing, The University of Jordan, Amman, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Wejdan Khater
- Department of Adults Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Rashed Alshahwan
- Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan
| | - Sultan Mosleh
- Faculty of Nursing, Mutah University, Mu'tah, Jordan
| | - Basema Nofal
- Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
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Alnajar MK, Abdalrahim MS, Mosleh SM, Farhan M, Amro K, Darawad MW. The need of patients living with cancer for palliative care. Int J Palliat Nurs 2023; 29:236-245. [PMID: 37224093 DOI: 10.12968/ijpn.2023.29.5.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND A comprehensive assessment of patients' problems and needs is essential for all patients with chronic diseases, including cancer. AIM This study assesses the problems, unmet needs and requirement for palliative care (PC) among patients with cancer. METHOD A descriptive cross-sectional design was employed using a valid self-reported questionnaire. RESULTS On average, 62% of patients had problems that were unresolved. The need for patients to have more information about their health was identified (75.1%), followed by financial problems because of the illness and ability to afford healthcare (72.9%), and psychological issues, such as depression, anxiety and stress (67.1%). Patients stated that their spiritual needs were not being met (78.8%), and that they were experiencing psychological distress and problems with daily living that needed to be addressed through PC (78%, 75.1%, respectively). A chi-square test revealed that all problems are significantly associated with the need for PC (P<.001). CONCLUSION Patients needed more assistance in psychological, spiritual, financial and physical domains, and this can be provided by palliative care. Palliative care in low-income countries is a human right for patients with cancer.
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Affiliation(s)
- Malek Kh Alnajar
- Graduate Research and Teaching Assistant, University of Utah, United States
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Fan R, Yang S, Bu X, Chen Y, Wang Y, Shen B, Qiu C, Li X. Symptomatic Features and Factors Associated With Do-Not-Resuscitate Consent in Advanced Cancer Patients Admitted to Palliative Care Ward. Am J Hosp Palliat Care 2022; 39:1312-1324. [PMID: 35041534 DOI: 10.1177/10499091211068824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to conduct a retrospective cross-sectional study to investigate the prevalence of symptoms and symptom clusters on sociodemographic and disease characteristics, as well as factors associated with Do-Not-Resuscitate (DNR) consent. Advanced cancer patients were enrolled between 2018 and 2020 with available data. Demographic and clinical data were obtained for analysis from Hospital Information System (HIS) in China. Symptom clusters were extracted by hierarchical cluster analysis. Chi-square test and multiple logistic regression were conducted to investigate the prevalence characteristics of symptoms and influencing factors of DNR consent, respectively. 798 advanced cancer patients were enrolled. The most prevalent symptoms were pain (93%), anorexia (36.5%), and sleep disorders (34.2%). High heart rate was associated with poor performance status and more symptoms. Three clusters were extracted: fatigue-related, respiratory-circulatory system, and digestive system symptom clusters. The incidence of symptoms was statistically significant in age, gender, education level, residence, BMI, performance status, distress score, ADL, and primary pain level. The DNR signature rate was 15.5%. Female, distant metastasis, in-ward rescue, and appearance of dyspnea were independent influencing factors of DNR signature.Chinese hospitalized cancer patients had more symptoms burden that were influenced by various demographic characteristics, especially pain and fatigue-related symptoms. Concerning the trajectory of vital signs is important among advanced cancer patients. The DNR signature rate was lower and our finding indicating an urgency to accurately assess the prognosis and give more palliative care education to enhance DNR rates and early signing in Chinese context.
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Affiliation(s)
- Rongrong Fan
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Siyu Yang
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Xiaofan Bu
- 12570Xiangya Nursing School of Central South University, Changsha, China
| | - Yongyi Chen
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Ying Wang
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Boyong Shen
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Cuiling Qiu
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
| | - Xuying Li
- 117924Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya Nursing School of Central South University, Changsha, China
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Okati-Aliabad H, Ansari-Moghadam A, Mohammadi M, Kargar S, Shahraki-Sanavi F. The prevalence of anxiety and depression and its association with coping strategies, supportive care needs, and social support among women with breast cancer. Support Care Cancer 2021; 30:703-710. [PMID: 34365523 DOI: 10.1007/s00520-021-06477-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/28/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE Diagnosis of breast cancer and its treatment dramatically affects women's psychological health. This study investigated the prevalence of depression and anxiety and their related factor in breast cancer women. METHODS We conducted a cross-sectional study with a sample of 120 women with breast cancer in Zahedan, Iran, 2020. Data were collected using instruments included: Hospital Anxiety and Depression Scale (HADS), Supportive Care Needs Survey (SCNS-SF34), Multidimensional Scale of Perceived Social Support (MSPSS), The adjustment to illness measurement inventory for Iranian women with breast cancer (AIMI-IBC). We analyzed the data using the ANOVA, independent sample t-test, Kruskal Wallis, Mann-Whitney U test, Pearson's and Spearman's correlation coefficients. RESULTS The prevalence of depression and anxiety in women with breast cancer was 66.6% and 60%, respectively. A significant positive correlation was found between anxiety and depression and unmet psychological needs, care/support needs, and emotional turmoil coping strategy, while reasonable efforts and avoidance coping strategies and adjusting to disease were negatively correlated with anxiety and depression. Also, linear regression results indicated unmet psychological needs, emotional turmoil coping strategy, and a high level of depression predicted a high anxiety level. A lower level of depression was indicated by reasonable efforts strategy and less level of anxiety. CONCLUSIONS Women with breast cancer reported a high level of depression and anxiety in Zahedan, and clinicians should pay more attention to these patients' psychological distress. Resolving the unmet need of patients, increasing social support, and using the right coping strategy have an essential role in breast cancer women's psychological distress control.
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Affiliation(s)
- Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Mahdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shiva Kargar
- School of Health, Zahedan University of Medical Sciences, Zahedan, Iran.
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Malak MZ, Tawalbeh LI, Al-Amer RM. Depressive Symptoms among Older Jordanian Patients with Cancer Undergoing Treatment. Clin Gerontol 2021; 44:133-142. [PMID: 32924883 DOI: 10.1080/07317115.2020.1818660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To date, predictive and risk factors for depression among older patients with cancer have not been adequately studied in the Middle Eastern countries including Jordan. Therefore, this study aimed to assess the levels of depressive symptoms, anxiety, and hope among older Jordanian patients with cancer aged 60 years and over who are currently undergoing treatment, and to identify the relationship between selected factors (socio-demographic, treatment, and psychological) and depressive symptoms. METHODS A cross-sectional design was conducted on a convenience sample consisting of 150 patients with cancer from one of the biggest governmental hospitals in Jordan. RESULTS The findings revealed that almost 34% and 27% of the patients experienced anxiety and depression and had a moderate level of hope. Correlating factors with depression were age, duration of treatment, hope, anxiety, educational level, and health insurance. However, low duration of treatment, high anxiety, and low hope were the significant predictors of high depression. CONCLUSION Understanding the risk factors correlated with depression could help develop early interventions to enhance the psychological consequences for patients with cancer at risk for depression. CLINICAL IMPLICATIONS Health-care providers need to develop psychological care for older patients with cancer and interventions directed at minimizing depression. Also, nurses should focus on providing holistic care including physical, social, psychological, and spiritual dimensions. Depression care should be an important part of the comprehensive treatment care plan for older patients undergoing cancer treatment.
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Affiliation(s)
- Malakeh Z Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan , Amman, Jordan
| | - Loai I Tawalbeh
- Adult Health Nursing, Faculty of Nursing, Al-AlBayt University , Al-Mafraq, Jordan
| | - Rasmieh M Al-Amer
- Psychiatric Health Nursing, Faculty of Nursing, Isra' University , Amman, Jordan.,School of Nursing and Midwifery, Western Sydney University , Sydney, Australia
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Structured multi-disciplinary psychosocial care for cancer patients and the perceived quality of care from the patient perspective: a cluster-randomized trial. J Cancer Res Clin Oncol 2019; 145:2845-2854. [DOI: 10.1007/s00432-019-03018-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/03/2019] [Indexed: 10/26/2022]
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The Relationship Between Emotional Functioning of the EORTC QLQ-C30 and A Measure of Anxiety and Depression (HADS) in Cancer Patients. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.94568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mosleh SM. Health-related quality of life and associated factors in Jordanian cancer patients: A cross-sectional study. Eur J Cancer Care (Engl) 2018; 27:e12866. [PMID: 29863298 DOI: 10.1111/ecc.12866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 03/06/2018] [Accepted: 04/25/2018] [Indexed: 11/29/2022]
Abstract
Understanding the factors associated with patients' health-related quality of life along with their social networks can help identify who may benefit from supportive programmes. This study sought to evaluate the impact of a cancer diagnosis on Jordanian cancer patients' health-related quality of life and its relationship with social support and emotional status. A descriptive design was utilized, and 226 clients were participated. Participants completed European Organization for Research and Treatment of cancer quality of life questionnaire (EORTC-version 3), the Hospice Comfort Questionnaire, and the Hospital Anxiety and Depression scale. The results revealed that participants demonstrated unsatisfactory quality of life and many complained of fatigue. A multiple linear regression analysis revealed that social support, hospitalization readmission and being a nonsmoker were significant predictors for poor global quality of life score. In addition, a high educational level, less rehospitalization and high anxiety and depression scores were significant predictors for comfort level. In conclusion, patients with cancer are at an elevated risk of impaired physical functioning and report unsatisfactory quality of life, particularly if they are anxious, depressed and lack social support. The associated factors with decreased quality of life or low comfort level could be amenable to change with appropriate interventions.
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Affiliation(s)
- Sultan M Mosleh
- Department of Adult Nursing, Faculty of Nursing, Mutah University, Karak, Jordan
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