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Panicker P, Iype T, Appireddy R, Ajithan A, Lijimol AS, Sasikumar A, Dileep R, Vijaya N, Booth C, Rajagopal MR. Palliative care needs of stroke patients at a tertiary care center in South India. J Neurosci Rural Pract 2024; 15:349-356. [PMID: 38746512 PMCID: PMC11090594 DOI: 10.25259/jnrp_7_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/03/2024] [Indexed: 05/16/2024] Open
Abstract
Objectives Stroke survivors have palliative care needs in multiple domains, which are overlooked. Accurate estimation of these is pivotal in ensuring proper rehabilitation and planning interventions to improve quality of life (QoL). We aimed to assess the palliative care needs of stroke patients in various domains in a structured manner at the neurology service of a tertiary care center in South India. Materials and Methods Seventy-five consecutive stroke patients presenting to the neurology service were recruited over six months with assessment across various domains including symptom burden, physical domain, activities of daily living (ADL), psychiatric/psychological domain, and QoL at baseline and with follow-up at one month and three months. Results Despite improvement in the conventional stroke impairment measures among stroke survivors, there were significant unmet needs across various domains; 98% were severely or entirely dependent on ADL at three-month follow-up; and pain and insomnia were the most frequent (33% incidence) troubling symptoms encountered. There were substantial mental health related issues. The QoL measurement tools employed were the stroke impact assessment questionnaire (SIAQ), a novel tool and the World Health Organization Quality Of Life Brief Version (WHO-QOL-BREF). SIAQ scores at one month showed that 19 patients (42.22%) had their QoL severely affected, and 36 patients (80%) showed the same trend at the three-month follow-up. WHO-BREF scores showed that 27 (62%) did not report good QoL, and 32 (73%) were found not to be satisfied with their health at a one-month follow-up. Conclusion There is a significant burden of unmet palliative care needs among stroke survivors in India across various domains.
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Affiliation(s)
- Praveen Panicker
- Department of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Thomas Iype
- Department of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Ramana Appireddy
- Department of Neurology, Queens University, Queens University School of Medicine, Kingston, Ontario, Canada
| | - Ayana Ajithan
- Department of Palliative Care, Pallium India, Thiruvananthapuram, Kerala, India
| | - A. S. Lijimol
- Department of Palliative Care, Pallium India, Thiruvananthapuram, Kerala, India
| | - Asha Sasikumar
- Department of Nursing, Government Medical College Thiruvananthapuram, Medical College, Thiruvananthapuram, Kerala, India
| | - R. Dileep
- Department of Neurology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Nirmala Vijaya
- Department of Palliative Care, Pallium India, Thiruvananthapuram, Kerala, India
| | - Chris Booth
- Department of Oncology, Queens University, Queens University School of Medicine, Kingston, Ontario, Canada
| | - M. R. Rajagopal
- Department of Palliative Care, Pallium India, Thiruvananthapuram, Kerala, India
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Prevalence and risk factors of cancer-related fatigue: A systematic review and meta-analysis. Int J Nurs Stud 2020; 111:103707. [DOI: 10.1016/j.ijnurstu.2020.103707] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 06/02/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022]
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Symptom prevalence and management in older adult patients in Lebanon. Palliat Support Care 2020; 17:464-471. [PMID: 30238866 DOI: 10.1017/s1478951518000676] [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: 11/12/2022]
Abstract
OBJECTIVE The purpose of this study is to explore symptoms and the effectiveness of their management in older adult palliative care candidates in Lebanon. The aims of this study were to: (1) determine symptom prevalence in Lebanese older adults who qualify for palliative care; (2) identify the severity and distress of symptoms; (3) identify the prevalence of symptom management and its efficacy; and (4) explore the relationship between overall symptom burden and its correlates. METHOD This study uses an observational cross-sectional design using convenience sampling (N = 203) to recruit older adults qualifying for palliative care from three major medical centers in Lebanon. RESULT The mean age of the sample was 78.61 years. The most prevalent symptoms were lack of energy (93.5%), worrying (83.2%), and pain (71.4%). Psychological symptoms had the highest mean scores, preceded only by the physical symptoms and lack of energy. The most treated symptoms were physical with pain having the highest treatment prevalence (91%). Although psychological symptoms were the most burdensome, they were poorly treated. Multiple regression analysis showed that symptom scores had significant positive associations with financial status, social functioning, and comorbidities; there was a negative association with age. SIGNIFICANCE OF RESULTS Lack of energy and psychological symptoms were the most prevalent, with the latter having the highest mean total symptom scores. Treatment was poor for psychological symptoms and effective for physical ones. Associations were found between age, comorbidity, financial problems, social functioning, and total physical and psychological mean symptom burden scores. More attention needs to be given to psychological symptoms and their management among older adults receiving palliative care.
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Al-Masri D, Wilbur K, Elazzazy S, Hassan AA, Wilby KJ. Law, Culture, and Fear: A Qualitative Study of Health Professionals' Perceptions of Narcotic Use Related to Cancer Pain. J Pain Palliat Care Pharmacother 2020; 34:55-62. [PMID: 32091944 DOI: 10.1080/15360288.2019.1704340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Studies have shown barriers to appropriate narcotic use in the Middle East have negatively impacted patient outcomes. This study aimed to explore health professionals' perspectives regarding opioid use for cancer patients in Qatar. Eight focus groups were conducted with physicians, pharmacists, and nurses. An eight-question topic guide framed discussions and targeted contextual barriers and cultural beliefs. Focus groups were audio-recorded and transcribed verbatim. Thematic analysis was used to identify the following themes: narcotic use process, patient-related factors, and healthcare professional-related factors. Laws and regulations were identified as major barriers to appropriate narcotic access, prescribing, and administration. Government-imposed restrictions on permitted dispensed quantities and associated paperwork impeded continuity of patient care and pain relief. The influence of a patient's culture underpinned patient-related barriers, including fear of addiction and family members discouraging opioid use. Fear of prescribing for patient addiction and accusation of inappropriate prescribing by authorities were identified as health professional-related barriers. Facilitators included patient and provider education, as well as the availability of specialized teams to assess and treat cancer-related pain. Findings show narcotic utilization is not simply influenced by a single factor or subset of factors but by a multitude of factors that can be both independent and interrelated.
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Affiliation(s)
- Dania Al-Masri
- Dania Al-Masri, BSc(Pharm), MSc(Pharm), is with the College of Pharmacy, Qatar University, Doha, Qatar; Kerry Wilbur, BSc(Pharm), ACPR, PharmD, MPH, is with the Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada; Shereen Elazzazy, BSc(Pharm), PharmD, is with the Department of Pharmacy - Clinical Services, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Azza A. Hassan, MB BCh, MSc, MD, is with the Supportive & Palliative Care Unit, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Kyle J. Wilby, BSP, ACPR, PharmD, PhD, is with the School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Kerry Wilbur
- Dania Al-Masri, BSc(Pharm), MSc(Pharm), is with the College of Pharmacy, Qatar University, Doha, Qatar; Kerry Wilbur, BSc(Pharm), ACPR, PharmD, MPH, is with the Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada; Shereen Elazzazy, BSc(Pharm), PharmD, is with the Department of Pharmacy - Clinical Services, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Azza A. Hassan, MB BCh, MSc, MD, is with the Supportive & Palliative Care Unit, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Kyle J. Wilby, BSP, ACPR, PharmD, PhD, is with the School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Shereen Elazzazy
- Dania Al-Masri, BSc(Pharm), MSc(Pharm), is with the College of Pharmacy, Qatar University, Doha, Qatar; Kerry Wilbur, BSc(Pharm), ACPR, PharmD, MPH, is with the Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada; Shereen Elazzazy, BSc(Pharm), PharmD, is with the Department of Pharmacy - Clinical Services, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Azza A. Hassan, MB BCh, MSc, MD, is with the Supportive & Palliative Care Unit, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Kyle J. Wilby, BSP, ACPR, PharmD, PhD, is with the School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Azza A Hassan
- Dania Al-Masri, BSc(Pharm), MSc(Pharm), is with the College of Pharmacy, Qatar University, Doha, Qatar; Kerry Wilbur, BSc(Pharm), ACPR, PharmD, MPH, is with the Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada; Shereen Elazzazy, BSc(Pharm), PharmD, is with the Department of Pharmacy - Clinical Services, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Azza A. Hassan, MB BCh, MSc, MD, is with the Supportive & Palliative Care Unit, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Kyle J. Wilby, BSP, ACPR, PharmD, PhD, is with the School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Kyle J Wilby
- Dania Al-Masri, BSc(Pharm), MSc(Pharm), is with the College of Pharmacy, Qatar University, Doha, Qatar; Kerry Wilbur, BSc(Pharm), ACPR, PharmD, MPH, is with the Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada; Shereen Elazzazy, BSc(Pharm), PharmD, is with the Department of Pharmacy - Clinical Services, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Azza A. Hassan, MB BCh, MSc, MD, is with the Supportive & Palliative Care Unit, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar; Kyle J. Wilby, BSP, ACPR, PharmD, PhD, is with the School of Pharmacy, University of Otago, Dunedin, New Zealand
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Kenny C, Regan J, Balding L, Higgins S, O'Leary N, Kelleher F, McDermott R, Armstrong J, Mihai A, Tiernan E, Westrup J, Thirion P, Walsh D. Dysphagia Prevalence and Predictors in Cancers Outside the Head, Neck, and Upper Gastrointestinal Tract. J Pain Symptom Manage 2019; 58:949-958.e2. [PMID: 31445137 DOI: 10.1016/j.jpainsymman.2019.06.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 06/23/2019] [Accepted: 06/24/2019] [Indexed: 01/14/2023]
Abstract
CONTEXT Dysphagia is usually associated with malignancies of the head, neck, and upper gastrointestinal tract but also occurs in those with tumors outside anatomic swallow regions. It can lead to aspiration pneumonia, malnutrition, reduced quality of life, and psychosocial distress. No studies have yet reliably described dysphagia prevalence in those with malignancies outside anatomic swallow regions. OBJECTIVE The objective of this study was to establish the prevalence and predictors of dysphagia in adults with solid malignancies outside the head, neck, and upper gastrointestinal tract. METHODS A cross-sectional, observational study using consecutive sampling was conducted. There were 385 participants (mean age 66 ± 12 years) with 21 different primary cancer sites from two acute hospitals and one hospice. Locoregional disease was present in 33%, metastatic in 67%. Dysphagia was screened by empirical questionnaire and confirmed through swallow evaluation. Demographic and clinical predictors were determined by univariate and multivariate binary regression. RESULTS Dysphagia occurred in 19% of those with malignancies outside anatomic swallow regions. Prevalence was 30% in palliative care and 32% in hospice care. Dysphagia was most strongly associated with cough, nausea, and worse performance status. It was also associated with lower quality of life and nutritional difficulties. CONCLUSION Dysphagia was common and usually undiagnosed before study participation. It occurred at all disease stages but coincided with functional decline. It may therefore represent a cancer frailty marker. Oncology and palliative care services should routinely screen for this symptom. Timely dysphagia identification and management may improve patient well-being and prevent adverse effects like aspiration pneumonia and weight loss.
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Affiliation(s)
- Ciarán Kenny
- Department of Clinical Speech and Language Studies, Trinity College, Dublin, Ireland; Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland.
| | - Julie Regan
- Department of Clinical Speech and Language Studies, Trinity College, Dublin, Ireland
| | - Lucy Balding
- Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
| | - Stephen Higgins
- Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
| | - Norma O'Leary
- Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
| | | | - Ray McDermott
- Tallaght University Hospital, Dublin, Ireland; Beacon Hospital, Dublin, Ireland
| | | | | | | | | | | | - Declan Walsh
- Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland; Department of Supportive Oncology, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina, USA
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Pedrosa TM, Martins TCDF, Souza ALLP, Silva DGF, Moura SF, Muzi CD, Guimarães RM. Avaliação clínica dos sintomas de pacientes com câncer de cabeça e pescoço. AVANCES EN ENFERMERÍA 2019. [DOI: 10.15446/av.enferm.v37n2.73149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objetivo: avaliar os sintomas mais frequentes apresentados pelos pacientes com câncer de cabeça e pescoço e fatores associados.Metodologia: trata-se de um estudo transversal realizado com 77 pacientes do serviço de cirurgia de cabeça e pescoço do Instituto Nacional de Câncer (Brasil). Foi utilizado o Memorial Symptom Assessment Scale (MSAS), adaptado ao Brasil. Foi avaliada a prevalência dos sintomas, bem como sua associação com variáveis demográficas e clínicas por meio dos testes de qui- quadrado e de ANOVA.Resultados: os sintomas mais prevalentes foram boca seca (62,5 %), tristeza (60 %), preocupações (53,75 %), nervosismo (48,75 %) e tosse (46,25 %). Quanto à faixa etária, identificou-se diferença nos sintomas físicos de baixa frequência (PHYS-L), com maior queixa entre os jovens (p < 0,01). Na escala global (TMSAS) houve queixa maior dos pacientes ambulatoriais comparados aos internados (p = 0,05). Houve, ainda, queixa maior de sintomas de baixa frequência entre pacientes sem metástase (p = 0,05).Conclusão: considerando-se a ocorrência de múltiplos sintomas no paciente oncológico, é necessário ter métodos que sejam capazes de avaliar, de forma mais ampla, os sintomas. Dessa forma, o enfermeiro terá melhor compreensão da complexidade dos grupos de sintomas, permitindo aperfeiçoar as intervenções clínicas no processo de enfermagem.
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Li Z, Aninditha T, Griene B, Francis J, Renato P, Serrie A, Umareddy I, Boisseau S, Hadjiat Y. Burden of cancer pain in developing countries: a narrative literature review. CLINICOECONOMICS AND OUTCOMES RESEARCH 2018; 10:675-691. [PMID: 30464561 PMCID: PMC6219110 DOI: 10.2147/ceor.s181192] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Cancer pain is one of the most common, feared, debilitating, and often undertreated symptoms among cancer patients. It needs attention since it has a significant impact on the quality of life (QoL) of the patients. Also, since cancer has emerged as a major health problem in developing countries, there is a need to strengthen preventive strategies for effective cancer pain management and provide comfort to cancer patients. Nonetheless, various barriers limit developing countries toward optimal cancer pain management. To bridge the gap between adequate pain management and burden of cancer pain in developing countries, a comprehensive understanding of the limitations faced and the prevalence of cancer pain should be addressed. The aim of this literature review is to provide a deeper understanding on the factors associated with cancer pain as well as barriers toward optimal cancer pain management in developing countries. Some of the barriers addressed were administrative, judicial, economic, and professional barriers. Also, estimates on the prevalence of cancer pain and detrimental effects of pain on the QoL of cancer patients have been addressed. In summary, pain, which is one of the most debilitating symptoms of cancer, remains uncontrolled and undertreated in developing countries. It has a profound impact on the patient’s QoL and can have physical, psychological, and social consequences; therefore, it needs to be managed urgently and appropriately. Most importantly, optimal treatment of cancer pain should be highlighted as a priority in developing countries and concerted efforts should be made to eliminate different barriers discussed in this review for effective and humane care.
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Affiliation(s)
- Zhang Li
- Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | | | | | | | - Paulo Renato
- Anesthesiology Service and Clinical Oncological IOC Group Pain, Brazil
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Kenny C, Gilheaney Ó, Walsh D, Regan J. Oropharyngeal Dysphagia Evaluation Tools in Adults with Solid Malignancies Outside the Head and Neck and Upper GI Tract: A Systematic Review. Dysphagia 2018; 33:303-320. [PMID: 29607447 DOI: 10.1007/s00455-018-9892-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 03/28/2018] [Indexed: 12/14/2022]
Abstract
Dysphagia is often associated with head and neck and upper gastrointestinal (GI) tract cancers. Evidence suggests that those with solid malignancies in other primary sites may also have swallowing difficulties. Timely and accurate identification of dysphagia is important given the impact it has on hydration, medical treatment, nutrition, prognosis, and quality of life. A systematic review was conducted to identify swallow screening, evaluation, and quality of life tools for those with solid malignancies outside the head and neck and upper GI tract. Ten electronic databases, one journal and two published conference proceedings were searched. Following deduplication, 7435 studies were examined for relevance. No tools were validated solely in this cancer population, though some included this group in larger cohorts. Comments are provided on the diagnostic properties and applicability of these tools. In the absence of appropriate diagnostic instruments, the exact prevalence of dysphagia and its impact on clinical and psychosocial well-being remain unknown. Accurate and adequate measurement of therapeutic intervention is also compromised. This review establishes the need for validated dysphagia evaluation tools for this clinical population.
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Affiliation(s)
- Ciarán Kenny
- Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Harold's Cross, Dublin 6W, Ireland.
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
| | - Órla Gilheaney
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin 2, Ireland
| | - Declan Walsh
- Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Harold's Cross, Dublin 6W, Ireland
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- School of Medicine & Medical Science, University College Dublin, Dublin 4, Ireland
| | - Julie Regan
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin 2, Ireland
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Hamieh NM, Akel R, Anouti B, Traboulsi C, Makki I, Hamieh L, Tfayli A. Cancer-Related Pain: Prevalence, Severity and Management in a Tertiary Care Center in the Middle East. Asian Pac J Cancer Prev 2018; 19:769-775. [PMID: 29582633 PMCID: PMC5980854 DOI: 10.22034/apjcp.2018.19.3.769] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Despite pain awareness and the development of treatment guidelines, cancer-related pain assessment and management remain suboptimal. Our objectives were to estimate the prevalence and severity of pain and its interference with daily activities, and evaluate adequacy of treatment in cancer patients in Lebanon. Methods: A total of 400 cancer patients aged 18 and above were interviewed at the American University of Beirut Medical Center surgical and medical oncology floors, outpatient clinics and chemotherapy units from March 2016-February 2017. The subjects covered were socio-demographics, clinical data, and presence of pain in the past month with use of the Brief Pain Inventory questionnaire. Descriptive statistics were conducted using t-test, chi-square and Fischer’s exact tests. Pearson’s correlation coefficients were used to examine relationships between pain severity and pain interference. Logistic regression was employed to determine risk factors for pain. Results: The majority of participants were Lebanese (76.0%), females (62.7%), married (80.2%), of Muslim faith (64.2%), of urban residence (85.8%), and with insurance plans (81.3%). Most had breast cancer (38.8%), were stage 4 (52.7%) and underwent a combination of surgery and systemic therapy (55.1%). The prevalence of pain in the past month was 29.8%. Among patients with pain, the highest proportion had moderate pain (37.8%) and around 46% received inadequate treatment. Conclusion: More awareness about cancer-related pain is needed to improve pain management and encourage referral to palliative care and pain specialists early-on in diagnosis of disease.
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Affiliation(s)
- Nadine M Hamieh
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Shi D, Li Z, Yang J, Liu BZ, Xia H. Symptom experience and symptom burden of patients following first-ever stroke within 1 year: a cross-sectional study. Neural Regen Res 2018; 13:1907-1912. [PMID: 30233063 PMCID: PMC6183032 DOI: 10.4103/1673-5374.239440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Symptoms that are multidimensional and concurrent should be assessed from different dimensions and managed together. Few studies have evaluated concurrent and multidimensional symptoms in patients with stroke. Most studies of stroke focused on dysfunctions and complications. We hypothesize that patients with stroke have a heavy symptom burden within 1 year. This study aimed to describe multidimensional and concurrent symptoms within 1 year after stroke. This study recruited 230 patients with stroke from the Rehabilitation Department of Xuhui District Center Hospital of Shanghai and the Shanghai Sunshine Rehabilitation Center in China from March to September 2017. The patients’ multidimensional symptom experience and symptom burden were analyzed using a self-made structured questionnaire and the influential factors for symptom burden were identified. The mean number of symptoms in patients with stroke was 11.7 ± 3.5. More than two thirds of the participants suffered from at least 10 co-occurring symptoms. Unilateral limb weakness had the highest prevalence and frequency. Participation restriction had the highest symptom dimensions of severity and distress. Lack of self-care ability (severity), memory deterioration (frequency), imbalance of body (distress), moodiness (distress), being unable to move limbs at will (distress), shoulder pain (distress), and slower response (frequency) were independent factors of the total symptom burden score. These findings can provide essential information for efficient symptom management of patients with stroke. This trial was registered with the ISRCTN registry (registration number: ISRCTN18421629).
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Affiliation(s)
- Dan Shi
- School of Nursing, Fudan University, Shanghai, China
| | - Zheng Li
- School of Nursing, Fudan University, Shanghai, China
| | - Jian Yang
- Xuhui District Center Hospital of Shanghai, Shanghai, China
| | - Bang-Zhong Liu
- Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Hui Xia
- School of Nursing, Fudan University, Shanghai, China
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Thiagarajan M, Chan CMH, Fuang HG, Beng TS, Atiliyana MA, Yahaya NA. Symptom Prevalence and Related Distress in Cancer Patients Undergoing Chemotherapy. Asian Pac J Cancer Prev 2016; 17:171-6. [PMID: 26838205 DOI: 10.7314/apjcp.2016.17.1.171] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Much has been done to examine the psychological impact of cancer treatment, but it remains unclear to what extent anxiety and depression is related to symptom prevalence. The present study concerned the characteristics and frequency of distress as related to symptom prevalence in cancer patients undergoing chemotherapy in Malaysia. MATERIALS AND METHODS Participants were 303 consecutive adult cancer patients undergoing chemotherapy in an academic medical center. The short form Memorial Symptom Assessment Scale (MSAS-SF), which covers three domains of symptoms (global distress, physical- and psychological symptoms) was used to cross-sectionally measure symptom frequency and associated distress via self-reporting. One-way ANOVA and t-tests were used to test mean differences among MSAS-SF subscale scores. RESULTS Complete data were available for 303 patients. The mean number of symptoms was 14.5. The five most prevalent were fatigue, dry mouth, hair loss, drowsiness and lack of appetite. Overall, symptom burden and frequency were higher than in other published MSAS-SF studies. Higher symptom frequency was also found to be significantly related to greater distress in cancer patients undergoing chemotherapy. CONCLUSIONS Patients undergoing chemotherapy suffer from multiple physical and psychological symptoms. Better symptom control or palliative care is needed. Greater frequency of reported symptoms may also indicate a subconscious bid by patients for care and reassurance - thus tailored intervention to manage distress should be offered.
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Affiliation(s)
- Muthukkumaran Thiagarajan
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia E-mail :
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Abu-Saad Huijer H, Sagherian K, Tamim H. Validation of the Arabic Version of the Memorial Symptom Assessment Scale Among Lebanese Cancer Patients. J Pain Symptom Manage 2015; 50:559-65. [PMID: 25242019 DOI: 10.1016/j.jpainsymman.2014.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 07/24/2014] [Accepted: 08/15/2014] [Indexed: 10/24/2022]
Abstract
CONTEXT To our knowledge, there have been no previous attempts to translate the Memorial Symptom Assessment Scale (MSAS) into the Arabic language and validate it among the Arab cancer population. OBJECTIVES The purpose of this study was to validate the MSAS in Arabic (MSAS-Leb) among 190 Lebanese oncology outpatients. METHODS The questionnaires were the MSAS-Leb and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Data were collected between 2009 and 2010 at a major teaching hospital in Lebanon. The psychometric indices used were reliability, convergent validity, principle component analysis, and confirmatory factor analysis (CFA). RESULTS The Cronbach's alpha coefficients for the MSAS and its subscales ranged from 0.71 to 0.83. On convergent validity testing, the psychological and global distress index subscales were moderately correlated (r > -0.50; P < 0.01) with the emotional functioning subscale of the EORTC QLQ-C30. Correlation coefficients between the MSAS items and selected subscales from the EORTC QLQ-C30 met the standards of convergent validity (r = -0.55 to 0.81; P < 0.01) except for the nausea/vomiting subscale. On principal component analysis (N = 95), four meaningful clusters were recovered. The clusters represented the psychological and physical components. CFA (N = 95) showed an acceptable model and a good fit (goodness-of-fit index = 0.59, adjusted goodness-of-fit index = 0.51, root mean square residual = 0.05, root mean square error of approximation = 0.2) with our data set. CONCLUSION The MSAS-Leb has acceptable psychometric properties of reliability and validity. We recommend its use in clinical practice and outpatient settings among health care professionals to assess and follow-up on symptom burden among patients diagnosed with cancer.
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Affiliation(s)
| | - Knar Sagherian
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
| | - Hani Tamim
- Biostatistics Unit, American University of Beirut, Beirut, Lebanon
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Nazik E, Ozdemir F, Soydan S. Social support and quality of life in Turkish patients with gynecologic cancer. Asian Pac J Cancer Prev 2015; 15:3081-6. [PMID: 24815451 DOI: 10.7314/apjcp.2014.15.7.3081] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The aim of this study was to determine the level of social support and quality of life in Turkish patients with gynecologic cancer using a cross-sectional survey design. A total of 108 patients admitted to the gynecologic oncology clinic at a university hospital from September 2011 to January 2012 were included. Data were collected using patient information forms, the Multidimensional Scale of Perceived Social Support (MSPSS) and The Quality of Life-Cancer Survivors Instrument (QOL-CS). Average age was 54.5±10.8 years and it was determined that 65.7% of patients had ovarian cancer and 19.4% had cervical cancer. The total QOL-CS mean score was 5.59±1.10. Average score of total MSPSS was found to be 69.7±14.64. Comparing socio-demographic and clinical characteristics of patients and average scores of QOL-CS and MSPSS, it was found that there was not a statisticaly significant corelation (p>0.05). Statistically significant relation was found between the average scores of QOL-CS and MSPSS. These results showed that quality of life was moderate and perceived social support was high in Turkish patients with gynecologic cancer.
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Affiliation(s)
- Evsen Nazik
- Obstetric and Gynecologic Nursing, Department of Nursing, Adana Health School, Cukurova University, Adana, Turkey E-mail :
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Opioid-taking self-efficacy affects the quality of life of Taiwanese patients with cancer pain. Support Care Cancer 2014; 23:2113-20. [DOI: 10.1007/s00520-014-2575-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 12/18/2014] [Indexed: 11/26/2022]
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Shao YJ, Ji K, Hao JL, Cheng XJ, Guan BQ, Liu WS, Wang K. Nonpain Symptom Prevalence and Intensity of Inpatients With Moderate to Severe Cancer Pain in China. Am J Hosp Palliat Care 2014; 33:448-55. [PMID: 25550408 DOI: 10.1177/1049909114565109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: To identify prevalence and severity of nonpain symptoms and to clarify possible influences on each nonpain symptom. Methods: The study used a descriptive survey design. Chinese version of the Edmonton Symptom Assessment System was used. Patients’ demographic and pain characteristics were collected. Results: The most common symptoms reported were loss of appetite (94.3%) followed by insomnia (93.3%), and tiredness (91.6%). Prevalence rates of nonpain symptom were all above 70% except “thinking clearly.” Prevalence and severity of nonpain symptoms varied by gender, age, primary cancer, and pain characteristics, especially intensity, number of breakthrough pain episodes per day, and number of pain sites. Conclusions: Most inpatients with cancer pain experienced concurrent nonpain symptoms. Comprehensive symptom assessment and intervention managing multiple symptoms are essential for these inpatients.
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Affiliation(s)
- Yue-Juan Shao
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, and Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China
| | - Kai Ji
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, and Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China
| | - Jian-Lei Hao
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, and Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China
| | - Xian-Jiang Cheng
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, and Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China
| | - Bing-Qing Guan
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, and Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China
| | - Wei-Shuai Liu
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, and Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China
| | - Kun Wang
- Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, and Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China
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Abu-Saad Huijer H, Sagherian K, Tamim H. Quality of life and symptom prevalence as reported by children with cancer in Lebanon. Eur J Oncol Nurs 2013; 17:704-10. [DOI: 10.1016/j.ejon.2013.09.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/27/2013] [Accepted: 09/17/2013] [Indexed: 11/29/2022]
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Cardoso F, Bese N, Distelhorst SR, Bevilacqua JLB, Ginsburg O, Grunberg SM, Gralla RJ, Steyn A, Pagani O, Partridge AH, Knaul FM, Aapro MS, Andersen BL, Thompson B, Gralow JR, Anderson BO. Supportive care during treatment for breast cancer: resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement. Breast 2013; 22:593-605. [PMID: 24001709 PMCID: PMC7442957 DOI: 10.1016/j.breast.2013.07.050] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 07/23/2013] [Indexed: 12/20/2022] Open
Abstract
Breast cancer patients may have unmet supportive care needs during treatment, including symptom management of treatment-related toxicities, and educational, psychosocial, and spiritual needs. Delivery of supportive care is often a low priority in low- and middle-income settings, and is also dependent on resources available. This consensus statement describes twelve key recommendations for supportive care during treatment in low- and middle-income countries, identified by an expert international panel as part of the 5th Breast Health Global Initiative (BHGI) Global Summit for Supportive Care, which was held in October 2012, in Vienna, Austria. Panel recommendations are presented in a 4-tier resource-stratified table to illustrate how health systems can provide supportive care services during treatment to breast cancer patients, starting at a basic level of resource allocation and incrementally adding program resources as they become available. These recommendations include: health professional and patient and family education; management of treatment related toxicities, management of treatment-related symptoms of fatigue, insomnia and non-specific pain, and management of psychosocial and spiritual issues related to breast cancer treatment. Establishing supportive care during breast cancer treatment will help ensure that breast cancer patients receive comprehensive care that can help 1) improve adherence to treatment recommendations, 2) manage treatment-related toxicities and other treatment related symptoms, and 3) address the psychosocial and spiritual aspects of breast cancer and breast cancer treatments.
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Affiliation(s)
| | - Nuran Bese
- Acibadem Maslak Hospital Breast Health, Istanbul, Turkey
| | | | | | - Ophira Ginsburg
- Women’s College Research Institute, Faculty of Medicine, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Steven M. Grunberg
- Multinational Association of Supportive Care in Cancer, Shelburne, Vermont, USA
| | | | - Ann Steyn
- Reach to Recovery International; Reach to Recovery South Africa, Cape Town. South Africa
| | - Olivia Pagani
- European School of Oncology and Institute of Oncology of Southern Switzerland, Viganello, Switzerland
| | | | - Felicia Marie Knaul
- Harvard Global Equity Initiative, Boston, Massachusetts, USA; Tómatelo a Pecho A.C., Mexico City, Mexico
| | | | | | - Beti Thompson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Julie R. Gralow
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Seattle Cancer Care Alliance, University of Washington, Seattle, Washington, USA
| | - Benjamin O. Anderson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Seattle Cancer Care Alliance, University of Washington, Seattle, Washington, USA
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Huijer HAS, Sagherian K, Tamim H. Validation of the Arabic version of the EORTC quality of life questionnaire among cancer patients in Lebanon. Qual Life Res 2012; 22:1473-81. [PMID: 22961075 DOI: 10.1007/s11136-012-0261-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 11/12/2022]
Abstract
PURPOSE The objective of this article was to evaluate the psychometric properties of the translated Lebanese Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 in a sample of adult cancer patients in Lebanon. METHODS The EORTC QLQ-C30 was translated into Lebanese Arabic and administered to a convenient sample of 200 adult patients diagnosed with cancer at a tertiary care center in Lebanon between 2009 and 2010. The psychometric indices assessed were reliability, multitrait scaling analysis, construct validity, and confirmatory factor analysis. RESULTS Six out of nine subscales had Cronbach's alpha coefficients above 0.70. Multitrait scaling analysis showed that all item-scale correlation coefficients met the set standards of convergent validity with the exception of item 5 only (95.8 %). In addition, 79.7 % of the item-scale correlation coefficients met the criterion for discriminant validity. In inter-scale correlations, all conceptually related scales had correlation coefficients of ≥ 0.40 with the exception of role functioning and fatigue scales having an undesirable correlation coefficient of -0.76. In known-groups comparison, the instrument differentiated significantly between some of the subscales with respect to education, employment, and age. CFA showed an almost good fit (GFI = 0.87) with respect to our current data set. CONCLUSION The translated Lebanese Arabic version of the EORTC QLQ-C30 is a reliable and valid instrument that can be used to assess the quality of life of Lebanese cancer patients.
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Affiliation(s)
- Huda Abu-Saad Huijer
- Hariri School of Nursing, American University of Beirut, Beirut, P.O. Box 11-0236, Lebanon.
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