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Linse K, Weber C, Reilich P, Schöberl F, Boentert M, Petri S, Rödiger A, Posa A, Otto M, Wolf J, Zeller D, Brunkhorst R, Koch J, Hermann A, Großkreutz J, Schröter C, Groß M, Lingor P, Machetanz G, Semmler L, Dorst J, Lulé D, Ludolph A, Meyer T, Maier A, Metelmann M, Regensburger M, Winkler J, Schrank B, Kohl Z, Hagenacker T, Brakemeier S, Weyen U, Weiler M, Lorenzl S, Bublitz S, Weydt P, Grehl T, Kotterba S, Lapp HS, Freigang M, Vidovic M, Aust E, Günther R. Patients' and caregivers' perception of multidimensional and palliative care in amyotrophic lateral sclerosis - protocol of a German multicentre study. Neurol Res Pract 2024; 6:34. [PMID: 38961496 PMCID: PMC11223310 DOI: 10.1186/s42466-024-00328-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/22/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION Amyotrophic lateral sclerosis (ALS) is an inevitably fatal condition that leads to a progressive loss of physical functioning, which results in a high psychosocial burden and organizational challenges related to medical care. Multidimensional and multiprofessional care is advised to meet the complex needs of patients and their families. Many healthcare systems, including Germany, may not be able to meet these needs because non-medical services such as psychological support or social counselling are not regularly included in the care of patients with ALS (pwALS). Specialised neuropalliative care is not routinely implemented nor widely available. Caregivers of pwALS are also highly burdened, but there is still a lack of support services for them. METHODS This project aims to assess the perceptions and satisfaction with ALS care in Germany in pwALS and their caregivers. This will be achieved by means of a cross-sectional, multicentre survey. The examination will assess, to which extend the patients' needs in the six domains of physical, psychological, social, spiritual, practical and informational are being met by current care structures. This assessment will be linked to mental well-being, subjective quality of life, attitudes toward life-sustaining measures and physician-assisted suicide, and caregiver burden. The study aims to recruit 500 participants from nationwide ALS centres in order to draw comprehensive conclusions for Germany. A total of 29 centres, mostly acquired via the clinical and scientific German Network for Motor Neuron Diseases (MND-NET), will take part in the project, 25 of which have already started recruitment. PERSPECTIVE It is intended to provide data-based starting points on how current practice of care in Germany is perceived pwALS and their caregivers and how it can be improved according to their needs. Planning and initiation of the study has been completed. TRIAL REGISTRATION The study is registered at ClinicalTrails.gov; NCT06418646.
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Affiliation(s)
- Katharina Linse
- University Hospital Carl Gustav Carus at Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
- German Center for Neurodegenerative Diseases Dresden, Tatzberg 41, 01307, Dresden, Germany.
| | - Constanze Weber
- University Hospital Carl Gustav Carus at Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Peter Reilich
- Department of Neurology with Friedrich-Baur-Institute, University Hospital, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, 81377, Munich, München, Germany
| | - Florian Schöberl
- Department of Neurology with Friedrich-Baur-Institute, University Hospital, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, 81377, Munich, München, Germany
| | - Matthias Boentert
- University Hospital Münster (UKM), Albert-Schweitzer-Campus 1, 48149, Münster, Germany
- Department of Medicine, UKM-Marienhospital Steinfurt, Mauritiusstr. 5, 48565, Steinfurt, Germany
| | - Susanne Petri
- Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | | | - Andreas Posa
- University Hospital Halle, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Markus Otto
- University Hospital Halle, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Joachim Wolf
- Deaconess Hospital Mannheim, Speyerer Strasse 91-93, 68163, Mannheim, Germany
| | - Daniel Zeller
- University Hospital Würzburg, Josef-Schneider-Strasse 11, 97080, Würzburg, Germany
| | - Robert Brunkhorst
- University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Jan Koch
- University Medical Center Göttingen, Robert-Koch-Strasse 40, 37075, Göttingen, Germany
| | - Andreas Hermann
- University Medical Center Rostock, Translational Neurodegeneration Section "Albrecht Kossel", Gehlsheimer Strasse 20, 18147, Rostock, Germany
- German Center for Neurodegenerative Diseases Rostock/Greifswald, Gehlsheimer Strasse 20, 18147, Rostock, Germany
| | | | - Carsten Schröter
- Hospital Hoher Meißner, Hardtstrasse 36, 37242, Bad Sooden-Allendorf, Germany
| | - Martin Groß
- Evangelic Hospital Oldenburg, Steinweg 13-17, 26122, Oldenburg, Germany
| | - Paul Lingor
- Klinikum rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
- German Center for Neurodegenerative Diseases Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
| | - Gerrit Machetanz
- Klinikum rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Luisa Semmler
- Klinikum rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Johannes Dorst
- University Hospital Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany
| | - Dorothée Lulé
- University Hospital Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany
| | - Albert Ludolph
- University Hospital Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany
| | - Thomas Meyer
- Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - André Maier
- Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Moritz Metelmann
- University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany
| | | | - Jürgen Winkler
- University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Berthold Schrank
- DKD Helios Clinic Wiesbaden, Aukammallee 33, 65191, Wiesbaden, Germany
| | - Zacharias Kohl
- University Hospital Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany
| | - Tim Hagenacker
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Svenja Brakemeier
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Ute Weyen
- BG University Hospital Bochum, Bürkle de la Camp-Platz 1, 44789, Bochum, Germany
| | - Markus Weiler
- Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Stefan Lorenzl
- Hospital Agatharied, Norbert-Kerkel-Platz, 83734, Hausham, Germany
- Institute of Palliative Care and Institute of Nursing Science, Paracelsus Medical University, Salzburg, Austria
- Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University (LMU), Marchioninistrasse 15, 81377, Munich, München, Germany
| | - Sarah Bublitz
- Hospital Agatharied, Norbert-Kerkel-Platz, 83734, Hausham, Germany
- Institute of Palliative Care and Institute of Nursing Science, Paracelsus Medical University, Salzburg, Austria
| | - Patrick Weydt
- University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Torsten Grehl
- Alfried-Krupp-Hospital Essen, Alfried-Krupp-Strasse 21, 45131, Essen, Germany
| | | | - Hanna-Sophie Lapp
- University Hospital Carl Gustav Carus at Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Maren Freigang
- University Hospital Carl Gustav Carus at Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Maximilian Vidovic
- University Hospital Carl Gustav Carus at Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Elisa Aust
- University Hospital Carl Gustav Carus at Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - René Günther
- University Hospital Carl Gustav Carus at Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
- German Center for Neurodegenerative Diseases Dresden, Tatzberg 41, 01307, Dresden, Germany.
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Huynh A, Adams K, Barnett-Tapia C, Kalra S, Zinman L, Yunusova Y. Accessing and Receiving Speech-Language Pathology Services at the Multidisciplinary Amyotrophic Lateral Sclerosis Clinic: An Exploratory Qualitative Study of Patient Experiences and Needs. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-13. [PMID: 37678221 DOI: 10.1044/2023_jslhr-23-00087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
PURPOSE This study sought to explore how patients with amyotrophic lateral sclerosis (ALS) presenting with coexisting bulbar and cognitive impairments and their caregivers experienced the speech-language pathologist (SLP) services provided in multidisciplinary ALS clinics in Canada and identified their perceived needs for bulbar symptom management. METHOD This qualitative study was informed by interpretive description. Seven interviews were conducted with patients with severe bulbar dysfunction or severe bulbar and cognitive dysfunction due to ALS or ALS-frontotemporal dementia, respectively, and/or their caregivers. Purposive sampling was used to recruit individuals with severe bulbar or bulbar and cognitive disease. Thematic analysis was used to analyze interview data. RESULTS Patients and caregivers reported difficulties with accessing and receiving SLP services at the multidisciplinary ALS clinic. These difficulties were further exacerbated in those with severe cognitive disease. Participants expressed a need for more specific (i.e., disease and service-related) information and personalized care to address their changing needs and preferences. Engaging caregivers earlier in SLP appointments was perceived as vital to support care planning and provide in-time caregiver education. CONCLUSIONS This study highlighted the challenges experienced by patients and caregivers in accessing and receiving SLP services. There is a pressing need for a more person-centered approach to ALS care and a continuing need for education of SLPs on care provision in cases of complex multisymptom diseases within a multidisciplinary ALS clinic. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24069222.
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Affiliation(s)
- Anna Huynh
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Ontario, Canada
| | | | | | - Sanjay Kalra
- Department of Medicine (Neurology), University of Alberta, Edmonton, Canada
| | - Lorne Zinman
- Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Yana Yunusova
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Ontario, Canada
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Young HM, Kilaberia TR, Whitney R, Link BM, Bell JF, Tonkikh O, Famula J, Oskarsson B. Needs of persons living with ALS at home and their family caregivers: A scoping review. Muscle Nerve 2023; 68:240-249. [PMID: 37248728 DOI: 10.1002/mus.27849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/31/2023]
Abstract
INTRODUCTION/AIMS Most persons with amyotrophic lateral sclerosis (ALS) live at home with support of family caregivers, with escalating complexity of care over the trajectory of the disease requiring resources and support to mitigate negative physical, social, and emotional outcomes. METHODS This scoping review identifies the home health/home care needs of persons with ALS and their caregivers as a basis for creating a home health medical standard. We used the PRISMA Extension for Scoping Reviews (PRISMA-ScR) to examine studies describing home care needs published between 2011 and 2021. RESULTS Our search yielded 481 articles, of which 44 were included with a total of 3592 (9-273) participants. Most studies used a cross-sectional design and 20 (45%) were rated as high quality. We grouped the needs identified as emotional/psychological, assistive devices and technology, information and education, and human resources and professional services. Most studies demonstrated persistent unmet needs and that available interventions were helpful while needs generally were not met proactively, despite the predictable trajectory. DISCUSSION This review describes biopsychosocial and equipment interventions over the trajectory of ALS with implications for anticipatory planning by clinicians, as well as policy for coverage of necessary services and supports. Interdisciplinary expert teams could develop consensus around needs across the trajectory and recommended services and supports. To make knowledge more accessible, encourage availability of services, and clarify the need for coverage of services, we aim to develop an expert consensus-based ALS home health medical standard guidance document in collaboration with the American Association of Neuromuscular and Electrodiagnostic Medicine.
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Affiliation(s)
- Heather M Young
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California, USA
| | - Tina R Kilaberia
- Silver School of Social Work, New York University, New York, New York, USA
| | - Robin Whitney
- Valley Foundation School of Nursing, San Jose State University, San Jose, California, USA
| | - Benjamin M Link
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California, USA
| | - Janice F Bell
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California, USA
| | - Orly Tonkikh
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California, USA
| | - Jessica Famula
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California, USA
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Wang X, Mo Y, Yuan Y, Zhou Y, Chen Y, Sheng J, Liu J. Exploring the influencing factors of unmet palliative care needs in Chinese patients with end-stage renal disease undergoing maintenance hemodialysis: a cross-sectional study. BMC Palliat Care 2023; 22:113. [PMID: 37543565 PMCID: PMC10403855 DOI: 10.1186/s12904-023-01237-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 07/29/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND The role of palliative care for end-stage renal disease (ESRD) patients have been proven in some developed countries, but it is still unclear in the mainland of China. In fact, patients with ESRD experience many unmet palliative care needs, such as physical, psychological, social and spiritual needs, but the factors influencing these needs have not investigated. METHODS A cross-sectional study was conducted at two hemodialysis centers in the mainland of China from January to September 2022. Convenience sampling was used to collect data on the participants' socio-demographics, clinical characteristics, the Palliative Care Outcome Scale (POS), the Dialysis Symptom Index (DSI), the Karnofsky Performance Status Scale (KPS), the Patient Health Questionnaire-9 item (PHQ-9), and the Social Support Rate Scale (SSRS). Data were analyzed using latent profile analysis, Kruskal-Wallis test, one-way analysis of variance (ANOVA), the chi-square test and multinomial logistic regression analysis. RESULTS Three hundred five participants were included in this study, and divided palliative care needs into three categories: Class 1, mild palliative care needs (n = 154, 50.5%); Class 2, moderate palliative care needs (n = 89, 29.2%); Class 3, severe palliative care needs (n = 62, 20.3%). Based on the analysis of three profiles, the influencing factors of unmet needs were further analyzed. Compared with Class 3, senior high school education, the household per capita monthly income < 2,000, low KPS scores, high PHQ-9 scores, and low SSRS scores were less likely to be in Class 1 (OR = 0.03, P = 0.012; OR = 0.003, P < 0.001; OR = 1.15, P < 0.001; OR = 0.55, P < 0.001; OR = 1.35, P = 0.002; respectively) and Class 2 (OR = 0.03, P = 0.007; OR = 0.05, P = 0.011; OR = 1.10, P = 0.001; OR = 0.60, P = 0.001; OR = 1.32, P = 0.003; respectively), and high symptom severity were less likely to be in Class 1 (OR = 0.82, P = 0.001). Moreover, compared with Class 1, the household per capita monthly income < 2,000 (OR = 16.41, P < 0.001), high symptom severity scores (OR = 1.12, P = 0.002) and low KPS scores (OR = 0.95, P = 0.002) were more likely to be in Class 2. CONCLUSIONS This study showed that almost half of ESRD patients receiving MHD presented moderate to severe palliative care needs, and the unmet needs were mainly affected by education level, financial pressure, functional status, symptom burden and social support. In the future, it is important to identify the populations with the greatest need for palliative care and consider the influencing factors of unmet needs from a comprehensive perspective, so as to help them improve health-related quality of life.
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Affiliation(s)
- Xuefei Wang
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China
| | - Yongzhen Mo
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China.
| | - Yingying Yuan
- School of Nursing, Department of Medicine, Soochow University, Suzhou, Jiangsu, China
| | - Yi Zhou
- School of Nursing, Department of Medicine, Soochow University, Suzhou, Jiangsu, China
| | - Yan Chen
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China
| | - Juan Sheng
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China
| | - Jing Liu
- Nanjing BenQ Medical Center, Nanjing, Jiangsu, China
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Ando H, Cousins R, Young CA. Flexibility to manage and enhance quality of life among people with motor neurone disease. Disabil Rehabil 2022; 44:2752-2762. [PMID: 33226867 DOI: 10.1080/09638288.2020.1846797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To identify influential factors for quality of life (QoL) among individuals with motor neurone disease (MND) and explore how regulatory flexibility and psychological flexibility may contribute towards maintaining and improving QoL. METHODS Semi-structured interviews were conducted with 26 individuals with MND. Thematic analysis, using both inductive and deductive analyses, was employed to examine subjective QoL in view of previous understanding of QoL. RESULTS Four factors were important for the QoL of participants: perceived illness prognosis, sense of self, concerns for significant others, and life to enjoy. These factors reflected psychological stress caused by MND, the participant's value system, and their beliefs about life. In optimising QoL, both regulatory flexibility and psychological flexibility were essential to maintain and enhance QoL. Often, regulatory flexibility was perceived among those employing a mindful approach, and psychological flexibility was found to involve savouring positive experiences. CONCLUSIONS People with MND reported that seeking ways to both maintain and enhance their QoL is crucial, and that this may be accomplished by increasing flexibility through mindfulness and savouring. (171/200 words)Implications for rehabilitationPeople with motor neurone disease (MND) seek to maintain quality of life (QoL) following changes caused by the condition, whilst attempting to enhance QoL by maximising their positive experiences.Regulatory flexibility is essential to maintain QoL and it was closely associated with mindful approach so that MND is not perceived as an inevitable threat to QoL.Psychological flexibility was found to enhance QoL and it involves savouring positive experiences, while abandoning fault-finding of the current situation.Positive inter-personal interactions can encourage people with MND to engage with mindfulness and savouring for favourable outcomes in terms of QoL; current support services should orient towards both mindfulness and savouring.
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Affiliation(s)
- Hikari Ando
- The Walton Centre NHS Foundation Trust, Liverpool, UK.,Department of Psychology, Liverpool Hope University, Liverpool, UK
| | - Rosanna Cousins
- Department of Psychology, Liverpool Hope University, Liverpool, UK
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Oh J, Moon S, Park K. Amyotrophic lateral sclerosis in social media: Content analysis of YouTube videos. Health Informatics J 2022; 28:14604582221105999. [PMID: 35726700 DOI: 10.1177/14604582221105999] [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]
Abstract
The purpose of this study is to analyze the characteristics, content, and quality of information available on YouTube regarding amyotrophic lateral sclerosis (ALS), and explore the search results and number of views and quality of the videos. A search was performed on YouTube on 10 June 2020, using the search term ''Lou Gehrig's disease" in the Korean language, and the first 100 videos were targeted for analysis. General characteristics (e.g., number of views, video length, etc.) were collected, and upload source, target audience, subject of the video, and quality of the videos using a global quality score (GQS) were assessed. About two-thirds of the videos were for the general public (62.0%), while the other third were made for patients and their families with ALS (38.0%). The mean GQS was 3.70 ± 1.42, and 60 videos were classified as high-quality videos. ALS-related videos on YouTube play a role in raising awareness among the general public of this devastating disease, however, practical information regarding disease management for patients and family is relatively insufficient. The quality and characteristics of the videos varied greatly and sometimes the lowest quality videos were shown in the top pages of search results.
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Affiliation(s)
- Juyeon Oh
- College of Nursing, 65383Dankook University, Cheonan, South Korea
| | - SeolHwa Moon
- College of Nursing, 26716Hanyang University, Seoul, South Korea
| | - Kyongok Park
- Department of Nursing, 34961Gangneung-Wonju National University, Wonju-si, South Korea
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Caregivers' View of Socio-Medical Care in the Terminal Phase of Amyotrophic Lateral Sclerosis-How Can We Improve Holistic Care in ALS? J Clin Med 2022; 11:jcm11010254. [PMID: 35011995 PMCID: PMC8745628 DOI: 10.3390/jcm11010254] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
Multidimensional socio-medical care with an early integration of palliative principles is strongly recommended in amyotrophic lateral sclerosis (ALS), but provided inconsistently. We conducted telephone interviews with 49 former caregivers of deceased ALS patients to examine their experience of care in the terminal phase including caregiver burden. Patients who received specialized palliative care (45% of patients) were more likely to die at home (p = 0.004) and without burdening symptoms (p = 0.021). The majority of caregivers (86%) reported deficits in socio-medical care. Most frequently mentioned were problems receiving medical aids (45%) and a lack of caregiver support (35%). A higher level of deficits experienced by caregivers was associated with negative health outcomes on the side of the caregivers (reported by 57% of them; p = 0.002) and stronger caregiver burden (p = 0.004). To provide good quality of dying to patients and reduce the burden on caregivers, multidimensional—including palliative—care in ALS urgently needs to be strengthened in the healthcare structures.
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Oh J, An J, Park K. Coping in people with amyotrophic lateral sclerosis and motor neuron disease: Systematic review. J Clin Nurs 2021; 30:1838-1853. [PMID: 33555628 DOI: 10.1111/jocn.15692] [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] [Received: 11/14/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To systematically review previous studies on the variables associated with coping strategies in people with amyotrophic lateral sclerosis and motor neuron disease (ALS/MND), such as demographics, clinical features and patient-reported outcomes. BACKGROUND Coping strategies are important factors for adjustment and quality of life (QOL) in patients with long-term conditions, and this topic in people with ALS/MND has not yet been the subject of a systematic review. DESIGN A systematic review was performed based on the PRISMA checklist. METHODS Electronic databases, including CINAHL, MEDLINE and EMBASE, were systemically searched from their inception to December 2019 for articles meeting the following inclusion criteria: (1) written in English, (2) published in peer-reviewed journals, (3) included subjects with ALS/MND and (4) used quantitative measurements of coping strategies in people with ALS/MND. RESULTS Twenty-one articles were included. Significant relationships between participants' demographics (age and sex) and any coping strategy aspect were shown in six studies. Eight studies found significant relationships between clinical characteristics (disease duration and physical functional status) and coping strategies, and ten studies reported coping strategies that were associated with patients' QOL and mental health outcomes. CONCLUSION Younger people used relatively more problem-focused, emotion-focused and social support coping strategies, and women used relatively more social support coping strategies. Problem-focused coping was generally related to better QOL and mental health, and emotion-focused coping was generally related to less depression. RELEVANCE TO CLINICAL PRACTICE As the pattern of coping strategies is related to demographic and clinical characteristics, this study could be used to inform the provision of patient-centred nursing in clinical care. Coping patterns are related to mental health and QOL; thus, in clinical care, it is recommended that people with ALS be encouraged to develop skills that enable them to cope more effectively and that their coping strategies be assessed.
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Affiliation(s)
- Juyeon Oh
- College of Nursing, Dankook University, Cheonan-si, South Korea
| | - Jiwon An
- Department of Nursing, Far East University, Eumseong-gun, South Korea
| | - Kyongok Park
- Department of Nursing, Gangneung-Wonju National University, Wonju-si, South Korea
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Quality of Life Structural Equation Model for Patients With Amyotrophic Lateral Sclerosis. Rehabil Nurs 2020; 46:253-261. [PMID: 32991398 DOI: 10.1097/rnj.0000000000000292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the study was to propose and test a quality of life model among Korean patients with amyotrophic lateral sclerosis (ALS) using structural equation modeling. DESIGN A cross-sectional study was performed. METHODS Data from 184 patients with ALS were collected from two university hospitals in Seoul and Busan, South Korea, between June and December 2018. FINDINGS The modified model indices indicated adequate data fit. Quality of life predictors were social support, physical functional status, depression, and general health perception. CONCLUSION This study improved the understanding of quality of life for Korean patients with ALS, including complex direct and indirect relationships among quality of life factors. CLINICAL RELEVANCE Depression was identified as the most influential factor in this population; hence, early assessment and timely intervention for depression are essential for better quality of life in patients with ALS.
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Jie Y, Wang Y, Chen J, Wang C, Lin Y, Hu R, Wu Y. Unmet supportive care needs and its relation to quality of life among adult acute leukaemia patients in China: a cross-sectional study. Health Qual Life Outcomes 2020; 18:199. [PMID: 32576289 PMCID: PMC7310469 DOI: 10.1186/s12955-020-01454-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/16/2020] [Indexed: 12/11/2022] Open
Abstract
Background Patients with acute leukaemia (AL) usually require prolonged periods of hospitalisation. The treatment and clinical symptoms may lead to patients’ supportive care needs (SCNs) not being met and impairs their quality of life (QoL). Studies on QoL and SCNs among AL patients are limited. This study aimed to identify the unmet SCNs and its relation to QoL of adult AL patients in China. Methods This multicentre cross-sectional study recruited 346 participants to complete a self-developed questionnaire, detailing demographic information and disease-related variables. A 34-item Supportive Care Needs Survey (SCNS-SF34) was used to identify unmet SCNs, and the Functional Assessment of Cancer Therapy-Leukaemia (FACT-Leu) questionnaire measured patients’ QoL. Results Unmet SCN rates for the 34 items ranged from17.6 to 81.7%. Patients’ needs were high for health systems and information, but low in the sexual domain. The results reveal nine factors associated with the unmet SCNs of adult AL patients, including marital status, original residence, age, education, occupation, other diseases, chemotherapy course, disease course, and treatment stage (p < 0.05). The total score of the FACT-Leu negatively correlated with the SCNS-SF34 in the physical/daily living (r = − 0.527, p < 0.01), psychological (r = − 0.688, p < 0.01), sexual (r = − 0.170, p < 0.01), patient care and support (r = − 0.352, p < 0.01), and health systems and information (r = − 0.220, p < 0.01) domains. Conclusions Adult AL patients exhibit a high demand for unmet SCNs, especially in the domain of health systems and information. There was a significant association between patients’ unmet SCNs and QoL. Future research should develop tailored interventions to address the unmet SCNs of adult AL patients, to further improve their QoL.
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Affiliation(s)
- Yan Jie
- School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China
| | - Ying Wang
- School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China
| | - Jingyi Chen
- School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China
| | - Chunfeng Wang
- School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China
| | - Yingchun Lin
- Department of Hematology, the First Affiliated Hospital of Fujian University, No. 20 of Chazhong Road, Taijiang District, Fuzhou City, 350004, Fujian Province, China
| | - Rong Hu
- School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China.
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China.
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