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Yılmaz Kara B, Toprak D, Kara E, Özçelik N, Özyurt S, Karadoğan D, Gümüş A, Şahin Ü. Caregiver Burden in Pulmonary Patients. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:400-412. [PMID: 35880439 DOI: 10.1080/01634372.2022.2103762] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/11/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
Caregiving has become an increasingly important medical and social issue in recent decades. We performed a cross-sectional study on pulmonary patients and accompanying informal caregivers who were hospitalized in the chest disease ward of a tertiary center in Turkey between January 2020 and April 2021. Informal caregivers were asked to complete the Zarit Caregiver Burden Interview. A total of 141 inpatients (39% female, mean age: 76.8 ± 10.2 years) and their informal caregivers (77% female, mean age: 54 ± 11.9 years) were evaluated. The caregivers were classified as light to medium burden (group 1, burden score ≤40) and medium to heavy burden (group 2, burden score >40). The mean burden score was 35.7 ± 13.3 points. The number of female caregivers was higher in group 2 (p = 0.025). There was a positive correlation between the burden score and female gender (p = 0.002) and the number of chronic diseases of caregivers (p = 0.020). Statistical analysis revealed a negative correlation between the burden score and the level of education (r = > -0.174, p = 0.040). Caregiver burden is related to the characteristics of the caregiver rather than those of the patient being cared for. Female caregivers with lower education and more than one chronic disease perceive a higher caregiver burden.
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Affiliation(s)
- Bilge Yılmaz Kara
- Department of Pulmonology, Recep Tayyip Erdoğan Univesity, Rize, Turkey
| | - Derya Toprak
- Department of Pulmonology, Recep Tayyip Erdoğan Univesity, Rize, Turkey
| | - Ekrem Kara
- Department of Nephrology, Recep Tayyip Erdoğan Univesity, Rize,Turkey
| | - Neslihan Özçelik
- Department of Pulmonology, Recep Tayyip Erdoğan Univesity, Rize, Turkey
| | - Songül Özyurt
- Department of Pulmonology, Recep Tayyip Erdoğan Univesity, Rize, Turkey
| | - Dilek Karadoğan
- Department of Pulmonology, Recep Tayyip Erdoğan Univesity, Rize, Turkey
| | - Aziz Gümüş
- Department of Pulmonology, Recep Tayyip Erdoğan Univesity, Rize, Turkey
| | - Ünal Şahin
- Department of Pulmonology, Recep Tayyip Erdoğan Univesity, Rize, Turkey
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Choratas A, Papastavrou E, Charalambous A, Kouta C. Developing and Assessing the Effectiveness of a Nurse-Led Home-Based Educational Programme for Managing Breathlessness in Lung Cancer Patients. A Feasibility Study. Front Oncol 2020; 10:1366. [PMID: 32983967 PMCID: PMC7492635 DOI: 10.3389/fonc.2020.01366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 06/29/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Breathlessness is the most common and refractory symptom in lung cancer patients. Even though various educational programmes have been developed, only a few were intended for implementation in the home setting for its management. Aim: Feasibility of a study for implementing a nurse-led educational programme for breathlessness management of lung cancer patients at home. Method: A randomized feasibility study was undertaken between February 2017 and October 2018. Patients were recruited through referral from oncologists from two oncology centers in Cyprus under certain inclusion and exclusion criteria. Patients were randomized in the intervention or control group via a computer programme, and their named family caregivers (f.c.) were allocated in the same group. Participants were not blinded to group assignment. The intervention consisted of a PowerPoint presentation and implementation of three non-pharmacological interventions. The control group received usual care. Patients were assessed for breathlessness, anxiety, and depression levels, whereas f.c. were assessed for anxiety, depression, and burden levels. F.c. also assessed patients' dyspnea level. The duration of the study process for both the intervention and control group was over a period of 4 weeks. Results: Twenty-four patients and their f.c. (n = 24) were allocated equally in the intervention and control group. Five patients withdrew, and the final sample entered analysis was 19 patients and 19 family caregivers. In the intervention group n = 11 + 11, and in the control group n = 8 + 8. In the intervention group patients' breathlessness and anxiety levels showed improvement and their f.c.s in the anxiety and burden levels. Major consideration was the sample size and the recruitment of the patients by the referring oncologists. Attrition was minor during the study process. No harm was recorded by the participants of the study. Conclusions: The study provided evidence of the feasibility of the implementation of the educational programme. For the future definitive study major consideration should be patients' recruitment method in order to achieve adequate sample size. Moreover, qualitative data should be collected in relation to the intervention and the involvement of f.c. The feasibility study was registered to the Cyprus Bioethics Committee with the registration number 2016/16. There was no funding of the study.
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Affiliation(s)
- Aristides Choratas
- Nursing Department, Cyprus University of Technology, Limassol, Cyprus
- *Correspondence: Aristides Choratas
| | | | - Andreas Charalambous
- Nursing Department, Cyprus University of Technology, Limassol, Cyprus
- Nursing Department, University of Turku, Turku, Finland
| | - Christiana Kouta
- Nursing Department, Cyprus University of Technology, Limassol, Cyprus
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Currow DC, Smith JM, Chansriwong P, Noble S, Nikolaidou T, Ferreira D, Johnson MJ, Ekström M. Missed opportunity? Worsening breathlessness as a harbinger of death: a cohort study. Eur Respir J 2018; 52:13993003.00684-2018. [DOI: 10.1183/13993003.00684-2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 07/12/2018] [Indexed: 12/13/2022]
Abstract
The aim of the study was to explore trajectories of breathlessness intensity by function and life-limiting illness diagnosis in the last 3 weeks of life in palliative care patients.A prospective, consecutive cohort study obtained point-of-care data of patients of Silver Chain Hospice Care Service (Perth, Australia) over the period 2011–2014 (n=6801; 51 494 data-points). Breathlessness intensity (0–10 numerical rating scale) and physical function (Australia-modified Karnofsky Performance Status (AKPS)) were measured at each visit. Time was anchored at death. Breathlessness trajectory was analysed by physical function and diagnosis using mixed effects regression.Mean±sdage was 71.5±15.1 years and 55.2% were male, most with cancer. The last recorded AKPS was >40 for 26.8%. Breathlessness was worst in people with cardiorespiratory disease and AKPS >40, and breathlessness in the last week of life increased most in this group (adjusted mean 2.92versusall others 1.51; p=0.0001). The only significant interaction was with diagnosis and function in the last week of life (p<0.0001).Breathlessness is more intense and increases more in people with better function and cardiorespiratory disease immediately before death. Whether there are reversible causes for these people should be explored prospectively. Omitting function from previous population estimates may have overestimated breathlessness intensity for many patients in the days preceding death.
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Brohard C. Initial Efficacy Testing of an Autobiographical Memory Intervention on Advance Care Planning for Patients With Terminal Cancer. Oncol Nurs Forum 2017; 44:751-763. [DOI: 10.1188/17.onf.751-763] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Michels CTJ, Boulton M, Adams A, Wee B, Peters M. Psychometric properties of carer-reported outcome measures in palliative care: A systematic review. Palliat Med 2016; 30:23-44. [PMID: 26407683 PMCID: PMC4708617 DOI: 10.1177/0269216315601930] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Informal carers face many challenges in caring for patients with palliative care needs. Selecting suitable valid and reliable outcome measures to determine the impact of caring and carers' outcomes is a common problem. AIM To identify outcome measures used for informal carers looking after patients with palliative care needs, and to evaluate the measures' psychometric properties. DESIGN A systematic review was conducted. The studies identified were evaluated by independent reviewers (C.T.J.M., M.B., M.P.). Data regarding study characteristics and psychometric properties of the measures were extracted and evaluated. Good psychometric properties indicate a high-quality measure. DATA SOURCES The search was conducted, unrestricted to publication year, in the following electronic databases: Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, PubMed, PsycINFO, Social Sciences Citation Index and Sociological Abstracts. RESULTS Our systematic search revealed 4505 potential relevant studies, of which 112 studies met the inclusion criteria using 38 carer measures for informal carers of patients with palliative care needs. Psychometric properties were reported in only 46% (n = 52) of the studies, in relation to 24 measures. Where psychometric data were reported, the focus was mainly on internal consistency (n = 45, 87%), construct validity (n = 27, 52%) and/or reliability (n = 14, 27%). Of these, 24 measures, only four (17%) had been formally validated in informal carers in palliative care. CONCLUSION A broad range of outcome measures have been used for informal carers of patients with palliative care needs. Little formal psychometric testing has been undertaken. Furthermore, development and refinement of measures in this field is required.
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Affiliation(s)
- Charlotte T J Michels
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Mary Boulton
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Astrid Adams
- Sir Michael Sobell House, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Bee Wee
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK Sir Michael Sobell House, Oxford University Hospitals NHS Trust, Oxford, UK Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Pottie CG, Burch KA, Thomas LPM, Irwin SA. Informal caregiving of hospice patients. J Palliat Med 2015; 17:845-56. [PMID: 24992371 DOI: 10.1089/jpm.2013.0196] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Informal caregivers play a critical role in the provision of care to hospice patients. The care they provide often impacts their physical and psychological well-being. OBJECTIVE This study synthesized 58 articles pertaining to informal hospice caregiving, focusing on caregivers' satisfaction with hospice services, the physical and psychological well-being of caregivers, the predictors of caregivers' well-being, the direct impact of hospice services on caregivers, and the effectiveness of targeted interventions for hospice caregivers. METHOD A systematic literature review of journal articles published between 1985 and 2012 was conducted. RESULTS The studies reviewed found hospice caregivers to experience clinically significant levels of anxiety, depression, and stress; however, results for caregiver burden and quality of life were mixed. Caregivers' perceptions regarding the meaningfulness of care as well as their levels of social support were associated with enhanced psychological outcomes. CONCLUSIONS Beyond satisfaction with hospice services, the direct impact of standard hospice care on caregivers remains uncertain. Caregiver intervention studies have demonstrated promising outcomes signifying a need for additional investigations into hospice-specific interventions that improve caregiver outcomes. Additional research and resources are needed to assist hospice caregivers, with the ultimate goal of minimizing their psychiatric and physical morbidity and enhancing their caregiving and subsequent bereavement processes.
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Affiliation(s)
- Colin G Pottie
- 1 Department of Psychiatry, Dalhousie University , Capital District Health Authority, Halifax, Nova Scotia, Canada
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Boyden JY, Connor SR, Otolorin L, Nathan SD, Fine PG, Davis MS, Muir JC. Nebulized Medications for the Treatment of Dyspnea: A Literature Review. J Aerosol Med Pulm Drug Deliv 2015; 28:1-19. [DOI: 10.1089/jamp.2014.1136] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
| | | | | | - Steven D. Nathan
- Advanced Lung Disease & Transplant Program, Inova Fairfax Hospital, Falls Church, VA 22042
| | - Perry G. Fine
- Department of Anesthesiology, School of Medicine, Pain Research Center, University of Utah, Salt Lake City, UT 84108
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Kavalieratos D, Kamal AH, Abernethy AP, Biddle AK, Carey TS, Dev S, Reeve BB, Weinberger M. Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer. J Palliat Med 2014; 17:475-81. [PMID: 24588568 DOI: 10.1089/jpm.2013.0526] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND As the role of palliative care (PC) has yet to be clearly defined in patients with heart failure (HF), such patients may face barriers regarding PC referral. In order to maximally meet the needs of HF patients, it is necessary to understand how they compare to the classic PC population: patients with cancer. OBJECTIVE To characterize the unresolved symptom and treatment needs with which patients with HF and those with cancer present to PC. METHODS We used data from the Palliative Care Research Registry (PCRR), a repository of quality improvement data from three community-based PC organizations. We abstracted first PC visit data from the PCRR for patients with primary diagnoses of HF or cancer seen between 2008 and 2012. We assessed the association of primary diagnosis (i.e., HF or cancer) on three outcomes: unresolved symptoms, treatment gaps, and a composite indicator of symptom control and quality of life. Analyses included descriptive statistics and multivariate Poisson regression. RESULTS Our analytic sample comprised 334 patients with HF and 697 patients with cancer, the majority of whom were white and male. Compared to patients with cancer, patients with HF presented with fewer unresolved symptoms, both overall and at moderate/severe distress levels. Patients with HF more commonly reported moderately/severely distressful dyspnea (25% versus 18%, p=0.02), and more commonly experienced dyspnea-related treatment gaps (17% versus 8%, p<0.001). CONCLUSIONS Patients with HF possess care needs that are squarely within the purview of PC. Future work is needed to delineate how PC referral policies should be refined to optimize PC access for patients with HF.
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Affiliation(s)
- Dio Kavalieratos
- 1 Center for Research on Health Care, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
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Ahluwalia SC, Leos RL, Goebel JR, Asch SM, Lorenz KA. Provider approaches to palliative dyspnea assessment: implications for informatics-based clinical tools. Am J Hosp Palliat Care 2012; 30:231-8. [PMID: 22669935 DOI: 10.1177/1049909112448922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIM To understand provider practices around dyspnea assessment to inform the development of an electronic medical record (EMR)-based dyspnea assessment module in an inpatient palliative care consultation template. DESIGN Qualitative analysis of palliative care provider interviews. RESULTS Three themes emerged: (1) integration of patient self-report of breathlessness with a clinical observation of dyspnea; (2) identification of patients for dyspnea assessment based on perceived patient need; and (3) variability in preferences for and use of existing severity scales for dyspnea. CONCLUSIONS The assessment approaches described by providers underscore the challenge of developing an informatics tool that supports the natural clinical experience and facilitates standardized care. The complexity of the dyspnea assessment process and variation in provider practices necessitate a level of flexibility and choice to be built into a computer-based tool.
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Affiliation(s)
- Sangeeta C Ahluwalia
- Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, CA 90064, USA.
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Given BA, Given CW, Sherwood PR. Family and Caregiver Needs over the Course of the Cancer Trajectory. ACTA ACUST UNITED AC 2012; 10:57-64. [DOI: 10.1016/j.suponc.2011.10.003] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 10/03/2011] [Accepted: 10/11/2011] [Indexed: 11/30/2022]
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Currow DC, Smith J, Davidson PM, Newton PJ, Agar MR, Abernethy AP. Do the trajectories of dyspnea differ in prevalence and intensity by diagnosis at the end of life? A consecutive cohort study. J Pain Symptom Manage 2010; 39:680-90. [PMID: 20413056 DOI: 10.1016/j.jpainsymman.2009.09.017] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 09/17/2009] [Accepted: 09/28/2009] [Indexed: 11/30/2022]
Abstract
CONTEXT Breathlessness reportedly worsens as death approaches for many people, but the differences in intensity and time course between underlying causes are not well described. OBJECTIVES To determine differences in the intensity of breathlessness by diagnosis over time as death approaches in a consecutive cohort seen by a specialist palliative care service. METHODS Patients referred to Silver Chain Hospice Care Service over a period of four years (January 2004 to December 2007) had dyspnea evaluated at every clinical encounter until death. A numeric rating scale (NRS) was used to measure the intensity. Patients were categorized into five clusters (lung cancer, secondary cancer to lung, heart failure, end-stage pulmonary disease, and no identifiable cardiorespiratory cause) at three time points (60-53 [T(3)], 30-23 [T(2)], and 7-0 [T(1)] days before death [T(0)]). Group differences were assessed using analysis of variance. Joinpoint regression models defined significant changes in mean breathlessness intensity. RESULTS For 5,862 patients, data were collected an average of 20 times (median: 13; 116,982 data points) for an average of 86 days (median: 48). Breathlessness was significantly higher at all three time points in people with noncancer diagnoses. Breathlessness increased significantly at days 10 and 3 before death for people with cancer (P<0.001 for both), but remained unchanged, albeit significantly higher for patients with noncancer diagnoses. In the three months leading to death, the prevalence of "no breathlessness" decreased from 50% to 35%, and the proportion of patients with severe breathlessness (>7 out of 10) increased from 10% to 26%. CONCLUSION Prevalence of breathlessness increases rapidly at life's end, especially for people with primary lung cancer; the levels of breathlessness became close to those experienced by people with noncancer diagnoses despite symptom control measures.
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Affiliation(s)
- David C Currow
- Department of Palliative and Supportive Services, Flinders University, Bedford Park, South Australia, Australia.
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Currow DC, Agar M, Smith J, Abernethy AP. Does palliative home oxygen improve dyspnoea? A consecutive cohort study. Palliat Med 2009; 23:309-16. [PMID: 19304806 DOI: 10.1177/0269216309104058] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Palliative oxygen for refractory dyspnoea is frequently prescribed, even when the criteria for long-term home oxygen (based on survival, rather than the symptomatic relief of breathlessness) are not met. Little is known about how palliative home oxygen affects symptomatic breathlessness. A 4-year consecutive cohort from a regional community palliative care service in Western Australia was used to compare baseline breathlessness before oxygen therapy with dyspnoea sub-scales on the symptom assessment scores (SAS; 0-10) 1 and 2 weeks after the introduction of oxygen. Demographic and clinical characteristics of people who responded were included in a multi-variable logistic regression model. Of the study population (n = 5862), 21.1% (n = 1239) were prescribed oxygen of whom 413 had before and after data that could be included in this analysis. The mean breathlessness before home oxygen was 5.3 (SD 2.5; median 5; range 0-10). There were no significant differences overall at 1 or 2 weeks (P = 0.28) nor for any diagnostic sub-groups. One hundred and fifty people (of 413) had more than a 20% improvement in mean dyspnoea scores. In multi-factor analysis, neither the underlying diagnosis causing breathlessness nor the demographic factors predicted responders at 1 week. Oxygen prescribed on the basis of breathlessness alone across a large population predominantly with cancer does not improve breathlessness for the majority of people. Prospective randomised trials in people with cancer and non-cancer are needed to determine whether oxygen can reduce the progression of breathlessness compared to a control arm.
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Affiliation(s)
- D C Currow
- Department of Palliative and Supportive Services, Flinders University, Bedford Park, South Australia, Australia.
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Thomas LA. Effective dyspnea management strategies identified by elders with end-stage chronic obstructive pulmonary disease. Appl Nurs Res 2009; 22:79-85. [DOI: 10.1016/j.apnr.2007.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2006] [Revised: 04/27/2007] [Accepted: 04/29/2007] [Indexed: 11/30/2022]
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Currow DC, Christou T, Smith J, Carmody S, Lewin G, Aoun S, Abernethy AP. Do Terminally Ill People who Live Alone Miss Out on Home Oxygen Treatment? An Hypothesis Generating Study. J Palliat Med 2008; 11:1015-22. [DOI: 10.1089/jpm.2008.0016] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- David C. Currow
- Department of Palliative and Supportive Services, Flinders University, Bedford Park, South Australia, Australia
| | - Toula Christou
- Southern Adelaide Palliative Services, Repatriation General Hospital, Daw Park, South Australia, Australia
| | - Joanna Smith
- Silver Chain Nursing Association, Perth, Western Australia
| | - Steve Carmody
- Silver Chain Nursing Association, Perth, Western Australia
| | - Gill Lewin
- Silver Chain Nursing Association, Perth, Western Australia
| | - Samar Aoun
- WA Center for Cancer and Palliative Care, Curtin University of Technology, Western Australia
| | - Amy P. Abernethy
- Department of Palliative and Supportive Services, Flinders University, Bedford Park, South Australia, Australia
- Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
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Wilder H, Parker Oliver D, Demiris G, Washington K. Informal Hospice Caregiving: The Toll on Quality of Life. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2008; 4:312-332. [PMID: 19779584 PMCID: PMC2749275 DOI: 10.1080/15524250903081566] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
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Henoch I, Bergman B, Gustafsson M, Gaston-Johansson F, Danielson E. The impact of symptoms, coping capacity, and social support on quality of life experience over time in patients with lung cancer. J Pain Symptom Manage 2007; 34:370-9. [PMID: 17616335 DOI: 10.1016/j.jpainsymman.2006.12.005] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2006] [Revised: 12/04/2006] [Accepted: 12/06/2006] [Indexed: 11/19/2022]
Abstract
The aims of the study were to investigate lung cancer patients' quality of life (QoL) over time in a palliative setting and to determine how QoL is influenced by symptoms, coping capacity, and social support. One hundred and five consecutive patients with incurable lung cancer were included. A comprehensive set of questionnaires was used at baseline, including the Assessment of Quality of Life at the End of Life, Cancer Dyspnea Scale, Visual Analog Scale of Dyspnea, Hospital Anxiety and Depression scale, Sense of Coherence Questionnaire, and Social Support Survey, of which the first four were used also at three, six, nine, and 12 months. Dyspnea, depression, and global QoL deteriorated over time. Performance status, anxiety, depression, components of dyspnea, pain, and the meaningfulness component of coping capacity correlated with global QoL at all, or all but one follow-up measurements. In a multivariate analysis with global QoL as the dependent variable, depression was a significant predictor at four out of five assessments, whereas coping capacity, anxiety, performance status, pain, and social support entered the model at one or two assessments. Emotional distress and coping capacity influence QoL and might be targets for intervention in palliative care.
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Affiliation(s)
- Ingela Henoch
- Institute of Health and Care Sciences and Department of Respiratory Medicine and Allergology, Sahlgrenska Academy at Göteborg University, Dr. Forselius gata 4, S-413 26 Göteborg, Sweden.
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Langeland E, Wahl AK, Kristoffersen K, Nortvedt MW, Hanestad BR. Quality of life among Norwegians with chronic mental health problems living in the community versus the general population. Community Ment Health J 2007; 43:321-39. [PMID: 17253145 DOI: 10.1007/s10597-006-9076-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Accepted: 11/21/2006] [Indexed: 10/23/2022]
Abstract
We used the Quality of Life Scale to assess quality of life among 107 Norwegians with chronic mental health problems (MHP) from the community health care system versus 1893 general population adults. The groups differed in quality of life, including broader life domains. Age and quality of life were more strongly positively correlated in the MHP group than in the general population. Mental symptoms (measured by the Symptom Checklist-90 Revised) and quality of life were strongly negatively correlated in the MHP group. Services for people with chronic MHP should focus on enhancing quality of life and on its role as an outcome variable.
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Affiliation(s)
- Eva Langeland
- Faculty of Health and Social Sciences, Bergen University College, Haugeveien 28, Bergen, 5005, Norway.
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Hampton DM, Hollis DE, Lloyd DA, Taylor J, McMillan SC. Spiritual needs of persons with advanced cancer. Am J Hosp Palliat Care 2007; 24:42-8. [PMID: 17347504 DOI: 10.1177/1049909106295773] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Spiritual needs, spiritual distress, and spiritual well-being of patients with terminal illnesses can affect their quality of life. The spiritual needs of patients with advanced cancer have not been widely studied. This study assessed the spiritual needs of 90 patients with advanced cancer who were newly admitted to hospice home care. They completed a demographic data form and the Spiritual Needs Inventory shortly after hospice admission. Scores could range from a low of 17 to a high of 85; study scores were 23 to 83. Results showed great variability in spiritual needs. Being with family was the most frequently cited need (80%), and 50% cited prayer as frequently or always a need. The most frequently cited unmet need was attending religious services. Results suggest the importance of a focus on the spiritual more than the religious in providing care to patients at the end of life.
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Affiliation(s)
- Diane M Hampton
- Clinical Pastoral Education Program, James A. Haley Veterans Hospital, Tampa, Florida, USA
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