Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Potter J, Hami F, Bryan T, Quigley C. Symptoms in 400 patients referred to palliative care services: prevalence and patterns. Palliat Med 2003;17:310-4. [PMID: 12822846 DOI: 10.1191/0269216303pm760oa] [Citation(s) in RCA: 189] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]

For:	Potter J, Hami F, Bryan T, Quigley C. Symptoms in 400 patients referred to palliative care services: prevalence and patterns. Palliat Med 2003;17:310-4. [PMID: 12822846 DOI: 10.1191/0269216303pm760oa] [Citation(s) in RCA: 189] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]

Number

Cited by Other Article(s)

Zanker T, Sacco J, Prota J, Palma M, Viola Lee KA, Wang RR, Liang Y, Cunningham J, Mackary M, Ovchinnikova P. Medical Marijuana for Pain Management in Hospice Care as a Complementary Approach to Scheduled Opioids: A Single Arm Study. Am J Hosp Palliat Care 2024;41:1002-1010. [PMID: 38100655 DOI: 10.1177/10499091231213359] [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] [Indexed: 12/17/2023] Open

Abstract

Background: Opioid therapy is critical for pain relief for most hospice patients but may be limited by adverse side effects. Combining medical cannabis with opioids may help mitigate adverse effects while maintaining effective pain relief. Aim: This single-arm study investigated the impact of combined medical cannabis/opioid therapy on pain relief, opioid dose, appetite, respiratory function, well-being, nausea, and adverse events in hospice inpatients. Design: Adult hospice inpatients using scheduled oral, parenteral, or transdermal opioids for pain were administered standardized oral medical cannabis, 40 mg CBD/1.5 mg THC or 80 mg CBD/3 mg THC. Descriptive statistics detailed demographic and clinical baseline characteristics, the Mann-Whitney test compared outcomes, and the longitudinal mixed effects regression model analyzed longitudinal effects of combined therapy. Setting/Participants: Sixty-six inpatients at The Connecticut Hospital, Inc. were assessed over 996 treatment days; average age was 68.2 ± 12.9 years, 90.9% were white. Cancer was the most common diagnosis. Results: The medical cannabis/opioid combination showed a significant longitudinal reduction in pain intensity (P = .0029) and a non-significant trend toward lower opioid doses. Well-being, appetite, nausea, and respiratory function showed non-statistically significant changes. Three patients (4.5%) experienced minor, reversible adverse events potentially related to medical cannabis. No serious or life-threatening adverse events were seen. Conclusion: Combination medical cannabis/opioid therapy showed statistically significant pain relief and may have the potential for reducing opioid dose and mitigating opioid toxicity, offering a safe pain management alternative to opioids alone for patients in end-of-life care settings, and warrants further investigation in larger controlled trials.

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Yamamoto A, Kessoku T, Ogata T, Jono T, Takahashi K, Tanaka K, Suzuki K, Takeda Y, Ozaki A, Kasai Y, Okubo N, Iwaki M, Kobayashi T, Misawa N, Yoshihara T, Suzuki A, Fuyuki A, Hasegawa S, Imajo K, Kobayashi N, Matsumoto M, Tamai N, Sanada H, Oyamada S, Ichikawa Y, Nakajima A. A Handheld Ultrasound Device Can Predict Constipation with Rectal Fecal Retention in a Palliative Care Setting. Diagnostics (Basel) 2024;14:1626. [PMID: 39125503 PMCID: PMC11311552 DOI: 10.3390/diagnostics14151626] [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: 05/27/2024] [Revised: 07/14/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open

Affiliation(s)

Atsushi Yamamoto Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.) Department of Gastroenterology, Fujisawa Syonandai Hospital, Fujisawa 252-0802, Japan
Takaomi Kessoku Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.) Department of Palliative Medicine, International University Health and Welfare, Narita Hospital, Narita 286-8520, Japan Department of Gastroenterology, International University Health and Welfare, Narita Hospital, Narita 286-8520, Japan
Tomoki Ogata Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
Tsumugi Jono Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
Kota Takahashi Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.) Department of Gastroenterology, Yokosuka General Hospital Uwamachi, Yokosuka 238-0017, Japan
Kosuke Tanaka Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.) Department of Palliative Medicine, International University Health and Welfare, Narita Hospital, Narita 286-8520, Japan Department of Gastroenterology, International University Health and Welfare, Narita Hospital, Narita 286-8520, Japan
Ko Suzuki Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
Yuma Takeda Department of Palliative Medicine, Yokohama City University, Yokohama 236-0004, Japan; (Y.T.); (Y.I.)
Anna Ozaki Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
Yuki Kasai Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
Naoki Okubo Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.) Department of Oncology, Yokohama City University, Yokohama 236-0004, Japan;
Michihiro Iwaki Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
Takashi Kobayashi Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
Noboru Misawa Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
Tsutomu Yoshihara Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
Akihiro Suzuki Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.) Department of Oncology, Yokohama City University, Yokohama 236-0004, Japan;
Akiko Fuyuki Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.) Department of Palliative Care, Shin-Yurigaoka General Hospital, Kawasaki 215-0026, Japan
Sho Hasegawa Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
Kento Imajo Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.) Department of Gastroenterology, Shin-Yurigaoka General Hospital, Kawasaki 215-0026, Japan
Noritoshi Kobayashi Department of Oncology, Yokohama City University, Yokohama 236-0004, Japan;
Masaru Matsumoto School of Nursing, Ishikawa Prefectural Nursing University, Kahoku 929-1210, Japan; (M.M.); (H.S.)
Nao Tamai Department of Nursing, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan;
Hiromi Sanada School of Nursing, Ishikawa Prefectural Nursing University, Kahoku 929-1210, Japan; (M.M.); (H.S.)
Shunsuke Oyamada Department of Biostatistics, JORTC Data Center, Tokyo 116-0013, Japan;
Yasushi Ichikawa Department of Palliative Medicine, Yokohama City University, Yokohama 236-0004, Japan; (Y.T.); (Y.I.) Department of Oncology, Yokohama City University, Yokohama 236-0004, Japan;
Atsushi Nakajima Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)

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Monsen RE, Lerdal A, Nordgarden H, Gay CL, Herlofson BB. A comparison of the prevalence of dry mouth and other symptoms using two different versions of the Edmonton Symptom Assessment System on an inpatient palliative care unit. BMC Palliat Care 2024;23:75. [PMID: 38493155 PMCID: PMC10943902 DOI: 10.1186/s12904-024-01405-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open

Phongtankuel V, Czaja S, Park T, Dignam R, Adelman R, Shah S, Vasquez F, Reid MC. Assessing the feasibility, acceptability, and preliminary efficacy of a novel symptom management care delivery intervention for caregivers receiving home hospice care: The I-HoME protocol. Contemp Clin Trials 2024;136:107389. [PMID: 37972753 PMCID: PMC10922463 DOI: 10.1016/j.cct.2023.107389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/17/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023]

Rojas-Concha L, Hansen MB, Petersen MA, Groenvold M. Symptoms of advanced cancer in palliative medicine: a longitudinal study. BMJ Support Palliat Care 2023;13:e415-e427. [PMID: 34162585 DOI: 10.1136/bmjspcare-2021-002999] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/05/2021] [Indexed: 11/03/2022]

Abstract

OBJECTIVES

This study aimed to examine the symptomatology of patients with advanced cancer at admittance to palliative care services and to investigate how the symptomatology changed during the first month, and whether these changes were associated with various patient characteristics.

METHODS

In a longitudinal study in Chile, outpatients with advanced cancer completed the questionnaires European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative Care and the Hospital Anxiety and Depression Scale. Prevalence and severity of symptoms and problems (S/Ps) at baseline were calculated. Differences in S/P scores from baseline to follow-up were calculated overall and according to patient characteristics. Multiple linear regression was used to study the associations between patient characteristics and changes in S/P scores.

RESULTS

At baseline, 201 patients answered the questionnaires and 177 completed the follow-up. Fatigue, pain and sleeping difficulties were the most prevalent S/Ps reported, and also had the highest mean scores at baseline. S/P scores at baseline varied significantly according to sex, age, civil status, residence, children, prior and current antineoplastic treatment. Emotional functioning, pain, sleeping difficulties, constipation and anxiety improved significantly during the first month of palliative care. Residence, cohabitation status, diagnosis and current antineoplastic treatment were associated with changes in S/P scores.

CONCLUSIONS

Patients reported moderate-to-severe levels of S/Ps at admittance to palliative care. Several S/Ps improved the first month. Certain patient characteristics were associated with changes in S/P scores. This information may guide clinicians to more effective interventions that can improve the quality of life of patients receiving palliative care.

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Zugaj MR, Züger A, Keßler J. [Factors influencing analgesic use patterns in patients with chronic tumor-associated pain. : A qualitative pilot study considering different groups of medications]. Schmerz 2023:10.1007/s00482-023-00765-y. [PMID: 37955709 DOI: 10.1007/s00482-023-00765-y] [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: 06/13/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 11/14/2023]

Abstract

BACKGROUND

Patients are surviving tumor diseases longer and longer due to the improvement of tumor-specific therapy and pain is a common symptom. The gold standard for tumor-associated chronic pain is multimodal therapy. Non-adherence causes high costs and may put patients at risk. The aim of this study was to investigate the adherence behavior and subjective treatment compliance of patients with tumor-associated chronic pain. The focus was on the patients' perspective. Different groups of medications, such as NOPA, opioids, co-analgesics and cannabinoids, as well as non-drug treatments were included.

METHODS

Semistructured guided interviews with 10 patients with chronic tumor pain were conducted within a qualitative research approach. The interviews were recorded and transcribed. The evaluation was using a focused content structuring interview analysis according to Kuckartz and Rädiker.

RESULTS

Five main categories were defined. The central category based on the research question was "Adherence behavior from the patient's perspective." The category "Medication therapy" formed the framework of the study. Other main categories were "History of illness", "Relationship with treatment providers" and "Attitudes and beliefs". A total of 77 additional subcategories were formed and interpreted. Adherence behavior from the patients' perspective differed between the different medication groups. A palliative setting influenced treatment decisions and adherence. The medication regimens used were complex and dynamic, especially when there were multiple practitioners involved. Furthermore, there was ambiguity in the use of cannabinoids. Non-drug therapies were marginalized by patients. From the point of view of the patients interviewed, it was not so much the treatment providers who influenced their adherence behavior, but rather their own experiences, attitudes, and convictions.

DISCUSSION

The study included all medication groups and non-drug therapies equally, complementing previous literature in a qualitative setting. Adherence factors known from previous research were reflected in the subjective perception of the group of patients with chronic pain after tumor diseases. Marginalization of non-medication methods could be explained by the fact that multimodal therapy approaches were too rarely constantly used and controlled in the phase of chronification. Therefore, drug and non-drug therapies should be applied even more consistently to patients with tumor-associated pain.

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Ribić R, Košanski T, Neuberg M, Meštrović T. Changes in hair cortisol levels and cognitive function among older patients in palliative care. Int J Palliat Nurs 2023;29:556-560. [PMID: 38039123 DOI: 10.12968/ijpn.2023.29.11.556] [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] [Indexed: 12/03/2023]

Shah K, Geller DA, Tohme S, Antoni M, Kallem CJ, Vodovotz Y, Ramanathan R, Naveen R, Geroni M, Devine L, Amin A, Kiefer GJ, Zandberg DP, Reyes V, Steel JL. Predictors and Consequences of Cancer and Non-Cancer-Related Pain in Those Diagnosed with Primary and Metastatic Cancers. Curr Oncol 2023;30:8826-8840. [PMID: 37887537 PMCID: PMC10605887 DOI: 10.3390/curroncol30100637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/08/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open

Abstract

OBJECTIVES

The aims of the study were to (1) describe types of pain in cancer patients, (2) examine the predictors and consequences of pain, (3) investigate the association between type of pain and survival, and (4) examine potential biological mediators of pain and survival.

METHODS

This was a secondary analysis of baseline data from patients diagnosed with cancer. Patients answered questionnaires that assessed sociodemographic characteristics, pain, depression, sleep, and fatigue. Blood was collected and cytokine assays were performed. Analysis of variance, Kaplan-Meier, and Cox regression survival analyses were used to test the aims.

RESULTS

Of the 779 patients diagnosed with cancer, the mean age was 63.5 years, 57.8% male, and 90.6% White. Of those who reported pain (total 70.3%), 46.5% stated their pain was cancer-related while 53.5% stated their pain was non-cancer-related. While both cancer and non-cancer-related pain was associated with depressive symptoms, fatigue, and sleep duration, those with cancer-related pain had significantly higher rates of depressive symptoms (F(1,516) = 21.217, p < 0.001) and fatigue (F(1,516) = 30.973, p < 0.001) but not poorer sleep (F(1,497) = 0.597, p = 0.440). After adjusting for sociodemographic, disease-related characteristics, depression, sleep duration, and morphine milligram equivalent, patient reports of cancer-related pain were significantly associated with poorer survival (HR = 0.646, 95% CI = 0.459-0.910, p = 0.012) compared to those with non-cancer-related pain, which was not associated with survival (HR = 1.022, 95% CI = 0.737-1.418, p = 0.896). Cytokines did not significantly mediate the link between pain and survival.

CONCLUSION

While nearly half of the pain reported was cancer-related, both types of pain resulted in greater symptom burden, but only cancer-related pain was associated with survival.

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Affiliation(s)

Kriti Shah Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
David A. Geller Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
Samer Tohme Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
Michael Antoni Department of Psychology, University of Miami, Coral Gables, FL 33124, USA;
Cramer J. Kallem Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
Yoram Vodovotz Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
Rekha Ramanathan Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
Raam Naveen Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
MacKenzie Geroni Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
LaNita Devine Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
Aarshati Amin Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)
Gauri J. Kiefer UPMC Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA; (G.J.K.); (D.P.Z.); (V.R.)
Dan P. Zandberg UPMC Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA; (G.J.K.); (D.P.Z.); (V.R.)
Vincent Reyes UPMC Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA; (G.J.K.); (D.P.Z.); (V.R.)
Jennifer L. Steel Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; (K.S.); (D.A.G.); (S.T.); (C.J.K.); (Y.V.); (R.R.); (R.N.); (M.G.); (L.D.); (A.A.)

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Chiaramonte R, Bonfiglio M, Caramma S, Condorelli R. The Role of Rehabilitation in the Treatment of Constipation in Oncological Patients. J Clin Med 2023;12:5083. [PMID: 37568485 PMCID: PMC10420032 DOI: 10.3390/jcm12155083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/26/2023] [Accepted: 07/30/2023] [Indexed: 08/13/2023] Open

Abstract

BACKGROUND

Chemotherapy, as well as opioid and antiemetic drugs, can contribute to constipation in oncological patients. This systematic review aims to analyse the potential of specific rehabilitation strategies and alternative strategies for improving constipation symptoms, with the goal of incorporating these strategies into a dedicated protocol for managing cancer-related constipation. This could potentially reduce the dosages of or eliminate the need for constipation medications.

METHODS

A systematic search was conducted on PubMed, Scopus and Web of Science. The review included studies analysing constipation complaints in cancer patients treated with rehabilitation, acupuncture and osteopathy.

RESULTS

The review included 16 studies in line with PRISMA and PICOS criteria. Most studies showed that physical exercise, abdominal massage, TENS, acupuncture and education on the correct defecation position positively impacted the management of constipation and quality of life in oncological patients. A physiotherapy program involving massages as well as aerobic and resistance training improved constipation in oncological women, regardless of age, sex and frailty. A combination of abdominal massage, abdominal muscle stretching and education on proper defecation position alleviated the severity of constipation and related depression. However, the outcomes regarding TENS were yet inconsistent. Another technique, becoming increasingly common for constipation, and demonstrating positive results, involved stimulating trigger points through acupressure and acupuncture. Conversely, osteopathic and superficial manipulations more frequently required constipation medications than did the other alternative approaches. However, no existing studies have proposed a specific protocol to manage cancer-related constipation.

CONCLUSIONS

The results of the studies confirm the positive influences of rehabilitation, osteopathy and acupuncture on constipation and pain in oncological patients. Nevertheless, further studies are required to establish the best type, timing and duration of treatment, as well as how the stage and location of the cancer and the cause of constipation (drug-induced or functional) impact the results.

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Tegenborg S, Fransson P, Martinsson L. The Abbey Pain Scale: not sufficiently valid or reliable for assessing pain in patients with advanced cancer. Acta Oncol 2023;62:953-960. [PMID: 37382384 DOI: 10.1080/0284186x.2023.2228992] [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: 04/26/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023]

Abstract

BACKGROUND

Patients with advanced cancer can be unable to verbalize their pain. The Abbey Pain Scale (APS), an observational tool, is used to assess pain in this setting, but has never been psychometrically tested for people with cancer. The aim of this study was to assess the validity, reliability, and the responsiveness of the APS to opioids for patients with advanced cancer in a palliative oncology care setting.

MATERIAL AND METHODS

Patients with advanced cancer and poor performance status, drowsiness, unconsciousness, or delirium, were assessed for pain using a Swedish translation of the APS (APS-SE) and, if possible, the Numeric Rating Scale (NRS). The assessments using APS were conducted simultaneously, but independently, by the same raters on two separate occasions, approximately one hour apart. Criterion validity was assessed by comparing the APS and NRS values using Cohen's kappa (κ). Inter-rater reliability was determined using the intraclass correlation coefficient (ICC), internal consistency using Cronbach's α, and responsiveness to opioids using the Wilcoxon signed-rank test.

RESULTS

Seventy-two patients were included, of whom n = 45 could rate their pain using the NRS. The APS did not detect any of the n = 22 cases of moderate or severe pain self-reported using the NRS. The APS at first assessment had a κ of 0.08 (CI: -0.06 to 0.22) for criterion validity, an ICC of 0.64 (CI: 0.43-0.78) for inter-rater reliability, and a Cronbach's α of 0.01 for internal consistency. The responsiveness to opioids was z = -2.53 (p = 0.01).

CONCLUSION

The APS was responsive to opioids but displayed insufficient validity and reliability and did not detect moderate or severe pain as indicated by the NRS. The study showed a very limited clinical use of the APS in patients with advanced cancer.

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Llamas-Ramos I, Alvarado-Omenat JJ, Rodrigo-Reguilón M, Llamas-Ramos R. Quality of Life and Side Effects Management in Cancer Treatment-A Cross Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023;20:1708. [PMID: 36767073 PMCID: PMC9914572 DOI: 10.3390/ijerph20031708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/13/2023] [Accepted: 01/15/2023] [Indexed: 06/18/2023]

Warth M, Stoffel M, Koehler F, Bardenheuer HJ, Kessler J, Ditzen B. Characteristics of salivary cortisol and alpha-amylase as psychobiological study outcomes in palliative care research. BMC Palliat Care 2022;21:226. [PMID: 36550454 PMCID: PMC9773457 DOI: 10.1186/s12904-022-01085-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/25/2022] [Indexed: 12/24/2022] Open

Abstract

BACKGROUND

Psychosocial interventions are rapidly emerging in palliative care. However, randomized trials often fail to provide evidence for their effectiveness with regard to patient-reported outcomes. Stress biomarkers could complement self-report data, but little is known about their feasibility, acceptance, and interpretability.

METHODS

Therefore, we designed a randomized crossover trial in which 42 patients in a palliative care unit participated in both a brief mindfulness intervention (MI) and a resting state control condition (CC) on two consecutive afternoons. On each day, we collected four saliva samples in 20-min intervals using Salivettes^© to determine salivary cortisol (sCort) and alpha-amylase (sAA) concentration levels. At all measurement points, self-rated well-being and stress as well as cardiovascular markers were assessed. Baseline measurements further included self-rated quality of life and clinician-rated functional status.

RESULTS

78.6% of the patients provided the maximum number of 8 saliva samples and 62.2% reported no subjective difficulties with the sampling procedures. 66.6% (sCort) and 69.6% (sAA) of all possible samples were finally included in the analysis. Xerostomia and nausea were the main reasons for missing data. Higher sCort levels were associated with higher heart rate and lower quality of life, functional status, and heart rate variability. Corticosteroid and sedative medication as well as time since last meal were identified as potential confounders. Regarding reactivity to the MI, we found an overall decrease in sCort levels over time (b = -.03, p = .01), but this effect did not differ significantly between the study conditions (b = .03, p = .21). sAA levels were higher in men than in women. Trajectories over time did not significantly differ between the two conditions (b = -.02, p = .80) and associations with other stress and health-related constructs were weak.

CONCLUSIONS

Findings indicate that sCort might serve as a psychobiological outcome in future palliative care trials. However, future research should refine the exact measurement and conceptualization strategies for sCort in palliative care research. High attrition rates should be expected in patients with xerostomia or nausea.

TRIAL REGISTRATION

Registered at the German Clinical Trials Registry (DRKS00013135) at 04/12/2017.

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Guenther M, Görlich D, Bernhardt F, Pogatzki-Zahn E, Dasch B, Krueger J, Lenz P. Virtual reality reduces pain in palliative care-A feasibility trial. BMC Palliat Care 2022;21:169. [PMID: 36195865 PMCID: PMC9533542 DOI: 10.1186/s12904-022-01058-4] [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: 03/17/2022] [Accepted: 09/21/2022] [Indexed: 11/20/2022] Open

Abstract

Background

Effective symptom control is a stated goal of palliative care (PC) to improve quality of life for terminally ill patients. Virtual reality (VR) provides temporary escapes from pharmacologically resistant pain and allows for experiences and journeys patients may not access in any other way. Enabling wishes through virtual worlds may also offer additional benefits such as controlling psychological and physical symptoms.

Aims

We investigated the feasibility of a single VR experience as a viable, satisfying, and effective tool for end-of-life pain relief for inpatients presenting palliative needs.

Design

This is an observational, single-arm and national single-center feasibility trial.

Methods

A one-time VR experience with a selection of several videos and games was offered to 45 inpatients receiving PC at Muenster University Hospital. Patients with brain tumors, brain metastases, seizures, motion sickness, claustrophobia, vertigo, hearing or visual impairment, or unable to consent were excluded. Primary outcome measured patient reported pain on a visual analogue scale (VAS). We also measured Karnofsky performance status, health-related quality of life (HRQOL) using the EQ-5D-5 L questionnaire, and the Pain Out Questionnaire for postoperative pain.

Results

We analyzed data from 21 women (52.5%) and 19 men (47.5%) at an average age of 51.9 (SD: 15.81) years. The mean Karnofsky score among the sample was 45.5 (SD: 14.97) and the HRQOL was 41.9 (SD: 23.08). While no serious side effects were reported during the intervention, three patients experienced nausea (7%), two headaches (5%), and three reported dry eyes (7%) afterwards. Significant pain reduction (baseline VAS 2.25 (SD: 0.4399)) was demonstrated during (VAS 0.7 (SD: 0.2983, p < 0.0001)), immediately after (VAS 0.9 (SD: 0.3354, p = 0.0001)) and one hour after the intervention (VAS 1.15 (SD: 0.4163, p = 0.0004)). More than 80% rated the VR experience as very good or good (85%, n = 34) and intended to make use of the device again (82.5%, n = 33). However, two participants (5%) also expressed sadness by becoming aware of old memories and previous opportunities that are gone.

Discussion

The present pilot study suggests that VR seems to be a feasible and effective tool for pain relief in PC. Its use encompasses the approach of a total pain and symptom therapy and enhances patients’ dignity and autonomy. Future research ought to include if and to what extent VR could reduce the necessity of pharmacological pain relief.

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Gil Herrero L, McNeely ML, Courneya KS, Castellanos Montealegre M, González Marquez AI, Pollan Santamaría M, Casla Barrio S. Safety, feasibility, and effectiveness of implementing supervised exercise into the clinical care of individuals with advanced cancer. Clin Rehabil 2022;36:1666-1678. [PMID: 35850600 DOI: 10.1177/02692155221114556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]

Abstract

OBJECTIVE

To evaluate the safety, feasibility, and preliminary effectiveness of implementing supervised exercise programming into the clinical care of individuals with advanced cancer.

DESIGN

Single group implementation feasibility study using a pre-posttest design.

SETTING

Exercise Oncology Unit of the Spanish Cancer Association (a cancer-specific community facility outside the hospital setting).

PARTICIPANTS

Adult individuals with advanced cancer profile involving advanced local cancer or distant metastases.

INTERVENTION

A 12-week, twice-weekly, supervised, clinic-based multi-component exercise program.

MAIN MEASURE

Paired t-tests were used to assess pre-post changes and analyses of covariance were used to compare effects based on selected participant characteristics.

RESULTS

Eighty-four individuals with advanced cancer completed the baseline assessment, with six participants withdrawing prior to the start of the program. Of the 78 participants, 17 dropped out, thus, a total of 61 completed the final assessment. Mean adherence was 82.5%. No serious adverse events occurred. Exercise significantly improved VO_2max by 5.2 mL·kg·min (p < 0.001), chest strength (p < 0.001), leg strength (p < 0.001), lean body mass (p = 0.003), skeletal muscle mass (p < 0.002), % body fat (p = 0.02), quality of life by 5.3 points (p = 0.009), fatigue by 3.2 points (p = 0.012), and physical activity by 1680 METs/week (p < 0.001).

CONCLUSIONS

Our clinically supervised and tailored exercise program involving moderate to vigorous intensity exercise was found to be feasible, safe, and effective for individuals with advanced cancer.

IMPLICATIONS FOR CANCER SURVIVORS

With proper screening and supervision, individuals with advanced cancer can benefit from tailored exercise oncology support as part of an overall therapeutic care plan.

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Mo J, Vickerstaff V, Minton O, Tavabie S, Taubert M, Stone P, White N. How effective is virtual reality technology in palliative care? A systematic review and meta-analysis. Palliat Med 2022;36:1047-1058. [PMID: 35635018 PMCID: PMC9248003 DOI: 10.1177/02692163221099584] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]

Chen M, Yang L, Yu H, Yu H, Wang S, Tian L, Liu S. Early Palliative Care in Patients With Non-Small-Cell Lung Cancer: A Randomized Controlled Trial in Southwest China. Am J Hosp Palliat Care 2022;39:1304-1311. [PMID: 35088602 DOI: 10.1177/10499091211072502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open

Sumimoto H, Hayashi K, Kimura Y, Nishikawa A, Hattori S, Hasegawa C, Morii H, Teramoto K, Morita S, Daigo Y. Factors Associated with Cancer-Related Pain Requiring High-Dose Opioid Use in Palliative Cancer Patients. Palliat Med Rep 2021;2:237-241. [PMID: 34927147 PMCID: PMC8675226 DOI: 10.1089/pmr.2021.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 11/22/2022] Open

Affiliation(s)

Hidetoshi Sumimoto Department of Medical Oncology, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Cancer Center, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Palliative Care Center, and Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
Komaki Hayashi Cancer Center, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Palliative Care Center, and Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
Yuri Kimura Cancer Center, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Palliative Care Center, and Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
Akihito Nishikawa Cancer Center, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Palliative Care Center, and Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
Seiko Hattori Cancer Center, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Palliative Care Center, and Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
Chiaki Hasegawa Department of Pharmacy, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
Hiroaki Morii Department of Pharmacy, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
Koji Teramoto Department of Medical Oncology, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Cancer Center, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Palliative Care Center, and Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
Sachiyo Morita Cancer Center, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Palliative Care Center, and Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
Yataro Daigo Department of Medical Oncology, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Cancer Center, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.,Palliative Care Center, and Shiga University of Medical Science Hospital, Otsu, Shiga, Japan

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Palliative Care of the Patient with Dementia. Dela J Public Health 2021;7:92-98. [PMID: 34604771 PMCID: PMC8482977 DOI: 10.32481/djph.2021.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open

Salmany SS, Rayyan M, Dabbous A, Mughrabi AE. Descriptive study of clinical pharmacist interventions in adult hospice and palliative care at a comprehensive oncology center in Jordan. J Oncol Pharm Pract 2021;28:1749-1753. [PMID: 34565251 DOI: 10.1177/10781552211040736] [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]

De Lazzari N, Niels T, Tewes M, Götte M. A Systematic Review of the Safety, Feasibility and Benefits of Exercise for Patients with Advanced Cancer. Cancers (Basel) 2021;13:cancers13174478. [PMID: 34503288 PMCID: PMC8430671 DOI: 10.3390/cancers13174478] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 12/15/2022] Open

Abstract

Simple Summary

Most advanced cancer patients suffer from severe symptoms due to cancer and medical treatment. Common symptoms are physical weakness, mental problems, and tiredness. Research has shown that exercise positively influences cancer-related side effects during and after treatment and longevity in cancer survivorship. However, exercise as a supportive therapy in advanced cancer patients is still not recommended in oncological guidelines. Therefore, the aim of this systematic review was to assess the safety, feasibility, and benefits of exercise for patients with advanced cancer. Based on the results of 14 included exercise intervention studies, we conclude that exercise is safe and feasible, seems to improve physical performance, and may lower symptoms like chronic tiredness. Early integration of exercise for advanced cancer patients should be considered as usual care as a supportive strategy.

Abstract

Exercise therapy is a common supportive strategy in curative cancer treatment with strong evidence regarding its positive effects on, for example, cancer-related fatigue, health- related quality of life, and physical function. In the field of advanced cancer patients, knowledge about exercise as a useful supportive strategy is missing. The aim of this systematic review was to evaluate the feasibility and safety of exercise interventions as well as its effects on lowering the symptom burden. We included randomized controlled trials and nonrandomized controlled trials with advanced cancer patients receiving any type of exercise intervention. After an extensive literature search (in accordance to PRIMSA guidelines) in PubMed, Cochrane Library, and SPORTDiscus, 14 studies including 940 participants with different cancer entities were eligible. The results indicated the safety of exercise. In total, 493 participants received exercise interventions, with nine adverse events and no severe adverse events. The median recruitment rate was 68.33%, and adherence to exercise intervention was 86%. Further research with a high-quality and larger sample size is needed to clarify the potential of exercise with advanced cancer patients. Different advanced cancer entities have distinguished symptoms, and future research should construct entities-specific trial populations to figure out the best supportive exercise interventions.

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Ergen M, Arikan F, Fırat Çetin R. Hiccups in Cancer Patients Receiving Chemotherapy: A Cross-Sectional Study. J Pain Symptom Manage 2021;62:e85-e90. [PMID: 33587996 DOI: 10.1016/j.jpainsymman.2021.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 11/30/2022]

Warth M, Koehler F, Brehmen M, Weber M, Bardenheuer HJ, Ditzen B, Kessler J. "Song of Life": Results of a multicenter randomized trial on the effects of biographical music therapy in palliative care. Palliat Med 2021;35:1126-1136. [PMID: 33876660 PMCID: PMC8188998 DOI: 10.1177/02692163211010394] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]

Abstract

BACKGROUND

Awareness for the importance of psychological and spiritual needs in patients with terminal diseases has increased in recent years, but randomized trials on the effects of psychosocial interventions are still rare.

AIM

To investigate the efficacy of the "Song of Life" music therapy intervention regarding the emotional and psycho-spiritual dimensions of quality of life.

DESIGN

Patients were randomly assigned to either "Song of Life" or a relaxation intervention. "Song of Life" is a novel three-session music therapy intervention working with a biographically meaningful song. Primary outcome was the improvement in psychological quality of life. Secondary outcomes included spiritual well-being, ego-integrity, momentary distress, and global quality of life and the explorative assessment of treatment satisfaction (patient and family member version). Intention-to-treat analysis was conducted including adjustment for multiple testing in secondary outcomes.

SETTING/PARTICIPANTS

Between December 2018 and August 2020, 104 patients receiving specialized palliative care were recruited from two palliative care wards.

RESULTS

No significant differences were found regarding psychological and global quality of life, but "Song of Life" participants reported significantly higher spiritual well-being (p = 0.04) and ego-integrity (p < 0.01), as well as lower distress (p = 0.05) than patients in the control group. Both patients' and family members' treatment satisfaction was higher after "Song of Life" with large between-group effect sizes on items asking for meaningfulness (d = 0.96) and importance (d = 1.00).

CONCLUSIONS

Our findings provide evidence that "Song of Life" is an effective and meaningful biographical music therapy intervention to facilitate psycho-spiritual integration in terminally ill patients.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS)-DRKS00015308 (date of registration: September 7th 2018).

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Gabriel LB, Rossetto EDM, Martins VB, Berbert MCB. Speech therapy aspects in patients’ palliative care. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/202123610421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open

Siemens W, Schönsteiner SS, Orellana-Rios CL, Schaekel U, Kessler J, Eschbach C, Viehrig M, Mayer-Steinacker R, Becker G, Gaertner J. Severe symptoms and very low quality-of-life among outpatients newly diagnosed with advanced cancer: data from a multicenter cohort study. Support Care Cancer 2020;28:5547-5555. [PMID: 32185557 PMCID: PMC7547028 DOI: 10.1007/s00520-020-05388-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/26/2020] [Indexed: 12/14/2022]

Basics of Pain Management in Hospice and Palliative Care. PHYSICIAN ASSISTANT CLINICS 2020. [DOI: 10.1016/j.cpha.2020.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]

Hansen MB, Petersen MA, Ross L, Groenvold M. Should analyses of large, national palliative care data sets with patient reported outcomes (PROs) be restricted to services with high patient participation? A register-based study. BMC Palliat Care 2020;19:89. [PMID: 32576171 PMCID: PMC7313093 DOI: 10.1186/s12904-020-00596-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 06/17/2020] [Indexed: 11/10/2022] Open

Gras M, Daguenet E, Brosse C, Beneton A, Morisson S. Art Therapy Sessions for Cancer Patients: A Single-Centre Experience. Oncology 2020;98:216-221. [DOI: 10.1159/000504448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 10/14/2019] [Indexed: 11/19/2022]

Psychosocial Interventions for Pain Management in Advanced Cancer Patients: a Systematic Review and Meta-analysis. Curr Oncol Rep 2020;22:3. [PMID: 31965361 PMCID: PMC8035102 DOI: 10.1007/s11912-020-0870-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]

Brinkman-Stoppelenburg A, Polinder S, Meerum-Terwogt J, de Nijs E, van der Padt-Pruijsten A, Peters L, van der Vorst M, van Zuylen L, Lingsma H, van der Heide A. The COMPASS study: A descriptive study on the characteristics of palliative care team consultation for cancer patients in hospitals. Eur J Cancer Care (Engl) 2019;29:e13172. [PMID: 31571338 DOI: 10.1111/ecc.13172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 07/03/2019] [Accepted: 09/04/2019] [Indexed: 12/25/2022]

Prevalence of palliative care patients in emergency departments. Wien Klin Wochenschr 2019;131:404-409. [PMID: 31375918 DOI: 10.1007/s00508-019-1530-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 10/26/2022]

Kupeli N, Chatzitheodorou G, Troop NA, McInnerney D, Stone P, Candy B. Expressive writing as a therapeutic intervention for people with advanced disease: a systematic review. BMC Palliat Care 2019;18:65. [PMID: 31375118 PMCID: PMC6676535 DOI: 10.1186/s12904-019-0449-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 07/25/2019] [Indexed: 11/26/2022] Open

Abstract

Background

Expressive writing involves writing about stressful or traumatic experiences. Despite trials in people with advanced disease, no systematic review to date has critiqued the evidence on expressive writing in this population. To synthesise the evidence of the effects of expressive writing on pain, sleep, depression and anxiety in people with advanced disease.

Methods

A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. CINAHL, CENTRAL, PsycINFO and PubMed were searched from January 1986 to March 2018. Other sources included clinical data registers and conference proceedings. Studies were included if they were randomised controlled trials that assessed the impact of an intervention involving expressive writing for adults with advanced disease and/or studies involving linguistic analysis on the expressive writing output. Methodological quality was assessed using the Cochrane risk of bias tool and the Mixed Methods Appraisal Tool. The Grading of Recommendations Assessment, Development and Evaluation tool was used to assess the level of evidence for the outcomes of interest. The protocol of this systematic review has been registered on PROSPERO (CRD42017058193).

Results

Six eligible studies with a total of 288 participants were identified, including four randomised controlled trials. All of the trials were in cancer and recruited predominantly women. None of the interventions were tailored to the population. Studies had methodological shortcomings and evidence was generally of low quality. Combined analysis of the four trials, involving 214 participants in total, showed no clear difference in the effect of expressive writing on sleep, anxiety or depression compared to an active control. Pain was not evaluated in the trials. In contrast, analysis of the four studies that included linguistic analysis alluded to linguistic mechanisms for potential effects.

Conclusion

Although the trial results suggest there is no benefit in expressive writing for people with advanced disease, the current evidence is limited. There is a need for more rigorous trials. It would be of benefit first to undertake exploratory research in trial design including how best to measure impact and in tailoring of the intervention to address the specific needs of people with advanced disease.

Trial registration

The protocol of this systematic review has been registered on PROSPERO, which can be accessed here (registration number: CRD42017058193).

Electronic supplementary material

The online version of this article (10.1186/s12904-019-0449-y) contains supplementary material, which is available to authorized users.

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Forbat L, Johnston N, Mitchell I. Defining 'specialist palliative care': findings from a Delphi study of clinicians. AUST HEALTH REV 2019;44:313-321. [PMID: 31248475 DOI: 10.1071/ah18198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/20/2019] [Indexed: 11/23/2022]

Abstract

Objective This study aimed to achieve consensus regarding what distinguishes specialist from non-specialist palliative care to inform service organisation and delivery to patients with life-limiting conditions. Methods A three-phase Delphi study was undertaken, involving qualitative interviews and two questionnaire cycles. Thirty-one clinicians (nurses, doctors and social workers) working with a wide range of patients participated in interviews, of whom 27 completed two questionnaire cycles. Results Consensus was gained on 75 items that define specialist palliative care and distinguish it from non-specialist palliative care. Consensus was gained that specialist palliative care clinicians have advanced knowledge of identifying dying, skills to assess and manage complex symptoms to improve quality of life, have advanced communication skills and perform distinct clinical practices (e.g. working with the whole family as the unit of care and providing support in complex bereavement). Non-specialist palliative care involves discussions around futile or burdensome treatments, and care for people who are dying. Conclusions Areas of connection were identified: clinicians from disease-specific specialties should be more involved in leading discussions on futile or burdensome treatment and providing care to people in their last months and days of life, in collaboration with specialists in palliative care when required. What is known about the topic? At present there is no evidence-based definition or agreement about what constitutes specialist palliative care (as opposed to palliative care delivered by non-specialists) in the Australian Capital Territory. An agreed definition is needed to effectively determine the workforce required and its clinical skill mix, and to clarify roles and expectations to mitigate risks in not adequately providing services to patients with life-limiting conditions. What does this paper add? This paper offers, for the first time, an evidence-based definition that distinguishes specialist palliative care from non-specialist palliative care. End of life care and bereavement support are not just the remit of specialist palliative care clinicians. Clinicians from beyond specialist palliative care should lead discussions about futile or burdensome treatment. What are the implications for practitioners? The findings of this study can facilitate implementation of palliative care strategies by enabling practitioners and patients to distinguish who should be delivering what care.

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Adeboye OO. Nonpain Symptom Management. Prim Care 2019;46:335-351. [PMID: 31375185 DOI: 10.1016/j.pop.2019.05.002] [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: 11/30/2022]

Goldman N, Frankenthaler M, Klepacz L. The Efficacy of Ketamine in the Palliative Care Setting: A Comprehensive Review of the Literature. J Palliat Med 2019;22:1154-1161. [PMID: 31090477 DOI: 10.1089/jpm.2018.0627] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open

Nkhoma K, Ahmed A, Alli Z, Sherr L, Harding R. Is symptom prevalence and burden associated with HIV treatment status and disease stage among adult HIV outpatients in Kenya? A cross-sectional self-report study. AIDS Care 2019;31:1461-1470. [PMID: 30913897 DOI: 10.1080/09540121.2019.1595514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]

Warth M, Koehler F, Weber M, Bardenheuer HJ, Ditzen B, Kessler J. "Song of Life (SOL)" study protocol: a multicenter, randomized trial on the emotional, spiritual, and psychobiological effects of music therapy in palliative care. BMC Palliat Care 2019;18:14. [PMID: 30700278 PMCID: PMC6354383 DOI: 10.1186/s12904-019-0397-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/21/2019] [Indexed: 01/04/2023] Open

Hong Kong Chinese Medicine Clinical Practice Guideline for Cancer Palliative Care: Pain, Constipation, and Insomnia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019;2019:1038206. [PMID: 30805017 PMCID: PMC6362507 DOI: 10.1155/2019/1038206] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 01/02/2019] [Indexed: 02/04/2023]

Potential quality indicators for seriously ill home care clients: a cross-sectional analysis using Resident Assessment Instrument for Home Care (RAI-HC) data for Ontario. BMC Palliat Care 2019;18:3. [PMID: 30626374 PMCID: PMC6325754 DOI: 10.1186/s12904-018-0389-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 12/27/2018] [Indexed: 11/10/2022] Open

Abstract

Background

Currently, there are no formalized measures for the quality of home based palliative care in Ontario. This study developed a set of potential quality indicators for seriously ill home care clients using a standardized assessment.

Methods

Secondary analysis of Resident Assessment Instrument for Home Care data for Ontario completed between 2006 and 2013 was used to develop quality indicators (QIs) thought to be relevant to the needs of older (65+) seriously ill clients. QIs were developed through a review of the literature and consultation with subject matter experts in palliative care. Serious illness was defined as a prognosis of less than 6 months to live or the presence of severe health instability. The rates of the QIs were stratified across Ontario’s geographic regions, and across four common life-limiting illnesses to observe variation.

Results

Within the sample, 14,312 clients were considered to be seriously ill and were more likely to experience negative health outcomes such as cognitive performance (OR = 2.77; 95% CI: 2.66–2.89) and pain (OR = 1.59; 95% CI: 1.53–1.64). Twenty subject matter experts were consulted and a list of seven QIs was developed. Indicators with the highest overall rates were prevalence of falls (50%) prevalence of daily pain (47%), and prevalence of caregiver distress (42%). The range in QI rates was largest across regions for prevalence of caregiver distress (21.5%), the prevalence of falls (16.6%), and the prevalence of social isolation (13.7%). Those with some form of dementia were most likely to have a caregiver that was distressed (52.6%) or to experience a fall (53.3%).

Conclusion

Home care clients in Ontario who are seriously ill are experiencing high rates of negative health outcomes, many of which are amenable to change. The RAI-HC can be a useful tool in identifying these clients in order to better understand their needs and abilities. These results contribute significantly to the process of creating and validating a standardized set of QIs that can be generated by organizations using the RAI-HC as part of normal clinical practice.

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Harder S, Herrstedt J, Isaksen J, Neergaard MA, Frandsen K, Sigaard J, Mondrup L, Jespersen BA, Groenvold M. The nature of nausea: prevalence, etiology, and treatment in patients with advanced cancer not receiving antineoplastic treatment. Support Care Cancer 2019;27:3071-3080. [PMID: 30610434 DOI: 10.1007/s00520-018-4623-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 12/18/2018] [Indexed: 01/24/2023]

The occurrence and risk factors of constipation in inpatient palliative care unit patients vs. nursing home residents. GASTROENTEROLOGY REVIEW 2018;13:299-304. [PMID: 30581504 PMCID: PMC6300848 DOI: 10.5114/pg.2018.79809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 04/25/2018] [Indexed: 01/06/2023]

Parry L. Can patient and carers' experiences shape services? BMJ Support Palliat Care 2018;9:287-290. [PMID: 30291104 DOI: 10.1136/bmjspcare-2018-001618] [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: 07/20/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 11/04/2022]

Liao P, Rossini K, Sauls R. Upper Extremity Subcutaneous Lymphatic Drainage "Lymphocentesis" for Symptom Relief in End-Stage Breast Cancer. Am J Hosp Palliat Care 2018;36:111-115. [PMID: 30099882 DOI: 10.1177/1049909118792179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open

Black A, McGlinchey T, Gambles M, Ellershaw J, Mayland CR. The 'lived experience' of palliative care patients in one acute hospital setting - a qualitative study. BMC Palliat Care 2018;17:91. [PMID: 29980197 PMCID: PMC6034290 DOI: 10.1186/s12904-018-0345-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/25/2018] [Indexed: 11/24/2022] Open

Abstract

Background

There is limited understanding of the ‘lived experience’ of palliative care patient within the acute care setting. Failing to engage with and understand the views of patients and those close to them, has fundamental consequences for future health delivery. Understanding ‘patient experience’ can enable care providers to ensure services are responsive and adaptive to individual patient need.

Methods

The aim of this study was to explore the ‘lived experience’ of a group of patients with palliative care needs who had recently been in-patients in one acute hospital trust in the north-west of England.

Qualitative research using narrative interviews was undertaken, and data was analysed using thematic analysis. A sample of 20 consecutive patients complying with the inclusion/exclusion criteria were recruited and interviewed.

Results

Patient Sample:

Of the 20 patients recruited, there was a fairly equal gender split; all had a cancer diagnosis and the majority were white British, with an age range of 43–87 years.

Findings from Interviews:

Overall inpatient experience was viewed positively. Individual narratives illustrated compassionate and responsive care, with the patient at the centre. Acts of compassion appeared to be expressed through the ‘little things’ staff could do for patients, i.e., time to talk, time to care, humanity and comfort measures. AHSPCT involvement resulted in perceived improvements in pain control and holistic wellbeing. However, challenges were evident, particularly regarding over-stretched staff and resources, and modes of communication, which seemed to impact on patient experience.

Conclusions

Listening to patients’ experiences of care across the organisation provided a unique opportunity to impact upon delivery of care. Further research should focus on exploring issues such as: why some patients within the same organisation have a positive experience of care, while others may not; how do staff attitudes and behaviours impact on the experience of care; transitions of care from hospital to home, and the role of social networks.

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Anneser J, Arenz V, Borasio GD. Neurological Symptoms in Palliative Care Patients. Front Neurol 2018;9:275. [PMID: 29922212 PMCID: PMC5996882 DOI: 10.3389/fneur.2018.00275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/09/2018] [Indexed: 12/25/2022] Open

Abstract

Background

Neurological expertise in palliative care may be required not only for patients with primary neurological disorders but also for patients with non-neurological diseases suffering from burdensome neurological symptoms. The aim of this study was to determine the prevalence of neurological diagnoses and symptoms in palliative care patients, as well as the related burden and impact on everyday life.

Methods

We analyzed retrospectively the medical records of 255 consecutive patients from a tertiary medical center, at the time point of referral to an inpatient palliative care consultation service. In addition, 100 patients prospectively answered a questionnaire which included the assessment of neurological symptoms, as well as numeric rating scales for quality of life, symptom-specific burden, and restrictions in everyday life.

Results

Forty-one patients (16%) suffered from a primary neurological disease. Most decisions regarding the termination of life-sustaining measures concerned this group (20/22, 91%). Neurological symptoms (excluding pain) were documented in 122 patients (48%) with an underlying non-neurological disease. In the questionnaire study, 98/100 patients reported at least one neurological or neuropsychiatric symptom, most frequently sleeping problems (N = 63), difficulty concentrating (N = 55), and sensory symptoms (N = 50). Vertigo/dizziness (N = 19) had the greatest impact on everyday life (7.57/10 ± 2.17) and the highest symptom-specific burden (7.14 ± 2.51). Difficulty concentrating (restrictions in everyday life/burden) and pain intensity were the only symptoms significantly correlated with quality of life (r = -0.36, p = 0.009/r = -0.32; p = 0.04; r = -0.327, p = 0.003).

Conclusion

Neurological diseases and symptoms are frequent among palliative care patients and are often associated with a high symptom burden, which may severely affect the patients' lives. It is thus of paramount importance to implement neurological expertise in palliative care.

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Kok M, van der Werff GFM, Geerling JI, Ruivenkamp J, Groothoff W, van der Velden AWG, Thoma M, Talsma J, Costongs LGP, Gans ROB, de Graeff P, Reyners AKL. Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs. BMC Palliat Care 2018;17:79. [PMID: 29793477 PMCID: PMC5967098 DOI: 10.1186/s12904-018-0331-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 05/08/2018] [Indexed: 01/23/2023] Open

Abstract

Background

Advance Care Planning (ACP) and its documentation, accessible to healthcare professionals regardless of where patients are staying, can improve palliative care. ACP is usually performed by trained facilitators. However, ACP conversations would be more tailored to a patient’s specific situation if held by a patient’s clinical healthcare team. This study assesses the feasibility of ACP by a patient’s clinical healthcare team, and analyses the documented information including current and future problems within the palliative care domains.

Methods

This multicentre study was conducted at the three Groningen Palliative Care Network hospitals in the Netherlands. Patients discharged from hospital with a terminal care indication received an ACP document from clinical staff (non-palliative care trained staff at hospitals I and II; specialist palliative care nurses at hospital III) after they had held ACP conversations. An anonymised copy of this ACP document was analysed. Documentation rates of patient and contact details were investigated, and documentation of current and future problems were analysed both quantitatively and qualitatively.

Results

One hundred sixty ACP documents were received between April 2013 and December 2014, with numbers increasing for each consecutive 3-month time period. Advance directives were frequently documented (82%). Documentation rates of current problems in the social (24%), psychological (27%) and spiritual (16%) domains were low compared to physical problems (85%) at hospital I and II, but consistently high (> 85%) at hospital III. Of 545 documented anticipated problems, 92% were physical or care related in nature, 2% social, 5% psychological, and < 1% spiritual. Half of the anticipated non-physical problems originated from hospital III.

Conclusions

Hospital-initiated ACP documentation by a patient’s clinical healthcare team is feasible: the number of documents received per time period increased throughout the study period, and overall, documentation rates were high. Nonetheless, symptom documentation predominantly regards physical symptoms. With the involvement of specialist palliative care nurses, psychological and spiritual problems are addressed more frequently. Whether palliative care education for non-palliative care experts will improve identification and documentation of non-physical problems remains to be investigated.

Electronic supplementary material

The online version of this article (10.1186/s12904-018-0331-3) contains supplementary material, which is available to authorized users.

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Affiliation(s)

Maaike Kok Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands.,Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands
Gertruud F M van der Werff Martini Hospital, Palliative Care Team, Van Swietenplein 1, Groningen, 9700 RM, The Netherlands
Jenske I Geerling Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands.,Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands
Jaap Ruivenkamp Ommelander Ziekenhuis Groningen, Palliative Care Team, Jachtlaan 50, Delfzijl, 9670 RA, The Netherlands
Wies Groothoff Ommelander Ziekenhuis Groningen, Palliative Care Team, Jachtlaan 50, Delfzijl, 9670 RA, The Netherlands
Annette W G van der Velden Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands.,Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands.,Martini Hospital, Palliative Care Team, Van Swietenplein 1, Groningen, 9700 RM, The Netherlands
Monique Thoma TSN Care Groningen, Dokter Stolteweg 60-66, Zwolle, 8002 LB, The Netherlands
Jaap Talsma Academic General Practice, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands
Louk G P Costongs Zonnehuisgroep Noord, Izarstraat 1, Zuidhorn, 9800 AB, The Netherlands
Reinold O B Gans Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands
Pauline de Graeff University of Groningen, University Medical Center Groningen, Department of Internal Medicine, University Center of Geriatric Medicine, Groningen, 9700 RB, The Netherlands
Anna K L Reyners Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands. .,Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands.

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Masman AD, Tibboel D, Baar FPM, van Dijk M, Mathot RAA, van Gelder T. Prevalence and Implications of Abnormal Laboratory Results in Patients in the Terminal Phase of Life. J Palliat Med 2018;19:822-9. [PMID: 27494223 DOI: 10.1089/jpm.2015.0548] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open

Jing X, Liu J, Wang C, Ji M, Chen X, Mei Y, Zhu QR. Auricular acupressure is an alternative in treating constipation in leukemia patients undergoing chemotherapy: A systematic review and meta-analysis. Complement Ther Clin Pract 2018;31:282-289. [PMID: 29705469 DOI: 10.1016/j.ctcp.2018.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/16/2018] [Accepted: 03/13/2018] [Indexed: 01/19/2023]

Abstract

OBJECTIVE

Auricular acupressure (AA) therapy has been widely used in Eastern Asia and Europe to prevent constipation in leukemia patients undergoing chemotherapy. The aim of this systematic review was to review data from randomized controlled trials (RCTs) of auricular acupressure therapy for preventing constipation in leukemia patients undergoing chemotherapy.

METHODS

Databases that were searched from their inception until August 2017 included: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, as well as four Chinese databases [Chinese BioMedical Database, China National Knowledge Infrastructure, Wan-Fang Data, and the Chinese WeiPu Database]. In this systematic review, only RCTs that were related to the effects of auricular acupressure therapy on preventing constipation in leukemia patients undergoing chemotherapy were included. Study selection, data extraction, and validation were performed independently by two reviewers. Quantitative analyses of RCTs were performed using RevMan 5.3 software, and cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials.

RESULTS

A total of 5 RCTs met the inclusion criteria, and most were of low methodological quality. Participants in the AA plus routine care group showed significantly greater improvements in the Bristol Stool Form (BSF) [MD = 0.55, 95% CI (0.39, 0.71), p < 0.01] with low heterogeneity (Chi² = 5.01, p = 0.29, I² = 20%). Moreover, when compared with routine care alone, meta-analysis of three RCTs indicated favorable statistically significant effects of AA plus routine care on the Constipation Assessment Scale (CAS) [MD = -1.51, 95% CI (-1.89, -1.14), p < 0.01] with low heterogeneity (Chi² = 1.63, p = 0.44, I² = 0%). Furthermore, when compared with routine care alone, meta-analysis of two RCTs demonstrated statistically significant effects of AA plus routine care on the Patient Assessment of Constipation-Quality Of Life (PAC-QOL) [MD = -1.28, 95% CI (-1.44, -1.13), p < 0.01], with low heterogeneity (Chi² = 0.19, p = 0.67, I² = 0%).

CONCLUSION

Taken together, as a potential safety therapy, only weak evidence supported the hypothesis that AA effectively prevented constipation in leukemia patients undergoing chemotherapy.

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Bischoff KE, O'Riordan DL, Fazzalaro K, Kinderman A, Pantilat SZ. Identifying Opportunities to Improve Pain Among Patients With Serious Illness. J Pain Symptom Manage 2018;55:881-889. [PMID: 29030211 DOI: 10.1016/j.jpainsymman.2017.09.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 09/28/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]

de Graaf E, Zweers D, de Graeff A, Stellato RK, Teunissen SCCM. Symptom Intensity of Hospice Patients: A Longitudinal Analysis of Concordance Between Patients' and Nurses' Outcomes. J Pain Symptom Manage 2018;55:272-281. [PMID: 28923527 DOI: 10.1016/j.jpainsymman.2017.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/04/2017] [Accepted: 09/04/2017] [Indexed: 11/23/2022]

Dhingra L, Barrett M, Knotkova H, Chen J, Riggs A, Lee B, Hiney B, McCarthy M, Portenoy R. Symptom Distress Among Diverse Patients Referred for Community-Based Palliative Care: Sociodemographic and Medical Correlates. J Pain Symptom Manage 2018;55:290-296. [PMID: 28844624 DOI: 10.1016/j.jpainsymman.2017.08.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/21/2017] [Accepted: 08/17/2017] [Indexed: 11/29/2022]

Abstract

CONTEXT

Community-based palliative care programs are appearing in the U.S. Many of these programs, particularly those in large cities, serve highly diverse populations. Information about the sources of variation in the conditions that drive illness burden, like symptom distress, may be useful in program planning.

OBJECTIVES

To characterize variation in symptom distress among highly diverse patients referred for palliative care in an urban setting.

METHODS

This is a retrospective cross-sectional survey of data obtained from patients at the time of enrollment in a community-based palliative care program. Symptom distress was measured using the Condensed Memorial Symptom Assessment Scale. Severe distress was defined as reporting either "quite a bit"/"very much" or "frequently"/"almost constantly" for one or more symptoms. Multivariate analysis evaluated the associations between symptom distress and sources of patient variability.

RESULTS

Patients (n = 1532) were aged 72.2 years on average; 60.0% were women, 56.4% were African-American or Hispanic, and 30.8% were non-English speaking. Most had cancer or congestive heart failure (68.6%); 90.2% had a Karnofsky Performance Status score of 40-70. The most prevalent symptoms were fatigue (71.8%), pain (47.3%), and sadness (41.6%); the most distressing symptoms were fatigue (58.5%), worrying (54.8%), and weight loss (52.1%). In multivariate analyses, Caucasian race, non-Asian language, low Karnofsky Performance Status scores, and cancer diagnosis predicted severe symptom distress.

CONCLUSION

In a diverse urban population receiving community-based palliative care, symptoms were highly prevalent and distressing, and both sociodemographic and medical factors predicted severe distress. Program planning should consider the needs of subpopulations at risk for high symptom burden.

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