Physical problems and needs of patients in palliative care center

Authors

  • Arun T. Mithrason Department of Community Medicine, DM WIMS, Naseera Nagar, Wayanad, Kerala, India
  • Gomathy Parasuraman Department of Community Medicine, Saveetha Medical College, Thandalam, Kanchipuram, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20174818

Keywords:

Palliative care, Physical problems, Pain, Insomnia, Fatigue, Loss of appetite

Abstract

Background: Palliative care provides care in the relief of pain and other distressing symptoms by early identification and impeccable assessment. The problems of the people suffering from incurable diseases are multiple and multi-dimensional. Also, suffering caused by the same problem differs among individuals. To provide effective and quality palliative care services, the health care team needs quality information about what the patients really need and what are their priority problems from their own point of view. This study aims to find out the problems and needs of palliative care patients.

Methods: A cross sectional study was done in ‘Jeevodaya Hospice care Centre’, located in North Chennai in Mathoor, Manali. 60 patients were included in the study. Questionnaire on problems and needs in palliative care was used to cover the physical problems. Data was analyzed using SPSS version 17.

Results: The most common physical problems perceived by the study subjects were pain (100%), insomnia (93.3%), fatigue (88.3%) and loss of appetite (83.3%).

Conclusions: This study indicates a need for more professional attention for palliative care patients. This does not imply dissatisfaction with present care. In fact, it is a desire for future care and room for improvement, not a judgment of the quality of care in the present or past. 

References

Geneva: World Health Organization. “WHO Definition of Palliative Care” Available from: http://www.who.int/cancer/palliative/definition/en. Accessed on 23 July 2017.

Jaarsma T, Beattie JM, Ryder M, Rutten FH, McDonagh T, Mohacsi P, et al. Palliative care in heart failure: a position statement from the palliative care workshop of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Failure. 2009;11(5):433-43.

McDermott E, Selman L, Wright M, Clark D. Hospice and palliative care development in India: a multimethod review of services and experiences. J Pain Symptom Management. 2008;35(6):583-93.

Wilkie DJ, Ezenwa MO. Pain and symptom management in palliative care and at end of life. Nursing outlook. 2012;60(6):357-64.

Connor SR, Bermedo MC, editors. Global atlas of palliative care at the end of life. Worldwide Palliative Care Alliance; 2014.

Iyer S, Taylor-Stokes G, Roughley A. Symptom burden and quality of life in advanced non-small cell lung cancer patients in France and Germany. Lung Cancer. 2013;81(2):288–93.

Nilmanat K, Promnoi C, Phungrassami T, Chailungka P, Tulathamkit K, Noo-urai P. Symptom management and its barriers among patients with terminal advanced cancer in Thailand. BMJ Supportive Palliative Care. 2012;2(Suppl 1):49.

Smith AK, Cenzer IS, Knight SJ, Puntillo KA, Widera E, Williams BA, et al. The epidemiology of pain during the last 2 years of life. Annals Internal Med. 2010;153(9):563-9.

Brechtl JR, Murshed S, Homel P, Bookbinder M. Monitoring symptoms in patients with advanced illness in long-term care: a pilot study. Journal of pain and symptom management. 2006;32(2):168-74.

Fadul NA, Osta BE, Dalal S, Poulter VA, Bruera E. Comparison of symptom burden among patients referred to palliative care with hematologic malignancies versus those with solid tumors. J Palliative Med. 2008;11(3):422-7.

Goebel JR, Doering LV, Shugarman LR, Asch SM, Sherbourne CD, Lanto AB, et al. Heart failure: the hidden problem of pain. J Pain Symptom Management. 2009;38(5):698-707.

Goy ER, Carter J, Ganzini L. Neurologic disease at the end of life: caregiver descriptions of Parkinson disease and amyotrophic lateral sclerosis. Journal of palliative medicine. 2008;11(4):548-54.

Kutner J, Smith M, Mellis K, Felton S, Yamashita T, Corbin L. Methodological challenges in conducting a multi-site randomized clinical trial of massage therapy in hospice. J Palliative Med. 2010;13(6):739-44.

Strassels SA, Blough DK, Veenstra DL, Hazlet TK, Sullivan SD. Clinical and demographic characteristics help explain variations in pain at the end of life. J Pain Symptom Management. 2008;35(1):10-9.

Fischer DJ, Villines D, Kim YO, Epstein JB, Wilkie DJ. Anxiety, depression, and pain: differences by primary cancer. Supportive Care in Cancer. 2010;18(7):801-10.

McMillan SC, Rivera HR Jr. The relationship between depressive symptoms and symptom distress in patients with cancer newly admitted to hospice home care. J Hospice Palliative Nursing. 2009;11(1):41-51.

Carr D, Goudas L, Lawrence D, Pirl W, Lau J, DeVine D, et al. Management of cancer symptoms: pain, depression, and fatigue. Evidence report/technology assessment. 2002;61:368-74.

Page AE, Adler NE, editors. Cancer care for the whole patient: Meeting psychosocial health needs. National Academies Press; 2008.

Pekmezaris R, Cooper L, Efferen L, Mastrangelo A, Silver A, Eichorn A, et al. Transforming the mortality review conference to assess palliative care in the acute care setting: a feasibility study. Palliative Supportive Care. 2010;8(4):421-6.

Chiu TY, Hu WY, Chen CY. Prevalence and severity of symptoms in terminal cancer patients: a study in Taiwan. Supportive Care Cancer. 2000;8(4):311-3.

Wang Y, Shen J, Xu Y. Symptoms and quality of life of advanced cancer patients at home: a cross-sectional study in Shanghai, China. Supportive Care in Cancer. 2011;19(6):789-97.

Walsh D, Donnelly S, Rybicki L. The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Supportive Care Cancer. 2000;8(3):175-9.

Savard J, Morin CM. Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol. 2001;19(3):895-908.

Radbruch L, Strasser F, Elsner F, Gonçalves JF, Løge J, Kaasa S. Research Steering Committee of the European Association for Palliative Care (EAPC), et al. Fatigue in palliative care patients—an EAPC approach. Palliative Med. 2008;1:13-32.

Smets EM, Garssen B, Schuster-Uitterhoeve AL, De Haes JC. Fatigue in cancer patients. Br J Cancer. 1993;68(2):220.

Woof R. Asthenia cachexia and anorexia. In: Faull C, editor. Handbook of Palliative care. Oxford: Blackwell Sci; 1998: 272–283.

Berglund G, Bolund C, Fornander T, Rutqvist LE, Sjödén PO. Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients. Eur J Cancer Clin Oncol. 1991;27(9):1075-81.

Beck SA, Mulligan HD, Tisdale MJ. Lipolytic factors associated with murine and human cancer cachexia. J National Cancer Institute. 1990;82(24):1922-6.

Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ, et al. Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition. Seminars Hematol 1997;34(3):4-12.

Hui D, dos Santos R, Chisholm GB, Bruera E. Symptom expression in the last seven days of life among cancer patients admitted to acute palliative care units. J Pain Symptom Management. 2015;50(4):488-94.

Davis MP, Dickerson ED. Cachexia and anorexia: cancer's covert killer. Supportive care in cancer. 2000;8(3):180-7.

Consul N, Guo X, Coker C, Lopez-Pintado S, Hibshoosh H, Zhao B. Monitoring metastasis and cachexia in a patient with breast cancer: a case study. Clin Med Insights Oncol. 2016;10:83.

Brurea E, Fadul N. Constipation and diarrhea. In: Bruera E, Higginson I, Von Gunten CF, Morita T, editors. Textbook of palliative medicine and supportive care. CRC Press; 2015.

Clemens KE, Klaschik E. Managing opioid-induced constipation in advanced illness: focus on methylnaltrexone bromide. Therap Clin Risk Management. 2010;6:77.

Rhondali W, Nguyen L, Palmer L, Kang DH, Hui D, Bruera E. Self-reported constipation in patients with advanced cancer: a preliminary report. J Pain Symptom Management. 2013;45(1):23-32.

Clemens KE, Klaschik E. Management of constipation in palliative care patients. Current Opinion in Supportive and Palliative Care. 2008;2(1):22-7.

Twycross R, Back I. Nausea and vomiting in advanced cancer. Eur J Palliative Care. 1998;5:39-45.

Pereira J, Bruera E: Chronic nausea. In: Bruera E, Higginson I, eds.: Cachexia-Anorexia in Cancer Patients. New York, NY: Oxford University Press; 1996: 23-37

Grond S, Zech D, Diefenbach C, Bischoff A. Prevalence and pattern of symptoms in patients with cancer pain: a prospective evaluation of 1635 cancer patients referred to a pain clinic. J Pain Symptom Management. 1994;9(6):372-82.

Fainsinger R, Miller MJ, Bruera E, Hanson J, MacEachern T. Symptom control during the last week of life on a palliative care unit. J Palliative Care. 1991;7(1):5-11.

Dunlop GM. A study of the relative frequency and importance of gastrointestinal symptoms, and weakness in patients with far advanced cancer: student paper. Palliative medicine. 1990;4(1):37-43.

Campora E, Merlini L, Pace M, Bruzzone M, Luzzani M, Gottlieb A, Rosso R. The incidence of narcotic-induced emesis. J Pain Symptom Management. 1991;6(7):428-30.

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Published

2017-10-25

How to Cite

Mithrason, A. T., & Parasuraman, G. (2017). Physical problems and needs of patients in palliative care center. International Journal Of Community Medicine And Public Health, 4(11), 4145–4150. https://doi.org/10.18203/2394-6040.ijcmph20174818

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Original Research Articles