ABSTRACT
There were no reports about long survival predictors in palliative care settings. We divided categories into more than 31 days of hospitalization (short period hospitalization) and more than 61 days of hospitalization) (long hospitalization) and analyzed prognostic factors in multivariate methods. We measured the association between the long hospitalization and short period hospitalization groups with regard to terminal symptoms (cancer pain, delirium, nausea and vomiting, fatigue, and dyspnea) and treatment (hydration, continuous sedation, and opioids). In the more than 31 days of hospitalization group, sex (Odds Ratio 0.502), consciousness (Odds Ratio 0.258), and calcium levels (Odds Ratio 0.559) were statistically significant. In the more than 61 days of hospitalization group, the serum CRP level (Odds Ratio 0.254) was statistically significant and serum calcium level (Odds Ratio 0.376) exhibited a trend. The prevalence of fatigue and amount of hydration were significantly low in the more than 31 days of hospitalization group. There were no differences in terminal symptoms and treatment in the more than 61 days of hospitalization group.
ABSTRACT
<p>Little is known about early death after admission during the terminal phase in advanced cancer patients. We retrospectively analyzed data from 510 advanced cancer patients who were at the end-of-life between August 2011 and August 2016, and found that 83 patients (16.3%) died within 3 days after admission to our institute. We divided the deceased patients into those who died within 3 days (early death group) and those who died after more than 4 days (non-early death group) after admission. Prevalence of delirium, cancer pain, dyspnea, nausea and vomiting, and fatigue patients showed no significant differences. Mean hydration at the end of life was significantly more per infusion for early death group than non-early death group. Continuous sedation and mean opioid use was significantly less for early death group than non-early death group. The risk factor of age, sex, clinical stage, histological state, overtreatment of chemotherapy, comorbidity had no significant associated with early death. The primary site of cancer, the number of metastatic sites, the consciousness level, and the performance status might be predictors for early death after admission in advanced cancer patients at the end-of-life.</p>
ABSTRACT
It was February 2007 that the pediatric surgery department was established in our hospital. Since then, the number of surgical cases of inguinal hernia has been increasing year after year. During 2013, a total of 48 patients underwent hernia surgery. Operations were performed mostly on the day the patients were hospitalized. Before the surgery, the patients and their relatives were told about the nature of the disease and treatment by word of mouth. Actually, however, we were to busy to take much time to talk with them. After surgery, members of patients’ families, being all anxiety, frequently asked us such questions as: - how soon will the patient be allowed to have a cup of tea or juice?; when can the patient do without the IV drip?; and how should the family take care of the patient at home? We presumed that the anxiety might stem from the inadequate explanation given orally by inexperienced nurses. To improve the situation, we, staffers in charge of pediatric inpatient care, and physicians in the outpatient clinic of the pediatric surgery department teamed up to prepare a pamphlet including a list of standardized answers to supposedly most frequently asked questions in the hospitalization setting. The draft of the pamphlet was shown to ward nurses to sound out their opinion on the contents. Based on the results of this survey, the pamphlet was completed. This paper deals with the pamphlet and a summary of nurses’s views on it.