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Aims: This study aimed at investigating the status of polypharmacy and the experience and perception of bereaved family members of patients with advanced cancer regarding the burden of oral medication. Methods: Self-administered questionnaires were mailed to 303 bereaved family members of patients with advanced cancer, and 102 valid responses were analyzed (response rate, 33.7%). Results: The number of patients in the polypharmacy group (patients taking six or more tablets at a time) was 65 and that in the non-polypharmacy group (patients taking less than six tablets at a time) was 37. The percentage of bereaved family members who felt that the oral administration burden of patients was significantly higher in the polypharmacy group (43.1% vs. 10.8%, p<0.01). The results of the analysis indicated that the bereaved families wanted to reduce the number of tablets taken at a time for alleviating the burden of polypharmacy. The bereaved families of patients in the polypharmacy group were greatly concerned that the number of oral medications was too large. They also expressed the need for medical staff from whom they could seek explanation and counseling regarding the oral medication of patients. Conclusion: It is suggested that medical staff need to be fully aware of the concerns of patients’ families regarding drugs besides checking the compliance status.
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Objective To explore the status of anticipatory grief in major caregivers of patients with advanced cancer and its influencing factors. Methods There were 329 major caregivers of patients with advanced cancer recruited between October 2017 and May 2018. The basic data questionnaire, Anticipatory Grief Scale and Perceived Social Support Scale were used in the investigation. Results The scores of anticipatory grief and perceived social support were 88.49 ± 16.47 and 60.33 ± 11.58 respectively. The result of multiple linear regression revealed that relationship with patients, perceived social support, gender and religion were associated with anticipatory grief and could explain 54.2％of the total variance. Conclusions Medical workers should provide assistance to the major caregivers of patients with advanced cancer, respect and encourage the appropriate participation of religious activities, encourage caregivers to fully express their feelings, decrease their adverse emotional reactions and improve their bereavement outcome.
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Purpose: To clarify the relationship between cancer pain self-management and pain in outpatients with advanced cancer taking opioid analgesics. Methods: 56 patients were surveyed using a questionnaire, which included items on cancer pain self-management deductively extracted from previous studies and items from the Japanese version of the Brief Pain Inventory. Results: Among patients self-managing their cancer pain, scores for “facilitation of around-the-clock opioid analgesics compliance” were significantly lower than scores for “interference with life”. Scores for “enduring end-of-dose failure pain” were significantly higher than scores for “severe pain”, “average pain”, and “interference with life”. Scores for “use of rescue doses when pain occurs” were significantly higher than scores for “sleep”. Scores for “methods to relieve pain other than analgesics” were significantly higher than scores for “mood”. Conclusions: The present study suggested that pain relief should be based on the use of opioid analgesics, and indicated the importance in pain relief of pain treatment that ensures good sleep and support for achieving self-management including holistic care.
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Objective@#To explore the status of anticipatory grief in major caregivers of patients with advanced cancer and its influencing factors.@*Methods@#There were 329 major caregivers of patients with advanced cancer recruited between October 2017 and May 2018. The basic data questionnaire, Anticipatory Grief Scale and Perceived Social Support Scale were used in the investigation.@*Results@#The scores of anticipatory grief and perceived social support were 88.49±16.47 and 60.33±11.58 respectively. The result of multiple linear regression revealed that relationship with patients, perceived social support, gender and religion were associated with anticipatory grief and could explain 54.2% of the total variance.@*Conclusions@#Medical workers should provide assistance to the major caregivers of patients with advanced cancer, respect and encourage the appropriate participation of religious activities, encourage caregivers to fully express their feelings, decrease their adverse emotional reactions and improve their bereavement outcome.
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OBJECTIVE: To explore the efficacy of moxibustion combined with medication in the treatment of refractory nausea and vomiting and quality of life (QOL) in advanced cancer patients. METHODS: A total of 266 advanced cancer patients with nausea and vomiting were randomly assigned to Metoclopramide group (M group, n＝70), Metoclopramide plus Haloperidol group (MH group, n＝65), moxibustion ＋ M group (n＝63), and moxibustion ＋ MH group (n＝68). Moxibustion was applied to bilateral Zusanli (ST 36), and Guanyuan (CV 4), Qihai (CV 6) for 20 min every time, twice a day for 2 weeks. The Rhodes' Index of nausea, Vomiting and Retching (INVR) was used for assessing the state of these symptoms in duration, frequency and severity (40 points), the 24-item Hamilton Depression Rating Scale (HAMD, 0－76 points) was employed to measure the patients' depression severity, and the Functional Assessment of Cancer Therapy-General (FACT-G, including physical, social/family, emotional, and functional dimensions, 27 items, 108 points) was adopted to measure the cancer patients' QOL. RESULTS: Following the treatment, the INVR and HAMD scores were significantly decreased in the M, MH, moxibusion＋M and moxibustion＋MH groups in comparison with their own pretreatment (P0.05)．. CONCLUSION: Moxibustion plus Metoclopramide and Haloperidol can relieve refractory nausea and vomiting, and better depression and QOL in advanced cancer patients, being worthy of popularization in clinical practice.
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Objective The objectives of this study were to use Nutrition Risk Screening 2002( NRS2002) to conduct nutri-tional assessment research on patients with advanced cancer in our hospital,and to assess the patients′nutritional deficiencies,nutri-tional risk and nutritional support,and to discuss the nutritional status and clinical indicators of patients with different tumor types in order to provide a scientific evidence for individualized nutritional support. Methods Patients with advanced tumors met the require-ments were enrolled from January 2016 to February 2017. Nutritional questionnaires and anthropometry were conducted and recorded the information of measurements and relevant laboratory tests. NRS2002 was used to screen nutritional risk of patients. Results The nutritional insufficiency rate was 19. 54% in 517 patients with advanced cancer and 49. 52% in nutrition risk. The proportion of nutri-tion-free patients receiving nutritional support was 14. 56% ,and the nutritional support patients with nutritional support were 63. 67%.Theaveragelengthofhospitalstaywas(14.43±11.82)daysforpatientswithnutritionalrisk,and(8.29±6.93)daysforpa-tients without nutritional risk. The incidence of nutritional risk in patients with digestive tract cancer was higher than other tumor types. Conclusion As an effective nutritional screening tool,NRS2002 can help clinicians to screen the potential nutritional risk of patients in oncology and provide the basis for patients to develop rational nutrition support.
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Introducción: En Cuba, los tumores malignos constituyen la segunda causa de muerte, con gran impacto en la dinámica familiar. Objetivos: caracterizar al cuidador informal oncológico y los aspectos que contribuyan a la calidad del cuidado domiciliario. Métodos: se realizó estudio descriptivo en el policlínico Diego Tamayo del municipio Habana Vieja durante el período de enero a junio del 2015. El universo estuvo constituido por 53 cuidadores informales de adultos oncológicos en estado avanzado. Para obtener la información se utilizó análisis documental y aplicación de encuesta, previo consentimiento informado. Resultados: la mayor representación de los cuidadores correspondió al sexo femenino, entre 60-64 y 55-59 años respectivamente. El nivel medio de escolaridad mostró superioridad numérica. Los cónyuges e hijos fueron el parentesco de mayor representatividad, con un período entre 1-3 años dedicado al rol de cuidador. Existió predominio con necesidad de instrucción para la atención paliativa domiciliaria, siendo los cuidadores satisfechos los de mayor representación. Conclusiones: la instrucción, asesoría, entrenamiento, aplicación de guías psicoeducativas y medidas de alivio, constituyen aspectos esenciales en la calidad de los cuidados paliativos domiciliarios, proporcionados en la fase avanzada de la enfermedad hasta la muerte y el duelo(AU)
Introduction: In Cuba, malignant tumors are the second leading cause of death, with great impact on family dynamics. Objectives: To characterize the informal caregiver and oncological aspects that contribute to the quality of home care. Methods: descriptive study was conducted at the polyclinic Diego Tamayo Habana Vieja municipality during the period from January to June 2015. The universe was composed of 53 informal caregivers of adults with advanced-stage cancer. Methods used: document analysis and survey application, prior informed consent. Results: the largest representation of caregivers were female between 60-64 years and 55 to -59 respectively. The average level of schooling showed numerical superiority. Spouses and children was the most representative relationship with a period of 1 -3 years dedicated to the role of caregiver. There was predominance in need of instruction for home palliative care, caregivers satisfied being the most represented. Conclusions: It is essential to improve and implement support programs caregiver respite services and temporary application of psychoeducational guidelines in primary care, to provide comprehensive palliative care from the time of diagnosis to death and mourning(AU)
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Humans , Male , Female , Palliative Care/psychology , Primary Health Care , Teaching , Terminal Care/psychology , Caregivers , Neoplasms , Epidemiology, Descriptive , CubaABSTRACT
<b>Purpose</b>: Escitalopram has been inadequately evaluated in cancer patients. Here, we report two patients with advanced cancer who benefited from escitalopram for depression. <b>Case 1</b>: A man aged in his 50s had postoperative recurrence of rectal cancer. He was diagnosed with a major depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The score of the Hamilton Rating Scale for Depression (HAMD-17) was 20 points. He began treatment with 10 mg/day of escitalopram. His symptoms began to improve at about 14 days, and the HAMD-17 score was 4 points at 23 days, suggesting a marked improvement. <b>Case 2</b>: A woman aged in her 50s had cancer of the external auditory canal. She was diagnosed with a major depressive episode according to DSM-IV-TR. The score of HAMD-17 was 26 points. She began treatment with 10 mg/day of escitalopram. Her symptoms began to improve at 15 days, and the HAMD-17 score at 28 days was 13 points, suggesting a marked improvement. In both cases, serious side effects, clear exacerbation of depression, and withdrawal syndrome due to acute drug deprivation associated with worsening of the symptoms were not noted. <b>Conclusion</b>: Escitalopram is considered a useful drug for depression in patients with advanced cancer.