Assessing needs of family members of inpatients with advanced cancer.

To provide high-quality and effective cancer care, problems and unmet needs of family members during their relatives' hospitalisation have to be identified as well. The aims were to determine how needs of family members of patients with terminal cancer are met and to analyse factors that influence them. The needs were assessed with the Family Inventory of Needs. Each item (n = 20) represents one need of family members, for which the importance and satisfaction are rated. The study comprised 270 family members of hospitalised advanced cancer patients staying in the University Hospital Ostrava who were receiving palliative care. The family members preferred sufficient basic information and patient comfort. The unmet needs were support of hope (73%) and provision of information (65%). The unmet needs were more frequently identified by women, individuals with lower education, younger persons, unemployed, patients' children and family members of patients with generally unfavourable health status (P < 0.05). There was a correlation between lower quality of life and higher numbers of unmet needs. Targeted interventions aimed at meeting important needs of the family members may improve their quality of life.

[Assessment of the spiritual needs of patients in palliative care]. / Hodnocení duchovních potreb pa-cientu v paliativní péci.

The appraisal and the right diagnostics of all needs and problems of patients, including the spiritual needs, are unavoidable for increase of the quality of the all-embracing nursing care. In the case of satisfying of the needs of the patients, it is important to have view the person as a unity of thebody and the soul. Identification and satisfying of the spiritual needs are not uncomplicated; moreover, spirituality does not have a target--ed and clear definition. In the palliative care, the solution and saturation of spiritual needs have a great priority, and it can be the key aspect of psychological activity. Also, medical experts are becoming aware of the meaning of spirituality as the part of psychological contentment more and more. Smaller importance is attached to measurement of spiritual needs, and in many medical institutions ends at the case history with the questions: "Are you a believer?", "Do you have any spiritual needs?". Spirituality and religion are very personal matters of every human. Many patients turn to religion to find answers to difficult questions while others find support through the spiritual beliefs outside the scope of organized religion. Mistaking of meanings of the spirituality and religionism can lead to many misunderstandings. The basic condition for the right diagnostics and satisfaction of spiritual needs are the definition of the used terms and using of standardized measurement devices in the clinical praxis. The target of summarizing study was to define the term of spirituality, to describe a lot of measurement devices these are suitable for the evaluation of human spiritual needs. For methodology for acquiring of the results of research works that are concerned with the questions of spiritual needs in case of the incurable patients, the following databases were used (2005-2013): EBSCO, Bibliographia Medica Cechoslovaca, Google Scholar, Solen - www.solen.cz, Profese on-line as the source of the data. The choice of studies were as follows the systematic overview, the summarizing essay, the qualitative and quantitative study.

Association between unmet needs and quality of life in hospitalised cancer patients no longer receiving anti-cancer treatment.

Assessing the quality of life and unmet needs of cancer patients is an integral part of palliative care. This cross-sectional study sought to determine whether there is an association between quality of life and unmet needs, anxiety and depression in cancer patients who are no longer receiving anti-cancer treatment. The sample consisted of 93 patients from the oncology department at the University Hospital in Ostrava for whom further cancer treatment had been terminated as ineffective in halting the progression of their cancer. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Patient Needs Assessment in Palliative Care (PNAP) questionnaire, and the Hospital Anxiety and Depression Scale (HADS) were used to collect data. The overall quality of life score was quite low at 46. Most unmet needs were defined in terms of physical, psychological or spiritual needs. Correlations were found between impaired quality of life and lower Karnofsky scores (r = 0.50); increased physical (r = 0.52), psychological (r = 0.44) and spiritual (r = 0.36) needs; and higher levels of anxiety (r = -0.30) and depression (r = -0.68). Effective management of patients' physical (pain, fatigue and depression), psychological and spiritual needs may improve their quality of life.

[The assessment of quality of life of patients at oncological clinic - pilot study]. / Hodnocení kvality zivota pacientu na onkologickém oddelení - pilotní studie.

BACKGROUND: In oncological care the main emphasis should not be put only on prolonging a patients life, but also on its quality. The aim of the study was to assess the quality of life of patients hospitalized at the oncology clinic of the University Hospital of Ostrava (UHO), who exhausted all the anticancer treatment options. PATIENTS (SAMPLE) AND METHODS: In a pilot study the sample consisted of 93 patients from the oncological clinic of UHO with Karnofsky score < 60. A questionnaire EORTC QOL C30 was used to evaluate the quality of life. RESULTS: The overall score of quality of life was 49%. Repeated measurement showed a significant decrease of the score to 37% (p < 0.001). Assessing the quality of life on a functioning scale, role functioning (47.3; 95% CI 42.6- 52.1) and social functioning (48.0; 95% CI 42.5- 53.5) were assessed the worst. When judging on a symptoms scale, patients reported the major problem was fatigue (48.8; 95% CI 44.8- 52.8) and pain (44.5; 95% CI 39.2- 48.8). Repeated measurement showed a statistically significant decrease in quality of life on the scale of functioning in all areas. On the symptoms scale there was similarly a decline of quality in fatigue, pain and breathlessness categories (p < 0.01). Furthermore, we observed a correlation between lower overall quality of life and a worse level of physical functions (r = 0.8047), social relationships (r = 0.7796), fatigue (r = 0.8166) and pain intensity (r = 0.8282). CONCLUSION: Palliative care patients admitted to the oncology clinic perceive their quality of life as inferior. Home palliative care or a hospice appears to be a more suitable environment for the management of terminal care.

[The influence of hormone replacement therapy on the quality of life of women in menopause]. / Vliv hormonální substitucní terapie na kvalitu zivota zen v postmenopauze.

OBJECTIVE: The objective of the study was to find out the quality of life of women in menopause and the extent of their menopausal symptoms in relation with hormone replacement therapy. DESIGN: Interventional study. SETTING: Institute of Nursing and Midwifery, Faculty of Medicine, the University of Ostrava. METHODS: A sample was made up of 136 women from 41 to 58 years, who started to take hormone replacement therapy in order to improve their menopausal symptoms. For the assessment of the quality of life the WHOQOL - BREF questionnaire was used, and for the assessment of menopausal symptoms a Czech version of the standardized The Menopause - Specific Quality of Life Questionnaire MENQOL was used. Both questionnaires were given to the women twice - before the treatment was started and six months later. RESULTS: When comparing the quality of life in relation with the treatment we found out a significantly better assessment of the quality of life in all domains of the WHOQOL-BREF questionnaire, as well as in individual items of the assessment of the overall quality of life (Q1) and health (Q2), and also in all domains of the questionnaire of menopausal symptoms MENQOL, six months after the replacement treatment was initiated. Before the treatment women pointed out the biggest problems with weight gain (4.2), avoiding intimate relationships (4.1), hot flashes (4.0), the changes of the skin (3.9), night sweats (3.9), feelings of fatigue (3.9) and the loss of energy (3.7). Out of 28 individual items of the questionnaire MENQOL a subjective improvement in the perception of menopausal symptoms were in 26 items, the biggest difference was in the item of night sweats (1.7), hot flashes (1.6), feelings of loss of energy (1.0) and fatigue (0.8). CONCLUSION: Hormone replacement therapy improves subjective assessment of the quality of life of women and the extent of menopausal symptoms already six months after a treatment initiation.