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.

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.