Purpose Examine the effects of an 8-week yoga therapy on fatigue in patients with different types of cancer. Methods A total of 173 cancer patients suffering from mild to severe fatigue were randomly allocated to yoga intervention (n = 84) (IG) versus waitlist control group (CG) (n = 88). Yoga therapy consisted of eight weekly sessions with 60 min each. The primary outcome was self-reported fatigue symptoms. Secondary outcomes were symptoms of depression and quality of life (QoL). Data were assessed using questionnaires before (T0) and after yoga therapy for IG versus waiting period for CG (T1). Results A stronger reduction of general fatigue (P = .033), physical fatigue (P = .048), and depression (P < .001) as well as a stronger increase in QoL (P = .002) was found for patients who attended 7 or 8 sessions compared with controls. Within the yoga group, both higher attendance rate and lower T0-fatigue were significant predictors of lower T1-fatigue (P ≤ .001). Exploratory results revealed that women with breast cancer report a higher reduction of fatigue than women with other types of cancer (P = .016) after yoga therapy. Conclusion The findings support the assumption that yoga therapy is useful to reduce cancer-related fatigue, especially for the physical aspects of fatigue. Women with breast cancer seem to benefit most, and higher attendance rate results in greater reduction of fatigue. Trial registration German Clinical Trials Register DRKS00016034

Aim The aim of this study was to evaluate the suitability and comprehensibility of the integrated palliative care outcome scale for the evaluation of palliative care needs in patients with heart failure. Methods and results This cross-sectional study investigated 100 heart failure patients (40 women, 60 men; median age 79 years) within the first few days of their hospitalisation by applying the integrated palliative care outcome scale (3-day recall period) and two additional self-developed questions about the suitability and comprehensibility of the integrated palliative care outcome scale. Clinically relevant somatic and psycho-emotional symptoms were reported very frequently (approximately 75% each), followed by communicational needs or practical issues. Ninety-five per cent of patients thought the integrated palliative care outcome scale very easy to understand, and 91% judged the integrated palliative care outcome scale suitable to assess palliative care needs. Conclusion The integrated palliative care outcome scale was well accepted by hospitalised patients with heart failure and identified a high burden of both physical and psycho-emotional symptoms. Screening for palliative care has to consider patients and their relatives alike, and should be part of a comprehensive care concept jointly integrated into clinical routine by primary and specialised palliative care teams.

Background In the SARS-CoV-2 pandemic, general and specialist Palliative Care (PC) plays an essential role in health care, contributing to symptom control, psycho-social support, and providing support in complex decision making. Numbers of COVID-19 related deaths have recently increased demanding more palliative care input. Also, the pandemic impacts on palliative care for non-COVID-19 patients. Strategies on the care for seriously ill and dying people in pandemic times are lacking. Therefore, the program ‘Palliative care in Pandemics’ (PallPan) aims to develop and consent a national pandemic plan for the care of seriously ill and dying adults and their informal carers in pandemics including (a) guidance for generalist and specialist palliative care of patients with and without SARS-CoV-2 infections on the micro, meso and macro level, (b) collection and development of information material for an online platform, and (c) identification of variables and research questions on palliative care in pandemics for the national pandemic cohort network (NAPKON). Methods Mixed-methods project including ten work packages conducting (online) surveys and qualitative interviews to explore and describe i) experiences and burden of patients (with/without SARS-CoV-2 infection) and their relatives, ii) experiences, challenges and potential solutions of health care professionals, stakeholders and decision makers during the SARS-CoV-2 pandemic. The work package results inform the development of a consensus-based guidance. In addition, best practice examples and relevant literature will be collected and variables for data collection identified. Discussion For a future “pandemic preparedness” national and international recommendations and concepts for the care of severely ill and dying people are necessary considering both generalist and specialist palliative care in the home care and inpatient setting.

Hintergrund Das deutsche Gesundheitssystem steht aufgrund der SARS-CoV-2-Pandemie vor bisher nicht gekannten Herausforderungen. Auch die Palliativversorgung schwerkranker Patient*innen und deren Angehörigen war vor allem während der ersten Welle der Pandemie im stationären und ambulanten Setting stark beeinträchtigt. Das betrifft auch palliativ behandelte Krebspatient*innen. Material und Methoden Die Arbeit beschreibt – basierend auf Teilergebnissen einer Studie, die im Rahmen des Verbundprojekts „Nationale Strategie für Palliativversorgung in Pandemiezeiten“ (PallPan) durchgeführt wurde, sowie aus eigenen Erfahrungen aus der stationären Versorgung von Patient*innen, die unter einer schweren oder lebenslimitierenden Erkrankung leiden, – Best-Practice-Beispiele zur Verbesserung bzw. Aufrechterhaltung der Palliativversorgung. Ergebnisse Eingeschränkte Besucherregelungen, Kommunikationsbarrieren und unzureichende Möglichkeiten zur Begleitung sterbender Patient*innen bzw. trauernder Angehöriger stellen nach wie vor große Herausforderungen in der allgemeinen wie spezialisierten stationären Palliativversorgung dar. Hier bedarf es der Schaffung von Strukturen, um z. B. innovative Kommunikationswege mittels Videotelefonie oder individuelle Ausnahmeregelungen von Besuchsverboten bei Therapiezielgesprächen oder Sterbebegleitungen möglich zu machen, um eine qualitativ hochwertige Palliativversorgung aufrechtzuerhalten. Schlussfolgerungen Eine adäquate Versorgung schwerkranker und sterbender Patient*innen sowie deren Angehörigen muss auch in der Pandemie gewährleistet werden. Individuelle Maßnahmen können abgesprochen und durchgeführt werden. Eine frühzeitige Einbindung spezialisierter Palliativteams kann von Vorteil sein.

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