A comprehensive approach in hospice shared care in Taiwan: Nonelderly patients have more physical, psychosocial and spiritual suffering

Abstract

While symptomatic differences exist between younger and older advanced cancer patients, few studies have examined the differences in their care with respect to age. Our goals were to examine the influences of age differences on physical, psychosocial and spiritual distress among advanced cancer patients. Advanced cancer patients who resided in Kaohsiung Medical University Hospital during 2007-2008 were recruited. Data were collected through professional consultants. The influences of age variations on physical, psychosocial and spiritual distress in nonelderly (<60 years old) and elderly (≧60 years old) patients were analyzed. A total of 1013 advanced cancer patients were included in the analyses with 467 nonelderly patients and 546 elderly patients. Nonelderly patients were identified to have a higher baseline pain level (4.0 vs. 2.8, p<0.001), breakthrough pain (19.3% vs. 9.9%, p<0.01), insomnia (6.4% vs. 2.7%, p=0.006), emotional distress (69.0% vs. 60.6%, p=0.013), and unwillingness to pass away because of concern for loved ones (18.8% vs. 11.9%, p=0.003) with significant difference. Elderly ones were concerned about unfulfilled wishes (29.7% vs. 18.4%, p<0.001) in spiritual concerns. After adjustments in regression models, nonelderly age (<60 years old) still revealed significant positive or negative impact on all categories of distress. Patients aged under 60 years have more physical, psychosocial and spiritual suffering. This study suggested that professional practitioners should provide intensive care for vulnerable terminally ill cancer patients.

Relationship With God, Loneliness, Anger, and Symptom Distress in Patients With Cancer Who Are Near the End of Life

“…It is not known why this would be the case, but it appears to be consistent with earlier research wherein younger patients reported more severe symptoms and suffering regardless of stage of disease 34 . It is possible that this greater level of distress, anger and loneliness was in some way related to the expectation that disease and infirmity were normal in older age but less so in younger age; thus, being faced with a life-threatening condition at a younger age caused more negative feelings.…”

Relationship between palliative care consultation service and end-of-life outcomes

“…They also found that the median number of physical and psychological symptoms were 11, and weakness, fatigue, anorexia, pain, and depression were the most common [16]. Yang et al recruited 1013 advanced cancer patients in Kaohsiung Medical University Hospital during 2007-2008 and found that nonelderly (<60 years old) patients have more physical, psychosocial, and spiritual suffering such as higher baseline pain level, breakthrough pain, insomnia, emotional distress, and unwillingness to pass away because of concern for loved ones [8]. A prospective cross-sectional descriptive study was conducted on patients referred to the pain and palliative care clinic of a tertiary hospital in North India and revealed that the most common primary diagnoses were head and neck cancers (38.5 %), cervix carcinoma (15.4 %), breast cancer (10.3 %), colorectal cancer (6.4 %), and lung cancer (4.5 %).…”

“…Yang et al used a comprehensive approach for hospice shared care in Taiwan and indicated that patients aged <60 years experience more physical, psychosocial, and spiritual suffering [8]. Loke et al reported experiences with PCCS in Taiwan and indicated that there was a significant improvement in the number of patients signing rate of do-not-resuscitate (DNR) orders, awareness of disease prognosis, and hospice utilization by terminal cancer patients [9].…”

The THE FEATURE OF SLEEP QUALITY IN CANCER PATIENTS UNDERGONE RADIOTHERAPY IN SANGLAH HOSPITAL DENPASAR

“…3 Perawatan paliatif bertugas menyediakan perawatan yang komprehensif bagi pasien kanker untuk meningkatkan kualitasnya kehidupannya. 4 Pasien kanker mungkin mengalami gangguan tidur karena efek langsung dari neoplasma, konsekuensi operasi, kemoterapi dan/atau radioterapi, nyeri, delirium, opioid, atau kondisi psikologi/psikiatri lain. Gangguan tidur dan kelelahan telah dilaporkan sebagai komponen penting klaster gejala kanker.…”