Unmet Palliative Care Needs Among Patients With End-Stage Kidney Disease: A National Registry Study About the Last Week of Life

Axelsson, Lena; Alvariza, Anette; Lindberg, Jenny; Öhlén, Joakim; Håkanson, Cecilia; Reimertz, Helene; Fürst, Carl Johan; Årestedt, Kristofer

doi:10.1016/j.jpainsymman.2017.09.015

Cited by 39 publications

(34 citation statements)

References 48 publications

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“…In accordance with earlier studies from the SRCP, examining other diagnoses and specific types of care, the prevalence of symptoms was high during the last week of life (Andersson, Årestedt, Lindqvist, Fürst, & Brännström, ; Årestedt et al, ; Axelsson et al, ; Smedbäck et al, ). It is not surprising that, for example, shortness of breath and rattles were common symptoms in MND, since the major direct causes of death are pneumonia and respiratory failure (Cheng et al, ; Gil et al, ).…”

Section: Discussionsupporting

confidence: 87%

“…Only around 32% of the patients with OND were offered end‐of‐life discussions, while the figure was around 69% in the case of their family members. It may be that these numbers are related to cognitive or consciousness decline and similar results are found for other diagnoses (Årestedt et al, ; Axelsson et al, ). It would be interesting to explore why patients do not receive this discussion.…”

Section: Discussionsupporting

confidence: 62%

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Symptom relief during last week of life in neurological diseases

et al. 2019

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Objectives The aim of this study was to investigate symptom prevalence, symptom relief, and palliative care indicators during the last week of life, comparing them for patients with motor neuron disease (MND), central nervous system tumors (CNS tumor), and other neurological diseases (OND). Material & Methods Data were obtained from the Swedish Register for Palliative Care, which documents care during the last week of life. Logistic regression was used to compare patients with MND ( n = 419), CNS tumor ( n = 799), and OND ( n = 1,407) as the cause of death. Results The most prevalent symptoms for all neurological disease groups were pain (52.7% to 72.2%) and rattles (58.1% to 65.6%). Compared to MND and OND, patients with CNS tumors were more likely to have totally relieved pain, shortness of breath, rattles, and anxiety. They were also more likely to have their pain assessed with a validated tool; to receive symptom treatment for anxiety, nausea, rattles, and pain; to have had family members receive end‐of‐life discussions; to have someone present at death; and to have had their family members offered bereavement support. Both patients with CNS tumor and MND were more likely than patients with OND to receive consultation with a pain unit and to have had end‐of‐life discussions. Conclusions The study reveals high symptom burden and differences in palliative care between the groups during the last week of life. There is a need for person‐centered care planning based on a palliative approach, focused on improving symptom assessments, relief, and end‐of‐life conversations.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 62%

Symptom relief during last week of life in neurological diseases

et al. 2019

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“…In both the univariate and multiple logistic regressions, the use of a validated pain symptom assessment scale was significantly associated with relief of pain, nausea, anxiety, and shortness of breath. Despite this, recent studies have shown that symptom assessment scales are seldom used in dying patients with end-stage kidney disease 28 and heart failure. 29 One explanation could be that persons at EOL may have restricted verbal communication, making it hard for them to express their needs.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Symptom Relief in End-of-Life Care in Residential Care Homes: A National Register-Based Study

Andersson

Årestedt

Lindqvist

et al. 2018

Journal of Pain and Symptom Management

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“…The biomarkers of urea, creatinine, hemoglobin, hematocrit, albumin, sodium, potassium, calcium, phosphorus, and C-reactive protein (CRP) values of the subjects who participate in the study were evaluated. The median number of medications used by the patients on a daily basis was three (min-max: [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Normally deviating values were determined and the relationship between the HSS, HSS subscales, TAS-20, and TAS-20 subscale scores was assessed.…”

Section: Resultsmentioning

confidence: 99%

“…14 It is not appropriate to handle symptom management or the psychosocial dimension of CRF solely through a nursing approach. 15 Therefore, a nurse has to adopt a holistic approach while performing care activities during CRF and hemodialysis treatment.…”

mentioning

confidence: 99%

Influence of Selected Biomarkers on Stress and Alexithymia in Patients Under Hemodialysis Treatment

Tayaz

Koç

2019

Yonago Acta Med.

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Background Hemodialysis treatment and the high stress brought about by the treatment are the circumstances which set the background for alexithymia. Alexithymic feelings basically emerge as restriction in the world of emotion and thought, and the inability to recognize physiological changes. Biomarkers that are indicators of physical change are influential in the stress lives of individuals. This research was carried out to discover the relationships between, and to determine the influence of urea, creatinine, sodium, potassium, hemoglobin, hematocrit, albumin, calcium, phosphorus and C-reactive protein biomarkers on stress and alexithymia in individuals, who are diagnosed with chronic renal failure and receive hemodialysis treatment. Methods The research environment was formed of patients who underwent hemodialysis treatment in a hospital in Turkey. The subject group was comprised of 72 individuals. Demographic data form, biomarker list form, Hemodialysis Stressor Scale and Toronto Alexithymia Scale were used in the research. Results It was found that the levels of perceived stress of individuals who participated in the research were high at all dimensions, and 59.7% were alexithymic. The means of the total scale scores of all patients were calculated as 87.81 ± 13.59 for Hemodialysis Stressor Scale and 62.46 ± 9.84 for Toronto Alexithymia Scale. The relationship between the Toronto Alexithymia Scale and Hemodialysis Stressor Scale and selected biomarkers were determined (P < 0.05). Conclusion It was concluded that stress and alexithymic feelings were high in patients who received hemodialysis treatment, and that there is a relationship between C-reactive protein, creatinine, sodium, hemoglobin, hematocrit, potassium from the biomarkers and the scales and scale sub-dimensions. It is necessary to increase the awareness of nurses on the importance of the skills to communicate with individuals who have to cope with stress, manage emotions, and have high stress and emotional deprivation.

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Unmet Palliative Care Needs Among Patients With End-Stage Kidney Disease: A National Registry Study About the Last Week of Life

Abstract: Even if death is expected, most patients dying with ESKD had unmet palliative care needs regarding symptom management, advance care planning, and bereavement support.

Cited by 39 publications

References 48 publications

Symptom relief during last week of life in neurological diseases

Symptom relief during last week of life in neurological diseases

Factors Associated With Symptom Relief in End-of-Life Care in Residential Care Homes: A National Register-Based Study

Influence of Selected Biomarkers on Stress and Alexithymia in Patients Under Hemodialysis Treatment

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