Research Article
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Palyatif bakım alan kanser hastalarında semptomlar, performans durumu ve yaşam kalitesi

Year 2022, Volume 61, Issue 1, 64 - 72, 15.03.2022
https://doi.org/10.19161/etd.1085738

Abstract

Amaç: Çalışmanın amacı, palyatif bakım alan kanser hastalarının yaşadıkları semptomları, hastaların performanslarını ve yaşam kalitelerine olan etkilerini tanımlamaktır.

Gereç ve Yöntem: Tanımlayıcı bir çalışma olup, Türkiye'nin batısında yer alan İzmir'de bir üniversite hastanesinin palyatif bakım ünitesine başvuran 106 hasta ile Aralık 2019-Nisan 2020 tarihleri arasında yapılmıştır. Veri toplama için Hasta Bilgi Formu, “Doğu Kooperatif Onkoloji Grubu (ECOG) Performans Durum Ölçeği”, “Edmonton Semptom Değerlendirme Ölçeği (ESAS)” ve “Kronik Hastalık Tedavisinin Fonksiyonel Değerlendirmesi-Palyatif Bakım (FACIT-Pal) Ölçeği” uygulandı. Verilerin analizinde betimsel istatistikler, Ki-kare testi, Kruskall Wallis Analizi ve lineer regresyon analizi kullanılmıştır.

Bulgular: Hastalar en sık yaşadıkları semptomların yorgunluk, kendini iyi hissetmeme, kaygı, üzüntü (depresyon) ve ağrı olduğunu bildirmiştir. Regresyon analizine göre hastaların toplam yaşam kalitesi puanları ile hastaların ESAS semptomlarından ağrı, yorgunluk ve bulantı arasında istatistiksel olarak anlamlı fark vardı. Hastanede yatan, hastalığı ileri evrede olan, metastazı olmayan veya metastaz durumunu bilmeyen ve performans durumu ECOG düşük olan hastalarda yaşam kalitesi puanları anlamlı olarak daha düşüktü. Hastaların ECOG performans durumu ile yaşam kalitesi arasında istatistiksel olarak anlamlı bir fark vardı.

Sonuç: Hastaların birden fazla semptomu ve düşük yaşam kalitesi vardır. Bulgularımız, yaşam kalitesini iyileştirmek için semptom değerlendirmesi ve yönetiminin önemini desteklemektedir.

References

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  • Ahlam A, Hind M, Haddou Rahou B, Rachid R, Hassan E. Quality of life of Moroccan patients on the palliative phase of advanced cancer. BMC research notes 2019; 12 (1): 351. https://doi.org/10.1186/s13104-019-4390-1.
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  • Saygılı M, Çelik Y. An evaluation of palliative care service effect in patients with cancer diagnosis: Comparison in terms of the symptom level and care satisfaction. Agri 2020; 32 (2): 61–71. https://doi.org/10.14744/agri.2019.95770. (In Turkish).
  • Bülbül Y, Ozlu T, Arinc S, et al. Assessment of palliative care in lung cancer in Turkey. Medical principles and practice: international journal of the Kuwait University, Health Science Centre 2017; 26 (1): 50–6. https://doi.org/10.1159/000452801
  • Riba MB, Donovan KA, Andersen B, et al. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network: JNCCN 2019; 17 (10): 1229–49. https://doi.org/10.6004/jnccn.2019.0048
  • WHO Report on cancer: setting priorities, investing wisely and providing care for all. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
  • Verkissen MN, Hjermstad MJ, Belle SV, Kaasa S, Deliens L, Pardon K. Quality of life and symptom intensity over time in people with cancer receiving palliative care: Results from the international European Palliative Care Cancer Symptom study. Plos One 2019; October 9: 1-16. https://doi.org/10.1371/journal.pone.0222988.
  • Quinten C, Coens C, Ghislain I, et al. The effects of age on health-related quality of life in cancer populations: A pooled analysis of randomized controlled trials using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 involving 6024 cancer patients. Eur J Cancer. 2015;51(18):2808-19. https://doi.org/10.1016/j.ejca.2015.08.027
  • Alam MM, Rahman T, Afroz Z, et al.. Quality of Life (QoL) of cancer patients and its association with nutritional and performance status: A pilot study. Heliyon 2020; 6 (10): e05250. https://doi.org/10.1016/j.heliyon.2020.e05250.
  • Nathania R, Fahman J, Saroso OJD, et al. Association between performance status and quality of life in breast cancer patients: A Preliminary Study. Ann Oncol 2019; 30 (6): 146. https://doi.org/10.1093/annonc/mdz343.133

Symptoms, performance status and quality of life in cancer patients receiving palliative care

Year 2022, Volume 61, Issue 1, 64 - 72, 15.03.2022
https://doi.org/10.19161/etd.1085738

Abstract

Aim: The aim of the study was to describe the symptoms experienced by cancer patients receiving palliative care, patients’ performance and the effects on their quality of life.

Materials and Methods: This is a descriptive study and was conducted with 106 patients admitted to palliative care unit at a university hospital in Izmir, located in the west of Turkey, between December 2019 and April 2020. For data collection, Patient Information Form, “Eastern Cooperative Oncology Group (ECOG) Performance Status Scale”, “Edmonton Symptom Assessment Scale (ESAS)” and “Functional Assessment of Chronic Illness Therapy-Palliative Care (FACIT-Pal) Scale” were applied. For data analysis, descriptive statistics, Chi-square test, Kruskall Wallis Analysis and linear regression analysis were used.

Results: Patients reported that the most common symptoms experienced were fatigue, sense of being unwell, anxiety, sadness (depression) and pain. According to the regression analysis, there was a statistically significant difference between the total quality of life scores of the patients and pain, fatigue and nausea from the patients' ESAS symptoms. The quality of life scores were significantly lower in the patients who were hospitalized, had an advanced disease stage, did not have metastases or did not know their metastases status and had a low performance status ECOG. There was a statistically significant difference between patients' ECOG performance status and quality of life.

Conclusion: Patients have multiple symptoms and poor quality of life. Our findings support the importance of symptom assessment and management to improve quality of life.

References

  • WHO Estimated number of deaths from 2020 to 2040 for all cancer in both sexes and all ages. World Health Organization. Retrieved June 09, 2021. https://gco.iarc.fr/tomorrow/en/dataviz/isotype.
  • American Cancer Society Palliative Care. Retrieved June 09, 2021. https://www.cancer.org/treatment/treatments-and-side-effects/palliative-care/what-is-palliative-care.html.
  • Agarwal R, Epstein AS. The Role of palliative care in oncology. Seminars in interventional radiology 2017; 34 (4): 307–12. https://doi.org/10.1055/s-0037-1608702.
  • Pehlivan S, Süner A, Yıldırım Y, Fadıloğlu Ç. Investigation into complementary and integrative health approaches for Turkish patients with gastrointestinal cancer. J Relig Health 2018; 57: 1497–508. https://doi.org/10.1007/s10943-017-0546-2.
  • Aydin-Avci I, Koc, Z, Sağlam Z. Use of complementary and alternative medicine by patients with cancer in northern Turkey: Analysis of cost and satisfaction. Journal of Clinical Nursing 2021; 21 (5–6): 677–88. https://doi.org/10.1111/j.1365-2702.2011.03732.x.
  • Yıldırım Y. Patterns of the complementary and alternative medicine in women with metastatic cancer. Cancer Nursing 2010; 33 (3): 194–200. https://doi.org/10.1097/NCC.0b013e3181c295ac.
  • Can G, Erol O, Aydiner A, Topuz E. Quality of life and complementary and alternative medicine use among cancer patients in Turkey. European Journal of Oncology Nursing 2009; 13 (4): 287–94. https://doi.org/10.1016/j.ejon.2009.03.007
  • Gayatri D, Efremov L, Kantelhardt EJ, Mikolajczyk R. Quality of life of cancer patients at palliative care units in developing countries: systematic review of the published literature. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation 2021; 30 (2): 315–43. https://doi.org/10.1007/s11136-020-02633-z
  • Ahlam A, Hind M, Haddou Rahou B, Rachid R, Hassan E. Quality of life of Moroccan patients on the palliative phase of advanced cancer. BMC research notes 2019; 12 (1): 351. https://doi.org/10.1186/s13104-019-4390-1.
  • Paleri A, Kumar S, Thankam K. Principles of Palliative Care. In: Varghese C, editor. Manual for palliative care. 1st ed. New Delhi: Directorate General of Health Services Ministry of Health and Family Welfare; 2005.
  • Kavak F, Özdemir A, Dural G. The Relation between spiritual wellbeing and psychological resilience among patients diagnosed with advanced gastrointestinal cancer. Current Psychology 2019: 1-7. https://doi.org/10.1007/s12144-018-0116-0.
  • Nayak MG, George A, Vidyasagar MS, Mathew S, Nayak S, Nayak BS, Shashidhara Y. N, Kamath A. Quality of Life among Cancer Patients. Indian journal of palliative care 2017; 23 (4): 445–50. https://doi.org/10.4103/IJPC.IJPC_82_17
  • Cherny N. Cancer pain syndromes. In: Melzack R, Wall PD, editors. Handbook of pain management. Edinburg: Churchill Livingstone. 2003; 603-39.
  • Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, Mcfadden ET, Carbone PP. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982; 5 (6): 649-56.
  • Pickard-Holley S. Fatigue in cancer patients. A descriptive study. Cancer Nurs 1991; 14 (1): 13-9.
  • Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients. Journal of Palliative Care 1991; 7 (2): 6–9.
  • Sadırlı SK, Ünsar S. Edmonton symptom assessment scale (ESAS) in patients with cancer: The Turkish study of validity and reliability. Fırat Sağlık Hizmetleri Dergisi 2009; 4 (11): 79–95. (In Turkish).
  • Kurt S, Unsar S. Assessment of symptom control in patients with cancer in Northwestern Turkey. European journal of oncology nursing: the official journal of European Oncology Nursing Society 2011; 15 (2): 137–44. https://doi.org/10.1016/j.ejon.2010.07.004.
  • Bağçivan G. Functional Assessment of Chronic Illness Therapy Pallıative Care (Facıt-Pal) Turkish Validity and Reliability Study of the Scale, Master's Thesis, Ankara. 2018.
  • Dong ST, Butow PN, Costa DS, Lovell MR, Agar M. Symptom clusters in patients with advanced cancer: a systematic review of observational studies. J Pain Symptom Manage 2014; Sep, 48 (3): 411-50. https://doi.org/10.1016/j.jpainsymman.2013.10.027
  • Tuna H, Ünver G, Molu B. Symptom clustering and nursing in end-stage cancer patients with palliative care. Ankara Journal of Health Sciences 2018; 7 (2): 64-9. https://dergipark.org.tr/en/download/article-file/599430. (In Turkish).
  • Saygılı M, Çelik Y. An evaluation of palliative care service effect in patients with cancer diagnosis: Comparison in terms of the symptom level and care satisfaction. Agri 2020; 32 (2): 61–71. https://doi.org/10.14744/agri.2019.95770. (In Turkish).
  • Bülbül Y, Ozlu T, Arinc S, et al. Assessment of palliative care in lung cancer in Turkey. Medical principles and practice: international journal of the Kuwait University, Health Science Centre 2017; 26 (1): 50–6. https://doi.org/10.1159/000452801
  • Riba MB, Donovan KA, Andersen B, et al. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network: JNCCN 2019; 17 (10): 1229–49. https://doi.org/10.6004/jnccn.2019.0048
  • WHO Report on cancer: setting priorities, investing wisely and providing care for all. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
  • Verkissen MN, Hjermstad MJ, Belle SV, Kaasa S, Deliens L, Pardon K. Quality of life and symptom intensity over time in people with cancer receiving palliative care: Results from the international European Palliative Care Cancer Symptom study. Plos One 2019; October 9: 1-16. https://doi.org/10.1371/journal.pone.0222988.
  • Quinten C, Coens C, Ghislain I, et al. The effects of age on health-related quality of life in cancer populations: A pooled analysis of randomized controlled trials using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 involving 6024 cancer patients. Eur J Cancer. 2015;51(18):2808-19. https://doi.org/10.1016/j.ejca.2015.08.027
  • Alam MM, Rahman T, Afroz Z, et al.. Quality of Life (QoL) of cancer patients and its association with nutritional and performance status: A pilot study. Heliyon 2020; 6 (10): e05250. https://doi.org/10.1016/j.heliyon.2020.e05250.
  • Nathania R, Fahman J, Saroso OJD, et al. Association between performance status and quality of life in breast cancer patients: A Preliminary Study. Ann Oncol 2019; 30 (6): 146. https://doi.org/10.1093/annonc/mdz343.133

Details

Primary Language English
Subjects Health Care Sciences and Services
Journal Section Research Articles
Authors

Emine KARAMAN This is me
Ege University Faculty of Nursing, Izmir, Turkiye
0000-0002-9358-2593
Türkiye


Kadriye SAYIN KASAR This is me
Aksaray University Faculty of Health Science, Aksaray, Turkiye
0000-0002-0635-2862
Türkiye


Kezban DENİZ This is me
Ege University Health Sciences Institute, Izmir, Turkiye
0000-0002-4197-3568
Türkiye


Yasemin YILDIRIM This is me (Primary Author)
Ege University Faculty of Nursing, Izmir, Turkiye
0000-0002-8970-3743
Türkiye

Publication Date March 15, 2022
Application Date October 4, 2021
Acceptance Date December 27, 2021
Published in Issue Year 2022, Volume 61, Issue 1

Cite

Vancouver Karaman E. , Sayın Kasar K. , Deniz K. , Yıldırım Y. Symptoms, performance status and quality of life in cancer patients receiving palliative care. Ege Tıp Dergisi. 2022; 61(1): 64-72.