Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-27T19:17:07.528Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparing the physical, psychological, social, and spiritual needs of patients with non-cancer and cancer diagnoses in a tertiary palliative care setting

Published online by Cambridge University Press:  27 November 2019

Suhair Bandeali Open the ORCID record for Suhair Bandeali [Opens in a new window] ,
Amanda Roze des Ordons  and
Aynharan Sinnarajah
Suhair Bandeali
Affiliation:
Department of Medicine, University of Calgary, Calgary, Alberta, Canada
Amanda Roze des Ordons
Affiliation:
Division of Palliative Care, Department of Oncology, University of Calgary, Calgary, Alberta, Canada Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
Aynharan Sinnarajah*
Affiliation:
Division of Palliative Care, Department of Oncology, University of Calgary, Calgary, Alberta, Canada Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
*
Author for correspondence: Dr. Aynharan Sinnarajah, Foothills Medical Centre North Tower, Room 710, 1403 29th St NW, Calgary, Alberta, CanadaT2N 2T9. E-mail: Ayn.Sinnarajah@albertahealthservices.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

The purpose was to describe the physical, psychological, social, and spiritual needs of patients with non-cancer serious illness diagnoses compared to those of patients with cancer.

Method

We conducted a retrospective chart review of all patients with a non-cancer diagnosis admitted to a tertiary palliative care unit between January 2008 and December 2017 and compared their needs to those of a matched cohort of patients with cancer diagnoses. The prevalence of needs within the following four main concerns was recorded and the data analyzed using descriptive statistics and content analysis:

  • • Physical: pain, dyspnea, fatigue, anorexia, edema, and delirium

  • • Psychological: depression, anxiety, prognosis, and dignity

  • • Social: caregiver burden, isolation, and financial

  • • Spiritual: spiritual distress

Results

The prevalence of the four main concerns was similar among patients with non-cancer and cancer diagnoses. Pain, nausea/vomiting, fatigue, and anorexia were more prevalent among patients with cancer. Dyspnea was more commonly the primary concern in patients with non-cancer diagnoses (39%), who also had a higher prevalence of anxiety and concerns about dignity. Spirituality was addressed more often in patients with cancer.

Significance of results

The majority of patients admitted to tertiary palliative care settings have historically been those with cancer. The tertiary palliative care needs of patients with non-cancer diagnoses have not been well described, despite the increasing prevalence of this population. Our description of the palliative care needs of patients with non-cancer diagnoses will help guide future palliative care for the increasing population of patients with non-cancer serious illness diagnoses.

Keywords

CancerCare needsChronic illnessPalliative careSymptom management
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Issue 5 , October 2020 , pp. 513 - 518
Check for updates
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bacon, J (2015) Integrating a palliative approach into the management of chronic, life-threatening diseases: Who, how and when? Ottawa, Ontario, Canada: Canadian Hospice Palliative Care Association.Google Scholar
Bostwick, D, Wolf, S, Samsa, G, et al. (2017) Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness. Journal of Pain and Symptom Management 53(6), 1079–1084.e1.CrossRefGoogle ScholarPubMed
Canadian Institute for Health Information (2007) Health care use at the end of life in Western Canada. Ottawa: Canadian Institute for Health Information.Google Scholar
Chockinov, HM, Tataryn, DJ, Wilson, KG, et al. (2000) Prognostic awareness and the terminally ill. Psychosomatics 41, 500–504.CrossRefGoogle Scholar
Coventry, AP, Grande, EG, Richards, AD, et al. (2005) Prediction of appropriate timing of palliative care for older adults with non-malignant life-threatening disease: A systematic review. Age and Ageing 34, 218–277.CrossRefGoogle ScholarPubMed
Fallon, M and Foley, P (2012) Rising to the challenge of palliative care for non-malignant disease. Palliative Medicine 26(2), 99–100.CrossRefGoogle ScholarPubMed
Fitzsimons, D, Mullan, D, Wilson, JS, et al. (2007) The challenge of patients’ unmet palliative care needs in the final stages of chronic illness. Palliative Medicine 21(4), 313–322.CrossRefGoogle ScholarPubMed
Gillick, MR (2005) Rethinking the central dogma of palliative care. Journal of Palliative Medicine 8(5), 909–913.CrossRefGoogle ScholarPubMed
Hess, S, Stiel, S, Hofmann, S, et al. (2014) Trends in specialized palliative care for non-cancer patients in Germany – Data from the National Hospice and Palliative Care Evaluation (HOPE). European Journal of Internal Medicine 25(2), 187–192.CrossRefGoogle Scholar
Higginson, IJ, Costantini, M, Silber, E, et al. (2011) Evaluation of a new model of short-term palliative care for people severely affected with multiple sclerosis: A randomized fast-track trial to test timing of referral and how long the effect is maintained. Postgraduate Medical Journal 87(1033), 769–775.CrossRefGoogle ScholarPubMed
Mitchell, GK (2011) Palliative care in Australia. The Ochsner Journal 11(4), 334–337.Google ScholarPubMed
Murray, SA, Boyd, K and Sheikh, A (2005) Palliative care in chronic illness. British Medical Journal 330(7492), 611–612.CrossRefGoogle ScholarPubMed
NICE. Improving supportive and palliative care for adults with cancer. Available at: www.nice.org.uk/page.aspx?o=110005 (accessed 10 July 2019).Google Scholar
Ostgathe, C, Alt-Epping, B, Golla, H, et al. (2011) Non-cancer patients in specialized care in Germany: What are the problems? Palliative Medicine 25(2), 148–152.CrossRefGoogle ScholarPubMed
Prasad, P, Sarkar, S, Dubashi, B, et al. (2017) Estimation of need for palliative care among non-cancer patients attending a tertiary care hospital. Indian Journal of Palliative Care 23(4), 403–408.CrossRefGoogle ScholarPubMed
Rocker, G, Downar, J and Morrison, RS (2016) Palliative care for chronic illness: Driving change. Canadian Medical Association Journal 188, 17–18.Google ScholarPubMed
Schimmel, E (2003) The hazards of hospitalization. Quality and Safety in Health Care 2(1), 58–63.CrossRefGoogle Scholar
Stiel, S, Matthies, DM, SeuB, D, et al. (2014a) Symptoms and problem clusters in cancer and non-cancer patients in specialized palliative care – Is there a difference? Journal of Pain and Symptom Management 48(1), 26–35.CrossRefGoogle Scholar
Stiel, S, Psych, D, Matthies, MKD, et al. (2014b) Symptoms and problem clusters in cancer and non-cancer patients in specialized palliative care – Is there a difference? Journal of Pain and Symptom Management 48(1), 26–35.CrossRefGoogle Scholar
Temel, JS, Greer, JA, Muzikansky, A, et al. (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine 363(8), 733–742.CrossRefGoogle ScholarPubMed
Thompson, GN, Chochinov, HM, Wilson, KG, et al. (2009) Prognostic acceptance and the well-being of patients receiving palliative care for cancer. Journal of Clinical Oncology 27, 2757–5762.CrossRefGoogle ScholarPubMed
Wilson, KG, Chockinov, HM, Skirko, MG, et al. (2007) Depression and anxiety disorders in palliative cancer care. Journal of Pain and Symptom Management 33, 118–129.CrossRefGoogle ScholarPubMed