Clinical and epidemiological characteristics of palliative patients of neurological and oncological treatment profiles
PDF (Українська)

Keywords

palliative and hospice care
visual analog pain scale
quality of life
satisfaction with treatment

How to Cite

Nesterenko, V., & Redka, I. (2024). Clinical and epidemiological characteristics of palliative patients of neurological and oncological treatment profiles. Medicine Today and Tomorrow, 93(4). https://doi.org/10.35339/msz.2024.93.4.ner

Abstract

In press

The study was conducted to study the unexplored issues of regional differences in the need for Palliative and Hospice Care (PHC) in Ukraine and to statistically test the relationship between the parameters of quality of life, pain level and quality of pain relief in palliative patients with oncological and neurological treatment profiles. Medical-statistical (in particular, Spear­man's rank correlation), sociological (in particular, the SF-36 questionnaire on quality of life) and comparative methods were used. The need for PHC in all regions of Ukraine fluctuated within 1% of the population. No regional impacts were detected. For the medical-social study, customized groups of neurological (50 patients, 1st group) and oncological (50 patients, 2nd group) treatment profiles were formed from a cohort of 171 patients from the Kharkiv hospice. Significant (p<0.05) direct correlations were found between indicators of general health and vitality of 1st group patients (r=0.316), and between indicators of physical functioning and subjective assessment of treatment results within 3–4 weeks of 2nd group patients (reduction in manifestations of cancer intoxication and organ and system failure; r=0.332). The results confirmed the correctness of the modification of the SF-36 questionnaire at the previous stages of the study. A significant (p<0.05) moderate inverse relationship (r=-0.613) was determined between satisfaction with treatment and the level of pain according to Visual Analog Scale (VAS) in the group of 1st group patients; and a significant strong inverse relationship (r=-0.713) between satisfaction with treatment and the level of pain according to VAS in the group of 2nd group patients. The adequacy of painkiller prescription (timeliness of prescription and choice of drug) is low even during inpatient hospice treatment: 78% in patients with neurological treatment profile and 84% in patients with oncological treatment profile

Keywords: palliative and hospice care, visual analog pain scale, quality of life, satisfaction with treatment.

https://doi.org/10.35339/msz.2024.93.4.ner
PDF (Українська)

References

Holovanova IA, Shevchenko AS. The issue of patient-oriented organization of palliative and hospice care in Ukraine. Experimental and Clinical Medicine. 2021;90(2):21-7. DOI: 10.35339/ekm.2021.90.2.hos.

Palliative care. WHO. [Internet]. Available at: https://www.who.int/health-topics/palliative-care [accessed 31 Dec 2024].

Holovanova IA, Shevchenko AS. Determination of the main needs of palliative patients and ways of their provision in the health care system of Ukraine. Experimental and Clinical Medicine. 2021;90(3):88-94. DOI: 10.35339/ekm.2021.90.3.hos.

Nesterenko V, Shevchenko A, Zhuravel Ya. Prevention of neurodegenerative diseases’ complications in palliative patients at home hospice: organizational principles. Proceedings of the International scientific conference "The greatest humankind achievements in healthcare and veterinary medicine" (Latvia, Riga, 7–8 Feb 2024). P. 96-9. DOI: 10.30525/978-9934-26-401-6-26. [In Ukrainian].

Building Integrated Palliative Care Programs and Services. Ed. Gómez-Batiste X, Connor S. WHO Collaborating Centre Public Health Palliative Care Programmes, Worldwide Hospice Palliative Care Alliance, 2017. 379 p.

Holovanova IA, Shevchenko AS. Evaluation of packaged funding programs for palliative and hospice care by the National Health Service of Ukraine. Experimental and Clinical Medicine. 2021;90(4):45-52. DOI: 10.35339/ekm.2021.90.4.hos.

Anekar AA, Hendrix JM, Cascella M. WHO Analgesic Ladder. [Updated 23 Apr 2023]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available at: https://www.ncbi.nlm.nih.gov/books/NBK554435/

Nesterenko VG, Shevchenko AS, Zelenska KO, Hryhorov MM. Clinical and epidemiological characteristics of disabling neurological diseases (literature review). International Neurological Journal. 2024;20(4):176-84. DOI: 10.22141/2224-0713.20.4.2024.1079. [In Ukrainian].

Nesterenko VH, Peresypkina TV, Shevchenko OS, Sarkhadova II. Palliative and hospice care in the Kharkiv region in the first year of the war. Ukraine. Nation's Health. 2023;73(3):106-12. DOI: 10.32782/2077-6594/2023.3/18.

Planning and implementing palliative care services: a guide for program managers. Geneva: WHO Press; 2016. 91 p. Available at: http://apps.who.int/iris/bitstream/handle/10665/250584/9789241565417-eng.pdf

Nesterenko VG, Shevchenko VV. Calculation of the national need for palliative care by the refined method of trends in the conditions of a military crisis. Eastern Ukrainian Medical Journal. 2024;12(3):711-20. DOI: 10.21272/eumj.2024;12(3):711-720.

Nesterenko VG, Redka IV, Sukhonosov RO, Grygorov SM, Shevchenko AS, Aliieva TD. Forecasting the need for palliative and hospice care using the creeping trend method with segment smoothing. Wiadomości Lekarskie. 2024;77(5):980-4. DOI: 10.36740/WLek202405116. PMID: 39008586.

Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163-96. DOI: 10.1016/S0140-6736(12)61729-2. Erratum in: Lancet. 2013;381(9867):628. PMID: 23245607.

WHO methods and data sources for global burden of disease estimates 2000–2019. Geneva: WHO; 2020. 47 p. Available at: https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_daly-methods.pdf

The need for palliative care: an assessment based on 2018 data. Ukrainian Center for Social Data. [Internet]. Available at: https://socialdata.org.ua/palliative/ [accessed 31 Dec 2024]. [In Ukrainian].

Prazak KA, Lester PE, Fazzari M. Evaluation of physician assistant student knowledge and perception of competence in palliative symptom management. J Allied Health. 2014;43(4):e69-74. PMID: 25433191.

Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S240-52. DOI: 10.1002/acr.20543. PMID: 22588748.

Population of Ukraine in 2018. Demographic Yearbook. Timonina MB (ed.) Kyiv: State Statistics Service of Ukraine; 2019. 188 p. Available at: https://www.ukrstat.gov.ua/druk/publicat/kat_u/2019/zb/12/zb_ukr_2018.pdf [accessed 31 Dec 2024]. [In Ukrainian].

Watson JC. Evaluation of Pain. MSD Manual. Professional Version, last upd. 2022. [Internet]. Available at: https://www.msdmanuals.com/professional/neurologic-disorders/pain/evaluation-of-pain [accessed 31 Dec 2024].

Nesterenko VG. Peculiarities of using the SF-36 questionnaire in palliative neurological patients. Medicine Today and Tomorrow. 2023;92(2):62-72. DOI: 10.35339/msz.2023.92.2.nes. [In Ukrainian].

Nesterenko VG. Peculiarities of using the SF-36 questionnaire in palliative oncological patients. Experimental and Clinical Medicine. 2023;92(3):73-85. DOI: 10.35339/ekm.2023.92.3.nes. [In Ukrainian].

Worldwide Hospice Palliative Care Alliance [Internet]. Available at: https://thewhpca.org/ [accessed 31 Dec 2024].

World Population Prospects. UN Department of Economic and Social Affairs. [Internet]. Available at: https://population.un.org/wpp/ [accessed 31 Dec 2024].

World Bank Country and Lending Groups [Internet]. Available at: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups [accessed 31 Dec 2024].

Palliative Care and Human Rights. Chapter 5 in: Health Care and Human Rights: Resource Assistance. 5th ed. Translated from English. Boston, Lviv, New York: Harvard Medical School, Francois-Xavier Bagnoux Center for Health and Human Rights, Lviv Regional Charitable Foundation "Medicine and Law", Open Society Foundation; 2015. 76 p. [Internet]. Available at: https://surl.li/hntiay [accessed 31 Dec 2024]. [In Ukrainian].

Help for the terminally ill: life until the last breath. Ukrainian Medical Journal, 17 Oct 2012. 2 p. [Internet]. Available at: https://api.umj.com.ua/wp/wp-content/uploads/2012/10/HosPis.pdf [accessed 31 Dec 2024]. [In Ukrainian].

Main Department of Statistics in Lviv Region. Demographic and Social Statistics [Internet]. Available at: http://lv.ukrstat.gov.ua/ukr/si/st_inf.php?1811 [accessed 31 Dec 2024]. [In Ukrainian].

The mayor of Lviv named the number of displaced people in the city. RBC-Ukraine, 14 Feb 2023. [Internet]. Available at: http://surl.li/jdhmvd [accessed 31 Dec 2024]. [In Ukrainian].

Almost 240 thousand displaced persons have registered in Lviv region. RBC-Ukraine, May 8, 2023. [Internet]. Available at: http://surl.li/zgamil [accessed 31 Dec 2024]. [In Ukrainian].

More care for those with serious illnesses: a new palliative care program has been developed in Lviv. Lviv City Council, 19 Dec 2024 [Internet]. Available at: https://surl.li/ibmthu [accessed 31 Dec 2024]. [In Ukrainian].

Miyashita M, Narita Y, Sakamoto A, Kawada N, Akiyama M, Kayama M, et al. Health-related quality of life among community-dwelling patients with intractable neurological diseases and their caregivers in Japan. Psychiatry Clin Neurosci. 2011;65(1):30-8. DOI: 10.1111/j.1440-1819.2010.02155.x. PMID: 21105961.

Radbruch L, Loick G, Kiencke P, Lindena G, Sabatowski R, Grond S, et al. Validation of the German version of the Brief Pain Inventory. J Pain Symptom Manage. 1999;18(3):180-7. DOI: 10.1016/s0885-3924(99)00064-0. PMID: 10517039.

Kaasa S, Loge JH, Knobel H, Jordhøy MS, Brenne E. Fatigue. Measures and relation to pain. Acta Anaesthesiol Scand. 1999;43(9):939-47. DOI: 10.1034/j.1399-6576.1999.430911.x. PMID: 10522741.

Capelli G, De Vincenzo RI, Addamo A, Bartolozzi F, Braggio N, Scambia G. Which dimensions of health-related quality of life are altered in patients attending the different gynecologic oncology health care settings? Cancer. 2002;95(12):2500-7. DOI: 10.1002/cncr.10993. PMID: 12467063.

Unified clinical protocol of palliative medical care for chronic pain syndrome. Approved by Order of the Ministry of Health of Ukraine No.311 on 25 Apr 2012. Kyiv: State Expert Center of the Ministry of Health of Ukraine; 2012. 38 p. Available at: https://www.dec.gov.ua/wp-content/uploads/2019/11/dod_311_2ykpmd.pdf [in Ukrainian].

Pinkerton R, Mitchell G, Hardy J. Stringent Control of Opioids: Sound Public Health Measures, but a Step Too Far in Palliative Care? Curr Oncol Rep. 2020;22(4):34. DOI: 10.1007/s11912-020-0900-5. PMID: 32170510.

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