Rehabilitation of Advanced Cancer Patients in Palliative Care Unit
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective To evaluate the compliance and satisfaction of rehabilitation recommendations for advanced cancer patients hospitalized in the palliative care unit. Methods Advanced cancer patients admitted to a hospice palliative care unit were recruited. Patients with advanced cancer and a life expectancy of less than 6 months, as assumed by the oncologist were included. Patients who were expected to die within 3 days were excluded. ECOG and Karnofsky performance scales, function ambulatory category, level of ambulation, and survival days were evaluated under the perspective of comprehensive rehabilitation. Problem-based rehabilitations were provided categorized as physical therapy at the gym, bedside physical therapy, physical modalities, medications and pain intervention. Investigation of compliance for each category was completed. Patient satisfaction was surveyed using a questionnaire. Results Forty-five patients were recruited and received evaluations for rehabilitation perspective. The subjects were reported to have gait-related difficulties (71.1%), pain (68.9%), poor medical conditions (68.9%), bladder or bowel problems (44.4%), dysphagias (11.1%), mental status issues (11.1%), edemas (11.1%), spasticity (2.2%), and pressure sores (2.2%). In the t-test, patients with good compliance for GymPT showed higher survival days (p<0.05). In the satisfaction survey, patients with performance scales showed a greater satisfaction in Spearman’s correlation analysis (p<0.05). Conclusion Advanced cancer patients admitted to the hospice palliative care unit have many rehabilitation needs. Patients with a longer survival time showed better compliance for GymPT. Patients with a better performance scale showed a higher satisfaction. Comprehensive rehabilitation may be needed to advanced cancer patients in the hospice palliative care unit.
Abstract
Objective To evaluate the compliance and satisfaction of rehabilitation recommendations for advanced cancer patients hospitalized in the palliative care unit. Methods Advanced cancer patients admitted to a hospice palliative care unit were recruited. Patients with advanced cancer and a life expectancy of less than 6 months, as assumed by the oncologist were included. Patients who were expected to die within 3 days were excluded. ECOG and Karnofsky performance scales, function ambulatory category, level of ambulation, and survival days were evaluated under the perspective of comprehensive rehabilitation. Problem-based rehabilitations were provided categorized as physical therapy at the gym, bedside physical therapy, physical modalities, medications and pain intervention. Investigation of compliance for each category was completed. Patient satisfaction was surveyed using a questionnaire. Results Forty-five patients were recruited and received evaluations for rehabilitation perspective. The subjects were reported to have gait-related difficulties (71.1%), pain (68.9%), poor medical conditions (68.9%), bladder or bowel problems (44.4%), dysphagias (11.1%), mental status issues (11.1%), edemas (11.1%), spasticity (2.2%), and pressure sores (2.2%). In the t-test, patients with good compliance for GymPT showed higher survival days (p<0.05). In the satisfaction survey, patients with performance scales showed a greater satisfaction in Spearman’s correlation analysis (p<0.05). Conclusion Advanced cancer patients admitted to the hospice palliative care unit have many rehabilitation needs. Patients with a longer survival time showed better compliance for GymPT. Patients with a better performance scale showed a higher satisfaction. Comprehensive rehabilitation may be needed to advanced cancer patients in the hospice palliative care unit.
참고문헌 (23)
- 신현영, "2014년 사망원인 통계", 대한의사협회지, 59(3), pp.221~232 (2016), 대한의사협회[DOI]
- Jung Mi Jo, "The Need of Cancer Patients for Rehabilitation Services", Annals of Rehabilitation Medicine, 34(6), pp.691~700 (2010), 대한재활의학회
- Okamura H, "Importance of rehabilitation in cancer treatment and palliative medicine", Jpn J Clin Oncol, 41, pp.733~738 (2011)[DOI]
- Lipsett A, "The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: a systematic review and meta-analysis", Breast, 32, pp.144~155 (2017)[DOI]
- Carduff E, "Living and dying with metastatic bowel cancer: serial in-depth interviews with patients", Eur J Cancer Care (Engl) (2017)
- Dasch B, "Care of cancer patients at the end of life in a German university hospital: a retrospective observational study from 2014", PLoS One, 12, pp.e0175124~ (2017)[DOI]
- Hartogh GD, "Suffering and dying well: on the proper aim of palliative care", Med Health Care Philos, 20, pp.413~424 (2017)[DOI]
- Kanach FA, "The role of rehabilitation in palliative care services", Am J Phys Med Rehabil, 93, pp.342~345 (2014)[DOI]
- McIlfatrick S, "Evaluating a dignity care intervention for palliative care in the community setting: community nurses' perspectives", J Clin Nurs, 26, pp.4300~4312 (2017)[DOI]
- Eyigor S, "Is exercise ignored in palliative cancer patients?", World J Clin Oncol, 5, pp.554~559 (2014)[DOI]
- Talbot Rice H, "An evaluation of the St Christopher's Hospice rehabilitation gym circuits classes: patient uptake, outcomes, and feedback", Prog Palliat Care, 22, pp.319~325 (2014)[DOI]
- Gerber LH, "Cancer rehabilitation into the future", Cancer, 92(4 Suppl), pp.975~979 (2001)[DOI]
- Oken MM, "Toxicity and response criteria of the Eastern Cooperative Oncology Group", Am J Clin Oncol, 5, pp.649~655 (1982)[DOI]
- Karnofsky DA, "The use of the nitrogen mustards in the palliative treatment of carcinoma: with particular reference to bronchogenic carcinoma", Cancer, 1, pp.634~656 (1948)[DOI]
- Holden MK, "Clinical gait assessment in the neurologically impaired. Reliability and meaningfulness", Phys Ther, 64, pp.35~40 (1984)[DOI]
- DeLisa JA, "A history of cancer rehabilitation", Cancer, 92(4 Suppl), pp.970~974 (2001)[DOI]
- Cheville A, "Rehabilitation of patients with advanced cancer", Cancer, 92(4 Suppl), pp.1039~1048 (2001)[DOI]
- 정한영, "국제 기능, 장애 및 건강 분류의 등장과 재활의학적 적용", Annals of Rehabilitation Medicine, 28(5), pp.401~411 (2004), 대한재활의학회
- Abrahm JL, "Spinal cord compression in patients with advanced metastatic cancer: "all I care about is walking and living my life", JAMA, 299, pp.937~946 (2008)[DOI]
- Stubblefield MD, "Upper body pain and functional disorders in patients with breast cancer", PM R, 6, pp.170~183 (2014)[DOI]
- Stubblefield MD, "Upper-extremity pain disorders in breast cancer", Arch Phys Med Rehabil, 87(3 Suppl 1), pp.S96~S99 (2006)
- Gheita TA, "Musculoskeletal manifestations in patients with malignant disease", Clin Rheumatol, 29, pp.181~188 (2010)[DOI]
- 양은주, "Current Practice and Barriers in Cancer Rehabilitation: Perspectives of Korean Physiatrists", Cancer Research and Treatment, 47(3), pp.370~378 (2015), 대한암학회[DOI]