Öz
Purpose: Palliative care has an important role in the late stages of diseases. Patients deal with many symptoms. Physiotherapy approaches are an essential part of palliative care in symptom control. This study was planned to investigate the level of independence of the patients, their performance status, symptoms, rehabilitation needs, and caregivers’ expectations.
Methods: The study was designed as cross-sectional and descriptive. Ninety individuals aged between 18 and 65 years were included. Care needs during palliative care were assessed with the Palliative Performance Scale. Independence level was assessed by the Barthel Index. The severity of the symptoms that the patients frequently experienced was investigated. Caregivers reported their primary expectations from physiotherapy.
Results: The most common diagnosis was found to be cerebrovascular accidents. The mean age of the patients was 64±20 years. The mean age of the caregivers was 49±13 years. The mean the Palliative Performance Scale score was 31±17. Most of the patients were totally dependent according to the Barthel Index. Most of the patients faced symptoms, such as reduced muscle strength (94.44%), atrophy (93.33%) and swallowing problems (82.22%). Improved physical functions was the most reported expectation among caregivers.
Conclusion: Over 90% of the patients were totally dependent and they had to deal with many symptoms. This result highlights the importance of physiotherapy. Caregivers expected the patient to be able to meet their own needs independently. This is very important for the caregiver, and the patient and caregiver should be in cooperation with the physiotherapist.
Anahtar Kelimeler
Kaynakça
- 1. Carlson JA, Schipperijn J, Kerr J, Saelens BE, Natarajan L, Frank LD, et al. Locations of Physical Activity as Assessed by GPS in Young Adolescents. Pediatrics. 2016;137(1).
- 2. Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM, et al. American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. Journal of clinical oncology. 2012.
- 3. Zimmermann C, Swami N, Krzyzanowska M, Leighl N, Rydall A, Rodin G, et al. Perceptions of palliative care among patients with advanced cancer and their caregivers. Cmaj. 2016;188(10):E217-E27.
- 4. Özalp GŞ, Uysal N, Oğuz G, Koçak N, Karaca Ş, Kadıoğulları NJ. Identification of symptom clusters in cancer patients at palliative care clinic. Asia-Pacific Journal of Oncology Nursing. 2017;4(3):259.
- 5. Xu M, Zhou W, Yang L, Liu G, Chen L. Effect of palliative care on the anxiety, depression and sleep quality in primary caregivers of elderly patients with terminal cancer. Am J Transl Res. 2021;13(4):3738-44.
- 6. Swetz KM, Shanafelt TD, Drozdowicz LB, Sloan JA, Novotny PJ, Durst LA, et al. Symptom burden, quality of life, and attitudes toward palliative care in patients with pulmonary arterial hypertension: results from a cross-sectional patient survey. The Journal of Heart Lung Transplantation. 2012;31(10):1102-8.
- 7. Putt K, Faville KA, Lewis D, McAllister K, Pietro M, Radwan A. Role of Physical Therapy Intervention in Patients With Life-Threatening Illnesses. Am J Hosp Palliat Care. 2017;34(2):186-96.
- 8. Reticker AL, Nici L, ZuWallack R. Pulmonary rehabilitation and palliative care in COPD: Two sides of the same coin? Chron Respir Dis. 2012;9(2):107-16.
- 9. Kumar SP, Jim A. Physical therapy in palliative care: from symptom control to quality of life: a critical review. Indian J Palliat Care. 2010;16(3):138-46.
- 10. Association APT. Guide to Physical Therapist Practice. American Physical Therapy Association. Physical therapy. 2001;81(1):9.
- 11. Mochamat, Cuhls H, Sellin J, Conrad R, Radbruch L, Muecke M. Fatigue in advanced disease associated with palliative care: A systematic review of non-pharmacological treatments. Palliative Medicine. 2021;35(4):697-709.
- 12. Wilson CM, Stiller CH, Doherty DJ, Thompson KA, Smith AB, Turczynski KL. Physical therapists in integrated palliative care: a qualitative study. BMJ Supportive & Palliative Care. 2022;12(e1):e59-e67.
- 13. Anderson F, Downing GM, Hill J, Casorso L, Lerch NJ. Palliative performance scale (PPS): a new tool. Journal of Palliative Care. 1996;12(1):5-11.
- 14. Lin JT, Lane JM. Falls in the elderly population. Physical medicine and rehabilitation clinics of North America. 2005;16(1):109-28.
- 15. Wilson CM, Stiller CH, Doherty DJ, Thompson KA. The Role of Physical Therapists Within Hospice and Palliative Care in the United States and Canada. Am J Hosp Palliat Care. 2017;34(1):34-41.
- 16. Vira P, Samuel SR, Amaravadi SK, Saxena PP, Rai Pv S, Kurian JR, et al. Role of Physiotherapy in Hospice Care of Patients with Advanced Cancer: A Systematic Review. Am J Hosp Palliat Care. 2021;38(5):503-11.
- 17. Iversen K, Oechsle K, Oing C, Bokemeyer C, Seidel CJ. Specific Characteristics of Patients with Advanced Genitourinary Cancer Receiving Specialized Inpatient Palliative Care. Oncology research treatment. 2017;40(10):609-15.
- 18. Uysal N, Şenel G, Karaca Ş, Kadıoğulları N, Koçak N, Oğuz G. Palyatif bakım kliniğinde yatan hastalarda görülen semptomlar ve palyatif bakımın semptom kontrolüne etkisi. Ağrı. 2015;27(2):104-10.
- 19. Tarolli CG, Holloway RG. Palliative care and Parkinson's disease: outpatient needs and models of care over the disease trajectory. Annals of Palliative Medicine. 2019;9(Suppl 1):S44-S51.
- 20. Gökçal E, Gür VE, Selvitop R, Babacan Yildiz G, Asil T. Motor and Non-Motor Symptoms in Parkinson's Disease: Effects on Quality of Life. Noro Psikiyatr Ars. 2017;54(2):143-8.
- 21. Garibaldi BT, Danoff SK. Symptom‐based management of the idiopathic interstitial pneumonia. Respirology. 2016;21(8):1357-65.
- 22. Fong DY, Ho JW, Hui BP, Lee AM, Macfarlane DJ, Leung SS, et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. Bmj. 2012;344:e70.
- 23. McLeod KE, Norman KE. “I've found it's very meaningful work”: Perspectives of physiotherapists providing palliative care in Ontario. Physiotherapy Research International. 2019;25(1):e1802.
- 24. Demir YP, Balci NÇ, Ünlüer NÖ, Uluğ N, Dogru E, Kilinç M, et al. Three different points of view in stroke rehabilitation: patient, caregiver, and physiotherapist. Topics in Stroke Rehabilitation. 2015;22(5):377-85.
- 25. Roh S-Y, Yeom H-A, Lee M-A, Hwang IYJ. Mobility of older palliative care patients with advanced cancer: a Korean study. European Journal of Oncology Nursing. 2014;18(6):613-8.
Öz
Amaç: Palyatif bakımın hastalıkların geç evrelerinde önemli bir rolü vardır. Hastalar birçok semptomla baş etmektedir. Fizyoterapi yaklaşımları semptom kontrolünde palyatif bakımın önemli bir parçasıdır. Bu çalışma, hastaların bağımsızlık düzeylerini, performans durumlarını, semptomlarını, rehabilitasyon ihtiyaçlarını ve bakım verenlerin beklentilerini araştırmak amacıyla planlanmıştır.
Yöntem: Çalışma kesitsel ve tanımlayıcı olarak tasarlanmıştır. 18-65 yaş grubu 90 birey dahil edildi. Palyatif bakımdaki hastaların bakım ihtiyaçları Palyatif Performans Ölçeği ile değerlendirildi. Bağımsızlık düzeyi Barthel Endeksi ile değerlendirildi. Hastaların sıklıkla yaşadığı semptomların şiddeti araştırıldı. Bakım verenler, fizyoterapiden birincil beklentilerini bildirdiler.
Sonuçlar: En çok raporlanan tanı serebrovasküler olay oldu. Hastaların yaş ortalaması 64±20 idi. Bakım verenlerin yaş ortalaması 49±13 idi. Ortalama Palyatif Performans Ölçeği skoru 31±17 idi. Hastaların çoğu Barthel İndeksine göre tamamen bağımlıydı. Hastaların çoğu azalmış kas gücü (% 94,44), atrofi (% 93,33) ve yutma problemleri (% 82,22) gibi semptomlarla karşı karşıya kaldığını belirtti. Bakım verenlerin beklentisi, hastanın fiziksel fonksiyonlarının iyileşmesi yönündeydi.
Tartışma: Hastaların %90'ından fazlası tamamen bağımlıydı ve semptomlarla uğraşmak zorunda kaldıklarını belirttiler. Bu sonuç fizyoterapinin önemini vurgulamaktadır. Bakım verenler hastanın ihtiyaçlarını bağımsız olarak karşılamasını istediğini belirttiler. Bu durum bakım veren için oldukça önemlidir ve hasta ve bakımverenler fizyoterapistlerle işbirliği içinde olmalıdır.
Anahtar Kelimeler
Kaynakça
- 1. Carlson JA, Schipperijn J, Kerr J, Saelens BE, Natarajan L, Frank LD, et al. Locations of Physical Activity as Assessed by GPS in Young Adolescents. Pediatrics. 2016;137(1).
- 2. Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM, et al. American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. Journal of clinical oncology. 2012.
- 3. Zimmermann C, Swami N, Krzyzanowska M, Leighl N, Rydall A, Rodin G, et al. Perceptions of palliative care among patients with advanced cancer and their caregivers. Cmaj. 2016;188(10):E217-E27.
- 4. Özalp GŞ, Uysal N, Oğuz G, Koçak N, Karaca Ş, Kadıoğulları NJ. Identification of symptom clusters in cancer patients at palliative care clinic. Asia-Pacific Journal of Oncology Nursing. 2017;4(3):259.
- 5. Xu M, Zhou W, Yang L, Liu G, Chen L. Effect of palliative care on the anxiety, depression and sleep quality in primary caregivers of elderly patients with terminal cancer. Am J Transl Res. 2021;13(4):3738-44.
- 6. Swetz KM, Shanafelt TD, Drozdowicz LB, Sloan JA, Novotny PJ, Durst LA, et al. Symptom burden, quality of life, and attitudes toward palliative care in patients with pulmonary arterial hypertension: results from a cross-sectional patient survey. The Journal of Heart Lung Transplantation. 2012;31(10):1102-8.
- 7. Putt K, Faville KA, Lewis D, McAllister K, Pietro M, Radwan A. Role of Physical Therapy Intervention in Patients With Life-Threatening Illnesses. Am J Hosp Palliat Care. 2017;34(2):186-96.
- 8. Reticker AL, Nici L, ZuWallack R. Pulmonary rehabilitation and palliative care in COPD: Two sides of the same coin? Chron Respir Dis. 2012;9(2):107-16.
- 9. Kumar SP, Jim A. Physical therapy in palliative care: from symptom control to quality of life: a critical review. Indian J Palliat Care. 2010;16(3):138-46.
- 10. Association APT. Guide to Physical Therapist Practice. American Physical Therapy Association. Physical therapy. 2001;81(1):9.
- 11. Mochamat, Cuhls H, Sellin J, Conrad R, Radbruch L, Muecke M. Fatigue in advanced disease associated with palliative care: A systematic review of non-pharmacological treatments. Palliative Medicine. 2021;35(4):697-709.
- 12. Wilson CM, Stiller CH, Doherty DJ, Thompson KA, Smith AB, Turczynski KL. Physical therapists in integrated palliative care: a qualitative study. BMJ Supportive & Palliative Care. 2022;12(e1):e59-e67.
- 13. Anderson F, Downing GM, Hill J, Casorso L, Lerch NJ. Palliative performance scale (PPS): a new tool. Journal of Palliative Care. 1996;12(1):5-11.
- 14. Lin JT, Lane JM. Falls in the elderly population. Physical medicine and rehabilitation clinics of North America. 2005;16(1):109-28.
- 15. Wilson CM, Stiller CH, Doherty DJ, Thompson KA. The Role of Physical Therapists Within Hospice and Palliative Care in the United States and Canada. Am J Hosp Palliat Care. 2017;34(1):34-41.
- 16. Vira P, Samuel SR, Amaravadi SK, Saxena PP, Rai Pv S, Kurian JR, et al. Role of Physiotherapy in Hospice Care of Patients with Advanced Cancer: A Systematic Review. Am J Hosp Palliat Care. 2021;38(5):503-11.
- 17. Iversen K, Oechsle K, Oing C, Bokemeyer C, Seidel CJ. Specific Characteristics of Patients with Advanced Genitourinary Cancer Receiving Specialized Inpatient Palliative Care. Oncology research treatment. 2017;40(10):609-15.
- 18. Uysal N, Şenel G, Karaca Ş, Kadıoğulları N, Koçak N, Oğuz G. Palyatif bakım kliniğinde yatan hastalarda görülen semptomlar ve palyatif bakımın semptom kontrolüne etkisi. Ağrı. 2015;27(2):104-10.
- 19. Tarolli CG, Holloway RG. Palliative care and Parkinson's disease: outpatient needs and models of care over the disease trajectory. Annals of Palliative Medicine. 2019;9(Suppl 1):S44-S51.
- 20. Gökçal E, Gür VE, Selvitop R, Babacan Yildiz G, Asil T. Motor and Non-Motor Symptoms in Parkinson's Disease: Effects on Quality of Life. Noro Psikiyatr Ars. 2017;54(2):143-8.
- 21. Garibaldi BT, Danoff SK. Symptom‐based management of the idiopathic interstitial pneumonia. Respirology. 2016;21(8):1357-65.
- 22. Fong DY, Ho JW, Hui BP, Lee AM, Macfarlane DJ, Leung SS, et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. Bmj. 2012;344:e70.
- 23. McLeod KE, Norman KE. “I've found it's very meaningful work”: Perspectives of physiotherapists providing palliative care in Ontario. Physiotherapy Research International. 2019;25(1):e1802.
- 24. Demir YP, Balci NÇ, Ünlüer NÖ, Uluğ N, Dogru E, Kilinç M, et al. Three different points of view in stroke rehabilitation: patient, caregiver, and physiotherapist. Topics in Stroke Rehabilitation. 2015;22(5):377-85.
- 25. Roh S-Y, Yeom H-A, Lee M-A, Hwang IYJ. Mobility of older palliative care patients with advanced cancer: a Korean study. European Journal of Oncology Nursing. 2014;18(6):613-8.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Rehabilitasyon |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Nisan 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 35 Sayı: 1 |
