Indian Journal of Palliative Care最新文献

[This retracts the article DOI: 10.25259/IJPC_98_21.].

This study sought to explore the unmet palliative care needs of patients diagnosed with Stage B chronic heart failure (CHF) according to the American Heart Association (AHA) and American College of Cardiology (ACC) classifications. We conducted this cross-sectional study between June 1 and August 31, 2020, at Kobe University Hospital. Patients were asked to complete the Integrated Palliative care Outcome Scale (IPOS) along with a customized questionnaire developed by a multidisciplinary team. These tools were filled out by the patients themselves or with help from family members. A total of 101 patients participated in the study, with 55 of them (55%) falling into the Stage B CHF group as classified by AHA/ACC. Among the physical symptoms, 22% reported dyspnea and 20% reported drowsiness as common concerns. Regarding specific problems, 47% identified issues related to exercise, 62% with eating, 26% with finances, and 18% with employment. Notably, financial difficulties were found to be significantly more common among Stage B patients when compared to those in Stages C and D (odds ratio [OR]: 5.22; 95% confidence interval [95% CI]: 1.03-26.5; p = 0.032). Almost 79% of Stage B patients expressed a desire to understand the progression of their disease. In conclusion, stage B CHF patients may face financial difficulties and have unmet informational needs. Therefore, further research is necessary to explore these aspects in greater detail.

Objective: The objective of this study was to validate the 'Functional Assessment of Chronic Illness Therapy-Spiritual-Well-being-Expanded(FACIT-SpEx) Version 4' tool in Malayalam and assess its feasibility among advanced cancer patients receiving palliative care.

Materials and methods: The study was carried out at the outpatient Department of Cancer Palliative Medicine of Malabar Cancer Centre between November 2022 and June 2023. Initially, the FACIT-Sp-Ex version 4 tool with 23 items was translated into the Malayalam language with a forward-backward translation procedure. This was followed by pilot testing in 10 advanced adult cancer patients receiving palliative care who could read and comprehend the Malayalam language. After answering the draft version of the validated tool, patients responded to questions from a Malayalam-translated cognitive debriefing script.

Results: The process of translation and cross-cultural adaptation went on smoothly with very few hurdles. The Malayalam terms used in three items Sp⁷, Sp⁹ and Sp²³ when back translated were found to be different from the source. These issues were resolved with the use of the most suitable translations and closest equivalents available in Malayalam. In the pilot testing, the majority (70%) of the patients were female. The mean age of patients was 45.90 (standard deviation [SD] = 7.62) years. Carcinoma breast (50%) was the most common type of cancer. All the patients knew their diagnosis, while only 80% knew the prognosis. Almost 90% of the patients were receiving some form of palliative anticancer treatment. All patients completed the draft version of the validated tool. The mean spiritual well-being score measured using this validated tool was 71.20 (SD = 15.10). Analysis of the debriefing interviews revealed that the Malayalam version was easy to complete, relevant, and appropriate.

Conclusion: Linguistic validation and cognitive debriefing produced the Malayalam translated FACIT-Sp-Ex version 4 tool conceptually equivalent to the original FACIT-Sp-Ex version 4 tool, and it is feasible for its use.

Objectives: The conventional healthcare system operates on the 'physiological man' and overlooks the 'spiritual man'. Many studies reported on the unmet spiritual needs of terminally ill patients. Despite spiritual care being a predictor of a positive mindset (meaning making) among patients with terminal illnesses, assessing spiritual needs and providing adequate spiritual care is still a distant phenomenon in the healthcare setting.

Materials and methods: With the help of a spiritual needs questionnaire, we analysed the unmet spiritual needs and preferences of 30 terminally ill patients. Specific attention was given to psychosocial, emotional, existential, religious and acceptance of death.

Results: The results show that 72% of terminally ill patients reported a strong desire to have their spiritual needs met. Psychosocial needs scored the highest, while acceptance of dying scored the least. The need to be connected with the family was one of the strongest wishes expressed in the study. Religious needs ranked as the second category of needs. Findings show that the highest needs are intertwined with the patients' culture.

Conclusion: In India, religion and family connections are essential; terminally ill patients expressed the desire that meeting these two aspects makes their lives meaningful even at the end stage. The results warrant a spiritual needs assessment as a deathbed test to make the end-of-life more meaningful.

This systematic review was carried out to appraise the evidence regarding the brassiere-wearing practices and problems faced by breast cancer survivors. An electronic search was carried out across eight databases such as PubMed, Scopus, Web of Science, Science Direct, Google Scholar, Embase, CINAHL and ProQuest. Two researchers independently screened the studies for their eligibility and study quality. A total of 309 studies were assessed for eligibility. After conflict resolution by the third reviewer, five studies were selected for systematic review. All study outcomes in terms of the pattern of brassieres/prostheses, issues and challenges faced by women post-mastectomy were reviewed. It was observed that very few studies were published from various countries all over the world. All the studies were of descriptive type except one, which adopted a prospective randomised crossover design. The brassieres or prostheses, the survivors preferred were homemade made of cotton, cloth, wool, rice, sponge or commercially silicon-made. Weight of the brassiere/prostheses, discomfort, displacement while doing activities of daily living and impaired body image were common issues identified, while the unavailability of size or fit of the brassieres or requirement of alteration in clothes to meet clothing styles were common challenges faced by post-mastectomy women. It was concluded that the post- mastectomy used varied types of brassieres or prostheses with various associated issues and challenges.

Objectives: Morphine is the cornerstone of pain management in a palliative care setting. Nausea with or without vomiting usually occurs when patients are initiated on morphine for the 1^st time or when the dose is substantially increased.

Materials and methods: A total of 90 patients fulfilling the inclusion criteria were randomly allocated into two groups of 45 each. Group M received a tablet of metoclopramide 10 mg orally 3 times a day; Group H received a tablet of haloperidol (2.5 mg) orally at night. All the patients were provided NCI CTCAE V4.3 NAUSEA AND VOMITING SCALE and asked to mark their response from day 1 to day 7. At the follow-up visit on the 7^th day, the form was collected, and data were analysed.

Results: In Group M and Group H, the mean nausea score was between 1 and 2 and the difference was statistically insignificant. In Group M, the maximum vomiting score was 1.28 on day 5, while in Group H, the maximum score was 2 on day 5. The difference between the two groups was statistically significant.

Conclusion: Metoclopramide and haloperidol are equally efficacious in preventing nausea, but metoclopramide was found to be more effective with lesser side effects than haloperidol for morphine-induced vomiting in cancer patients when used prophylactically.

Objectives: The prevalence and burden of neurological diseases are high among the older age group. Stroke and other neurological diseases significantly impair functional capacity and lead to poor quality of life. This study aims to provide a national-level estimate for palliative and supportive care needs among older Indian adults with stroke and other neurological diseases.

Materials and methods: The Longitudinal Ageing Study in India (LASI), a national-level survey of older adults, was used as a representative sample to estimate palliative and supportive care needs. The supportive and palliative care indicator tool income setting (SPICT-LIS) was used to identify palliative care needs in older adults with stroke and other neurological diseases. A total of 31,902 older adults aged 60 years and above were identified from the LASI data, and among them, 1458 older adults with stroke and other neurological diseases were selected for the analysis. The SPICT-LIS indicators were compared with the selected LASI data. Both univariate analysis and multivariate logistic regression were performed to determine the association between supportive and palliative care needs and background characteristics of older adults.

Results: The analysis showed that 63.6% of older adults with stroke and other neurological diseases in India have supportive and palliative care needs. In regression analysis, the burden of supportive and palliative care needs was observed to be high among older adults who were in the underweight, overweight/obese category, who experienced ill-treatment, and who had diabetes and hypertension. In contrast, the burden of supportive and palliative care needs was observed to be low among older adults with stroke and neurological diseases who belonged to richer and richest economic quintiles, those receiving at least one social support scheme, those engaged in social activity and those performing physical activity.

Conclusion: The palliative care needs among the older adult population with stroke and other neurological diseases in India are high. The findings of this study underscore the importance of screening for supportive and palliative care needs among patients with stroke and other neurological diseases to identify these unmet needs. The workforce trained in the provision of generalist and specialist palliative care will be required to meet this need, and the population of older adults is estimated to double in the next three decades.

Chronic kidney disease (CKD) is a widespread health issue impacting millions globally. Recognizing the potential benefits of yoga in enhancing physical and mental well-being, this research aims to develop and validate a yoga module tailored for CKD patients, with a specific focus on improving their general health. The yoga module was meticulously crafted through an extensive review of traditional and contemporary literature, incorporating postures, breathing techniques and meditation practices deemed safe and beneficial for CKD patients. Content validity was established through input yoga experts with over 7 years of experience. The study spanned from January 2020 to December 2021. The final version of the yoga module retained 83.33% of the proposed yoga techniques, incorporating modifications suggested by experts. The content validity index for the entire yoga module averaged 0.83. This work establishes the viability, validity and practicality of a yoga module designed for CKD patients. With 35 out of 42 items retained, the module exhibited significant health improvements after 12 weeks of practice. The findings position yoga therapy as a potentially effective complementary treatment for CKD patients, offering improvements in general health and quality of life and potentially slowing disease progression.

Spiritual intelligence (SI) has recently gained traction in various fields, including nursing. Given the increasing emphasis on patient-centred care and the holistic well-being of patients and nurses, SI is particularly relevant in nursing practice. A bibliometric analysis of recent publications (2014-2024) in the field helps synthesise and evaluate the existing research on SI in the general field of nursing, identify literature gaps, suggest future research directions and raise awareness of the importance of SI in nursing practice. The present study reports bibliometric data (n = 461) from the Scopus database on SI, spiritual quotient and spiritual care in nursing and health care. The data are analysed using MS Excel and VOSviewer software. The publications' trend analysis revealed a significant increase in SI-related publications since 2015. The study presents top-cited articles. Journal of Religion and Health was found to be a prominent journal with the maximum number of publications, and Sage was found to be the top publisher of journals with articles on SI. Network visualisation reveals central figures such as Wilfred McSherry, Trove Giske, Elizabeth Johnston Taylor, Fiona Timmins, Silvia Caldeira and Linda Ross as key researchers in the field. The United States and Iran have the most substantial connections of authors publishing on SI. This study reveals an increasing interest in SI and care within nursing research, confirming its growing significance in the field. By reporting areas where research on SI in nursing remains underdeveloped, the study paves the way for the development of new or updated curricula in nursing programs. The study can guide faculty development initiatives by highlighting the importance of SI and providing resources for educators to incorporate these concepts into their teaching. This study presents specific research questions to address these knowledge gaps. Future studies which can address these questions will enrich nursing education and practice, leading to improved patient outcomes and enhanced nurse well-being using the full potential of SI in nursing practice.

In cancer patients, physical and psychological issues are very common. There is a need for family support and high utilisation of healthcare resources commonly. Palliative care (PC) has grown in popularity to better fulfil of needs of patients and their families and potentially lowering hospital costs. Given that the majority of patients still die in hospitals, there is a need for an effective model of PC for advanced gynaecological cancer, as well as the wise allocation of scarce resources. The main aim of this study was to compare the efficacy of PC to conventional treatment for adults with cancer, including gynaecological cancers, and their caregivers. Four randomised controlled trials (RCTs) were identified by searching PubMed, PubMed Central, Clinical Key, Embase and other grey literature from a duration of 2011-2021. Cochrane criteria were used to calculate the risk of bias, and the Grade Profiler Guideline Development Tool was used to check the quality of the included studies. Standardised mean differences (SMDs), I² value and forest plot were prepared by using Review Manager 4.0. A total of four RCTs were extracted by following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and found to have a high risk for bias and low to poor quality of evidence. Included study sample sizes ranged from 22 to 104 participants, including 670 people in total, including 289 patients with advanced cancer patients, including gynaecological cancer and 381 unpaid caregivers. Results also showed that PC enhances patients' quality of life (SMD = 0.26; 95% confidence interval [CI] = -0.29-0.80; I² = 76%), lowered symptom burden amongst patients (SMD = -0.75, 95% CI = -1.75-0.25; I² = 89%), reduces patient depression (SMD = 0.08, 95% CI = -0.19-0.34; I2 = 0%) and decreases depression in unpaid caregivers (SMD = -0.16, 95% CI = -0.56-0.24; I² = 59%). PC treatment increases patients' quality of life and lowers their symptom burden. In comparison to conventional care, it also reduces depression among patients and caregivers. We believe that the findings should be viewed with care until more recent exclusive RCTs are available.