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1.
J Clin Nurs ; 33(8): 3018-3032, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38481092

RESUMO

AIMS: To describe what is known from existing scientific literature on children's and parents' experiences of hospital-based home care and to identify future research areas. DESIGN: The scoping review design used adheres to the methodological framework of Arksey and O'Malley, and to the PRISMA-ScR checklist. REVIEW METHODS: A systematic search was conducted, and peer-reviewed scientific papers were screened through the application of Rayyan software. Data were extracted and presented in table and synthesised thematically as narrative text. DATA SOURCES: Searches were carried out November 2021 and updated November 2022 in the CINAHL, MEDLINE, Embase, Cochrane, Scopus, Web of Science, Academic Search Elite, and Amed databases and Google Scholar. RESULTS: A total of 1950 studies were screened and assessed for eligibility. Eight studies met the inclusion criteria by reporting on parents' experiences, whereas five out of these eight studies also reported on the experiences of children. Parents of children with cancer and preterm children reported feeling more in control, being empowered, and being more connected to their children's care team when their children were receiving hospital-based home care. The family's own resources were activated, and they felt more involved in their children's care compared to being in an inpatient setting. Children with cancer, acute infection, chronic disease, and/or a syndrome reported feeling safer and more comfortable in their home environment and experienced better interaction with their care providers. Some aspects of the children's health-related quality of life (HRQOL) were improved. CONCLUSION: The identified studies indicate that hospital-based home care is a valued alternative to traditional inpatient care by both parents and children. The mode of care has no crucial negative effects. Future studies should encompass the experiences of children with different diagnoses and syndromes and compare patients treated in a traditional hospital setting with those in a hospital-based home-care programme. RELEVANCE TO CLINICAL PRACTICE: Children's and parents' experiences of HBHC indicate that it offers a good solution if parents are well prepared and feel in control. In addition, certain structural conditions must be in place before this type of care can be established: there must be a certain number of patients and the hospital must not be too far away. In the field of neonatal home care, professionals should be more responsive to fathers' needs and tailor support by focusing on their individual experiences and needs. Our findings may guide and inform best practice for present and future providers of HBHC. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Hospital-based home care can offer families a greater degree of autonomy, more flexible care options, improved family functioning, improved communication with care providers, and more control over the child's care. When certain structural conditions are met, such as a certain number of patients, the hospital not being too far away, and parents being well prepared and feeling in control, then hospital-based home care is valued as an alternative to traditional inpatient care. Specific aspects of children's HRQOL may improve, and the psychosocial burden on the family does not increase. IMPACT: HBHC provides a valued alternative to traditional inpatient care and allows families to receive care in the comfort of their own home. Our findings may guide and inform best practice for present and future providers of hospital-based home care. REPORTING METHOD: In this scoping review, we have adhered to the Preferred Reporting Items for Systematic reviews and Meta Analyses Extension for Scoping Reviews checklist. PATIENT OR PUBLIC CONTRIBUTION: There has been no direct patient or public contribution to the review. TRIAL AND PROTOCOL REGISTRATION: Not required.


Assuntos
Pais , Humanos , Pais/psicologia , Criança , Serviços de Assistência Domiciliar , Recursos Humanos em Hospital/psicologia , Masculino , Feminino , Pré-Escolar , Serviços Hospitalares de Assistência Domiciliar , Lactente
2.
Int J Orthop Trauma Nurs ; 50: 101017, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37019045

RESUMO

OBJECTIVES: The aim of this study was to examine opioid use, health, quality of life, and pain after discharge from hospital in opioid naïve patients receiving opioid treatment for sub acute pain after trauma or surgery. METHODS: A prospective cohort with a four-week follow-up was conducted. Of the 62 patients included, 58 remained in the follow-up. The following questionnaires were assessed: Numeric Rating Scale for pain (NRS), EQ-5D-5L (health-related quality of life) and EQ-VAS (self-reported health). Paired t-test, two-sample t-test and chi square test were used in the study. RESULTS: Every fourth participant still received opioid treatment at follow-up, and reported no significant increase in EQ-VAS. Overall, an improvement in EQ-5D-5L (0.569 (SD = 0.233) to 0.694 (SD = 0.152), p < 0.001) and EQ-VAS (55 (SD = 20) to 63 (SD = 18), p = 0.001) from baseline to follow-up was found. Pain intensity decreased in the same period (6.4 (SD = 2.2) to 3.5 (SD = 2.6), p < 0.001). An unmet need for information regarding pain management was reported by 32% of the participants. CONCLUSIONS: Our findings show that patients with acute pain, treated with opioids, reported improved pain intensity, health-related quality of life and self-reported health four weeks after discharge. There is room for improvement regarding the provision of patient information on pain management.


Assuntos
Dor Aguda , Qualidade de Vida , Humanos , Estudos Prospectivos , Analgésicos Opioides/uso terapêutico , Dor Aguda/tratamento farmacológico , Dor Aguda/etiologia , Alta do Paciente , Hospitais , Inquéritos e Questionários
3.
Health Qual Life Outcomes ; 20(1): 154, 2022 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-36443850

RESUMO

OBJECTIVE: Quality of Life (QoL) in elderly cancer patients is a topic that has been little explored. This systematic review aims to identify, assess, and report the literature on QoL in home-dwelling cancer patients aged 80 years and older and what QoL instruments have been used. METHODS: We systematically searched the databases of Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsykINFO, Scopus, Epistemonikos and Cinahl to identify studies of any design measuring QoL among home-dwelling cancer patients aged 80 years and older. We screened the titles and abstracts according to a predefined set of inclusion criteria. Data were systematically extracted into a predesigned data charting form, and descriptively analyzed. The included studies were assessed according to the Critical Appraisal Skills Programme (CASP) checklists, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) checklist was used to ensure rigor in conducting our investigations and reporting our findings. This systematic review was registered in PROSPERO (CRD42021240170). RESULTS: We included three studies that specifically analyze QoL outcomes in the subgroup of home-dwelling cancer patients aged 80 years and older, with a total of 833 participants having various cancer diagnoses. 193 of the participants included in these three studies were aged 80 years or more. Different generic and cancer-specific QoL instruments as well as different aims and outcomes were studied. All three studies used a diagnosis-specific instrument, but none of them used an age-specific instrument. Despite heterogeneity in cancer diagnoses, instruments used, and outcomes studied, QoL in home-dwelling cancer patients aged over 80 years old seems to be correlated with age, physical function, comorbidity, living alone, needing at-home care services, being in a poor financial situation and having a small social network. CONCLUSION: Our systematic review revealed only three studies exploring QoL and its determinants in the specific subgroup of home-dwelling cancer patients aged 80 years and over. A gap in the knowledge base has been identified. Future studies of this increasingly important and challenging patient group must be emphasized. Subgroup analyses by age must be performed, and valid age and diagnosis specific QoL instruments must be used to generate evidence in this segment of the population.


Assuntos
Serviços de Assistência Domiciliar , Neoplasias , Idoso , Humanos , Idoso de 80 Anos ou mais , Qualidade de Vida , Lista de Checagem , Bases de Dados Factuais
5.
Health Qual Life Outcomes ; 19(1): 98, 2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33743742

RESUMO

OBJECTIVE: The aim of this systematic review was to summarize and assess the literature on quality of life (QoL) among cancer patients 80 years and older admitted to hospitals and what QoL instruments have been used. METHODS: We searched systematically in Medline, Embase and Cinahl. Eligibility criteria included studies with any design measuring QoL among cancer patients 80 years and older hospitalized for treatment (surgery, chemotherapy or radiation therapy). EXCLUSION CRITERIA: studies not available in English, French, German or Spanish. We screened the titles and abstracts according to a predefined set of inclusion criteria. All the included studies were assessed according to the Critical Appraisal Skills Programme checklists, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement checklist was used to ensure rigor in conducting and reporting. This systematic review was registered in PROSPERO (CRD42017058290). RESULTS: We included 17 studies with 2005 participants with various cancer diagnoses and Classification of Malignant Tumors stages (TNM). The included studies used a range of different QoL instruments and had different aims and outcomes. Both cancer-specific and generic instruments were used. Only one of the 17 studies used an age-specific instrument. All the studies included patients 80 years and older in their cohort, but none specifically analyzed QoL outcomes in this particular subgroup. Based on findings in the age-heterogeneous population (age range 20-100 years), QoL seems to be correlated with the type of diagnosed carcinoma, length of stay, depression and severe symptom burden. CONCLUSION: We were unable to find any research directly exploring QoL and its determinants among cancer patients 80 years and older since none of the included studies presented specific analysis of data in this particular age subgroup. This finding represents a major gap in the knowledge base in this patient group. Based on this finding, we strongly recommend future studies that include this increasingly important and challenging patient group to use valid age- and diagnosis-specific QoL instruments.


Assuntos
Pacientes Internados/psicologia , Neoplasias/psicologia , Qualidade de Vida , Idoso de 80 Anos ou mais , Hospitalização , Humanos , Neoplasias/terapia , Inquéritos e Questionários
6.
SAGE Open Nurs ; 6: 2377960820907778, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33415270

RESUMO

Limited information exists regarding the natural development of loneliness and its determinants among cognitively intact nursing home residents. We aimed to examine loneliness among nursing home residents by following up for 6 years and to determine whether sociodemographic factors, diagnosis of cancer, sense of coherence, social support, and depression symptoms influence loneliness. The study was longitudinal and prospective and included baseline assessment and 6-year follow-up. After baseline assessment of 227 cognitively intact nursing home residents (Clinical Dementia Rating score ≤0.5), 52 respondents were interviewed a second time at the 5-year follow-up and 18 respondents a third time at the 6-year follow-up. Data from the interviews were recorded using a global question of loneliness, the Social Provisions Scale, Sense of Coherence Scale, and Geriatric Depression Scale. Scores on Groll's index (p = .02) and the Sense of Coherence Scale (p = .04) were positively correlated with loneliness and negatively correlated with geriatric depression (p = .001). Having a diagnosis of cancer, social support, and age were not correlated with loneliness 6 years from baseline. Loneliness did not change during the 6 years of follow-up, and symptoms of depression and the sense of coherence appeared to be important components of loneliness. Finally, having a diagnosis of cancer and social support were not associated with loneliness.

7.
PLoS One ; 13(3): e0193761, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29499064

RESUMO

PURPOSE: The purpose of this study was to investigate disability among patients who were accepted for admission to a Norwegian rehabilitation center and to identify predictors of disability. MATERIALS AND METHODS: In a cross-sectional study including 967 adult participants, the World Health Organization Disability Assessment Schedule version 2.0 36-item version was used for assessing overall and domain-specific disability as outcome variables. Patients completed the Hospital Anxiety and Depression Scale (HADS), EuroQoL EQ-5D-5L and questions about multi-morbidity, smoking and perceived physical fitness. Additionally, the main health condition, sociodemographic and environmental variables obtained from referrals and public registers were used as predictor variables. Descriptive statistics and linear regression analyses were performed. RESULTS: The mean (standard error) overall disability score was 30.0 (0.5), domain scores ranged from 11.9 to 44.7. Neurological diseases, multi-morbidity, low education, impaired physical fitness, pain, and higher HADS depressive score increased the overall disability score. A low HADS depressive score predicted a lower disability score in all domains. CONCLUSIONS: A moderate overall disability score was found among patients accepted for admission to a rehabilitation center but "life activities" and "participation in society" had the highest domain scores. This should be taken into account when rehabilitation strategies are developed.


Assuntos
Avaliação da Deficiência , Reabilitação , Atenção Secundária à Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Depressão/complicações , Depressão/diagnóstico , Depressão/reabilitação , Autoavaliação Diagnóstica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Multimorbidade , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/reabilitação , Dor/complicações , Dor/diagnóstico , Dor/reabilitação , Aptidão Física , Prognóstico , Escalas de Graduação Psiquiátrica , Centros de Reabilitação , Fatores Socioeconômicos , Adulto Jovem
8.
Cancer Nurs ; 41(2): E13-E20, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28146014

RESUMO

BACKGROUND: Life expectancy is increasing continuously, which increases the likelihood of developing dementia or cancer. Both dementia and cancer are serious conditions that give manifold symptoms. The interaction of these conditions is however complex and less explored. OBJECTIVES: The aim of this study was to identify the prevalence of cancer and differences regarding neuropsychiatric symptoms (NPS) and medication among nursing home (NH) patients with and without dementia and cancer. METHODS: This is a cross-sectional study of Norwegian NH patients (N = 1825). Participants were categorized according to degree of dementia (Clinical Dementia Rating > 1) and cancer diagnoses. Differences in NPS and other symptoms, as well as the use of medication, were explored. RESULTS: Eighty-four percent of NH patients had dementia, and 5.5% had comorbid dementia and cancer. Patients with comorbid dementia and cancer received significantly more analgesics compared with patients without cancer but with dementia (P < .05). Compared with patients without dementia but with cancer, patients with comorbid dementia and cancer had significantly more NPS, including sleep disturbances and agitation. CONCLUSIONS: Patients with comorbid dementia and cancer receive more analgesics than patients with dementia but still display more agitation and sleep disturbances than patients with cancer and patients with neither dementia nor cancer, suggesting that symptoms may not be treated adequately. IMPLICATIONS FOR PRACTICE: The results indicate a considerable strain for patients with comorbid dementia and cancer and highlight essential challenges for the clinician who is responsible for treatment and care. Nurses should pay attention to agitation and sleep disturbances among patients with comorbid dementia and cancer.


Assuntos
Analgésicos/uso terapêutico , Comorbidade , Demência/complicações , Demência/tratamento farmacológico , Neoplasias/complicações , Enfermagem Oncológica/normas , Transtornos do Sono-Vigília/tratamento farmacológico , Transtornos do Sono-Vigília/etiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Noruega , Casas de Saúde/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Prevalência , Agitação Psicomotora/tratamento farmacológico
9.
Artigo em Inglês | MEDLINE | ID: mdl-28490913

RESUMO

BACKGROUND: Limited information exists regarding the natural development of health-related quality of life (HRQOL) and its determinants among mentally intact nursing home (NH) residents. We aimed to examine HRQOL over time during a 6-year period among residents of NHs, who are not cognitively impaired, and to examine whether sense of coherence and a diagnosis of cancer influence HRQOL. METHODS: The study was prospective and included baseline assessment and 6-year follow-up. After baseline assessment of 227 cognitively intact NH residents (Clinical Dementia Rating score ≤ 0.5), we interviewed 52 living respondents a second time at the 5-year follow-up and 18 respondents a third time at the 6-year follow-up. We recorded data from the interviews using the Short Form-36 (SF-36) Health Survey and the Sense of Coherence Scale. To study different developments over time for residents without and with cancer, we tested interactions between cancer and time. RESULTS: The subscores of physical functioning and role limitation-physical domains declined with time (P < 0.001 and P = 0.02, respectively). Having a diagnosis of cancer at baseline was negatively correlated with general health (P = 0.002). Sense of coherence at baseline was positively correlated with all the SF-36 subscores from baseline to follow-up (P < 0.001). CONCLUSION: The study indicates that the HRQOL changed over time during the 6 years of follow-up, and the sense of coherence appeared to be an important component of the HRQOL. Finally, our results showed that having a diagnosis of cancer was associated with decline in the general health subdimension.

10.
PeerJ ; 4: e2096, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27330859

RESUMO

BACKGROUND: Symptoms of depression are often reported among patients with a cancer diagnosis. Strong sense of coherence (SOC) is shown to be associated with less depression in the general older population and among nursing homes (NH) residents in particular. Knowledge about mixed-methods perspectives that examine symptoms of depression and SOC among cognitively intact NH residents with cancer is scarce. AIM: To investigate symptoms of depression and SOC among NH residents who are cognitively intact and have cancer. METHODS: We used a quantitatively driven mixed-methods design with sequential supplementary qualitative components. We facilitated the collection of quantitative survey data of 60 NH residents (≥ 65 years) with cancer using the Geriatric Depression Scale (GDS) and SOC scale. The supplementary psychosocial component comprised qualitative research interviews about experiences related to depression with nine respondents from the same cohort. RESULTS: In fully adjusted multiple regression analysis of the sociodemographic variables, the GDS was significantly correlated with SOC (P < 0.001). The experience of sadness was identified by the following theme: sadness. Coping with the experience of symptoms of depression was dominated by coping with sadness. CONCLUSION: More than half the NH residents reported symptoms of depression, and the SOC was associated with reduced symptoms. A mixed-methods design contributed to nuanced and detailed information about the meaning of depression, and the supplementary component informs and supports the core component. To improve the situation of NH residents with cancer, more attention should be paid to the residents' experience of symptoms of depression and their SOC.

11.
Patient Prefer Adherence ; 10: 275-82, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27022249

RESUMO

OBJECTIVE: To study whether health-related quality of life (HRQOL), activities of daily living (ADL), and anxiety and depression symptoms affect the risk of hospital admission and potential interactions with having a cancer diagnosis. METHODS: This study was a prospective observational study with 5-year follow-up and analyzed the follow-up data on hospital admissions until 2010 using baseline data from 227 cognitively intact nursing home (NH) residents (60 of whom had cancer) in 2004-2005. Data on HRQOL were collected by using the Short Form-36 Health Survey, divided into physical component summary (PCS) and mental component summary (MCS), and symptoms of anxiety and depression were collected by using the Hospital Anxiety and Depression Scale (HADS). ADL were obtained from registered observation and sociodemographic variables, diagnoses, and hospital admissions from the NH records. Personal identification numbers were linked to the record systems of the hospitals, thereby registering all hospital admissions. We analyzed the time elapsing between inclusion and the first hospital admission. RESULTS: Residents with higher HRQOL (MCS) had significantly more hospital admissions after adjustment for age, sex, marital status, education, and comorbidity. HRQOL (PCS), ADL, depression, and anxiety symptoms were not associated with hospital admissions. Cancer increased the risk after adjustment for all other risk factors but did not increase the effects of MCS, PCS, ADL, or depression or anxiety symptoms. Having a higher level of education and being less than 75 years of age were associated with hospitalization. The residents diagnosed with cancer had the most days in hospital related to diseases of the respiratory system and cancer, and diseases of the circulatory and respiratory systems were more frequent among the residents without a cancer diagnosis. CONCLUSION: Better self-reported HRQOL (MCS) was associated with hospital admissions, whereas self-reported HRQOL (PCS), ADL, and depression and anxiety symptoms were not. Cancer increased the risk but not the effects of MCS, PCS, ADL, or depression or anxiety symptoms. Having a higher level of education and being less than 75 years of age were also associated with hospitalization.

12.
Clin Interv Aging ; 10: 1529-36, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26451093

RESUMO

BACKGROUND: Loneliness is a significant psychosocial effect following a cancer diagnosis and may prevent people from engaging in social activities, thus creating difficulties in interpersonal relationships. This study investigated loneliness and social support among cognitively intact nursing home residents with cancer by using a quantitatively driven mixed-methods design with sequential supplementary qualitative components. METHODS: The quantitative component consisted of face-to-face interviews of 60 nursing home residents (≥65 years) using the one-item Loneliness Scale and the Social Provisions Scale. The supplementary psychosocial component consisted of qualitative research interviews about experiences related to loneliness with nine respondents. RESULTS: The quantitative results indicated that reassurance of worth was associated with loneliness. The experience of loneliness was identified by the following: loneliness that was dominated by a feeling of inner pain, feeling of loss, and feeling small. Loneliness was alleviated by the following: being engaged in activities, being in contact with other people, and occupying oneself. CONCLUSION: Enhancing the lives of nursing home residents with cancer requires attending to the residents' experience of loneliness and social relationships in a targeted and individualized manner. This might require screening all nursing home residents for early detection of loneliness. Revealing factors that may contribute to or reduce loneliness improves the ability to enhance people's lives.


Assuntos
Solidão , Neoplasias/psicologia , Casas de Saúde , Apoio Social , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Avaliação Geriátrica , Humanos , Entrevistas como Assunto , Masculino
13.
J Pain Symptom Manage ; 48(4): 699-710.e1, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24703946

RESUMO

CONTEXT: Many older nursing home (NH) residents with cancer experience pain and distressing symptoms. Although some develop cancer during their time in the institution, an increasing number are admitted during their final stages of their lives. Numerous studies have evaluated various treatment approaches, but how pain and symptoms are assessed and managed in people with cancer with and without dementia is unclear. OBJECTIVES: The objective of this review was to summarize the evidence on cancer-related symptoms among NH residents with and without dementia. METHODS: We systematically searched the PubMed (1946-2012), Embase (1974-2012), CINAHL (1981-2012), AgeLine, and Cochrane Library (1998-2012) databases using the search terms neoplasms, cancer, tumor, and nursing home. The inclusion criteria were studies including NH residents with a diagnosis of cancer and outcome measures including pain and cancer-related symptoms. RESULTS: We identified 11 studies (cross-sectional, longitudinal, clinical trial, and qualitative studies). Ten studies investigated the prevalence and treatment of cancer-related symptoms such as vomiting, nausea, urinary tract infections, and depression. Studies clearly report a high prevalence of pain and reduced prescribing and treatment, regardless of the cognitive status. Only one small study included people with cancer and a diagnosis of dementia. Studies of new cancer diagnoses in NHs could not be identified. CONCLUSION: This review clearly reports a high prevalence of pain and reduced drug prescribing and treatment among NH residents with cancer. This issue appears to be most critical among people with severe dementia, emphasizing the need for better guidance and evidence on pain assessment for these individuals.


Assuntos
Demência/diagnóstico , Demência/epidemiologia , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Dor/diagnóstico , Dor/epidemiologia , Avaliação de Sintomas/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Causalidade , Comorbidade , Demência/terapia , Feminino , Instituição de Longa Permanência para Idosos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , New Hampshire/epidemiologia , Casas de Saúde , Manejo da Dor/estatística & dados numéricos , Prevalência , Fatores de Risco
14.
Qual Life Res ; 22(2): 317-25, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22383105

RESUMO

PURPOSE: It is generally known that health-related quality of life (HRQOL) predicts cause-specific mortality. Few studies have explored whether generic self-reported HRQOL, sociodemographic factors and illness variables are independently associated with mortality among cognitively intact nursing home (NH) residents with and without cancer. We hypothesized that sociodemographic factors and illness variables would be associated with mortality and that HRQOL, measured using the SF-36 Health Survey, would predict mortality among NH residents with and without cancer. METHODS: We followed a cohort of 227 cognitively intact (Clinical Dementia Rating scale score ≤ 0.5) older residents (60 with cancer and 167 without) from 30 NH from 2004-2005 to 2010. We collected data by face-to-face interview. We obtained sociodemographic variables and medical diagnoses from the records. RESULTS: Survival did not differ between residents with and without cancer (P = 0.31). Twenty percent of the residents with cancer and 13% without cancer were still alive. After adjustment for sociodemographic and illness variables, increasing age (P < 0.001), higher education (P = 0.009), comorbidity (P = 0.04) and the subdimension physical functioning (P = 0.009) predicted mortality. Bodily pain was only marginally associated with mortality (P = 0.08). CONCLUSIONS: Independent of cancer, HRQOL and comorbidity predicted mortality among NH residents without cognitive impairment.


Assuntos
Cognição/fisiologia , Nível de Saúde , Mortalidade , Neoplasias/diagnóstico , Casas de Saúde , Qualidade de Vida/psicologia , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Seguimentos , Inquéritos Epidemiológicos , Instituição de Longa Permanência para Idosos , Humanos , Entrevistas como Assunto , Masculino , Neoplasias/mortalidade , Neoplasias/psicologia , Dor/etiologia , Autorrelato , Fatores Socioeconômicos
15.
J Clin Nurs ; 22(1-2): 106-14, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22882807

RESUMO

AIMS AND OBJECTIVES: Hypothesised that sociodemographic factors and illness variables would be associated with mortality and that emotional and social loneliness measured using the Social Provisions Scale would influence mortality among nursing homes residents with cancer. BACKGROUND: Studies are lacking on how emotional and social loneliness influence mortality among cognitively intact older people in nursing homes with and without a diagnosis of cancer. DESIGN: A cross-sectional design was used at baseline with a five-year follow-up of mortality. Methods. A cohort of 227 cognitively intact (Clinical Dementia Rating scale score ≤0·5) older residents (60 with cancer and 167 without) from 30 nursing homes were followed from 2004-2005 to 2010. Data were collected by face-to-face interview. Sociodemographic variables and medical diagnoses were obtained from the records. RESULTS: Survival did not differ significantly between residents with and without cancer. After adjustment for sociodemographic and illness variables, increasing age, higher education and comorbidity were associated with mortality. In the final model from a backward selection procedure, attachment (emotional loneliness) was associated with mortality. CONCLUSIONS: Independent of a cancer diagnosis or not, emotional loneliness, age, education and comorbidity influenced mortality among nursing homes residents without cognitive impairment. RELEVANCE TO CLINICAL PRACTICE: Nurses should pay attention to emotional loneliness among nursing homes residents independent of cancer and especially give attention to the importance to have a close confidant who provides emotional support.


Assuntos
Emoções , Solidão , Competência Mental , Mortalidade , Neoplasias/psicologia , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Seguimentos , Humanos , Pacientes Internados/psicologia , Masculino , Neoplasias/mortalidade
16.
Cancer Nurs ; 36(4): E68-74, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23051868

RESUMO

BACKGROUND: Studies are lacking on how anxiety and depression symptoms influence mortality among cognitively intact older people in nursing homes (NHs) with a diagnosis of cancer versus those without cancer. OBJECTIVE: We hypothesized that anxiety or depression was associated with survival and has greater effects on survival for residents with cancer than for those without cancer. METHODS: A cohort of 227 cognitively intact (Clinical Dementia Rating scale score ≤0.5) older residents (60 with cancer and 167 without) from 30 NHs were followed from 2004-2005 to 2010. Data were collected using face-to-face interviews. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale subscales. Sociodemographic variables and medical diagnoses were obtained from the records. RESULTS: The overall survival after 5 years was 17% for residents with cancer and 22% for residents without cancer. Depression and comorbidity were associated with significantly worse survival independent of a cancer diagnosis. Residents with cancer and symptoms of anxiety (subscores at least 8) had worse survival than those without anxiety symptoms (P = .02), but this was not found among the noncancer group. CONCLUSIONS: Independent of a cancer diagnosis, depression symptoms and comorbidity were associated with mortality among cognitive intact NH residents. Having symptoms of anxiety predicted shorter survival among residents with a cancer diagnosis. IMPLICATIONS FOR PRACTICE: Nurses should pay attention to depression symptoms among NH residents with and without a cancer diagnosis. Giving attention to residents with cancer and anxiety symptoms is especially important.


Assuntos
Ansiedade/mortalidade , Transtorno Depressivo/mortalidade , Competência Mental , Neoplasias/mortalidade , Neoplasias/psicologia , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Ansiedade/diagnóstico , Cognição/fisiologia , Estudos de Coortes , Intervalos de Confiança , Transtorno Depressivo/diagnóstico , Feminino , Seguimentos , Avaliação Geriátrica , Instituição de Longa Permanência para Idosos , Humanos , Estudos Longitudinais , Masculino , Neoplasias/diagnóstico , Modelos de Riscos Proporcionais , Valores de Referência , Medição de Risco , Índice de Gravidade de Doença , Análise de Sobrevida
17.
Cancer Nurs ; 35(4): 295-301, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-21946900

RESUMO

BACKGROUND: Studies are lacking on how cancer influences physical, mental, and social functioning beyond comorbidity among older people without cognitive impairment in nursing homes (NHs). OBJECTIVE: The objective was to study the sociodemographic characteristics and health-related quality of life (HRQOL) among NH residents with and without a cancer diagnosis, adjusting for comorbidity. METHODS: This was a cross-sectional observation study: 30 NHs; 227 residents 65 to 102 years old: 60 with cancer and 167 without, at least 6 months' residence. All had Clinical Dementia Rating of 0.5 or less and could converse. Health-related quality of life was measured using the 36-item Short-Form Health Survey in face-to-face interviews. Sociodemographic variables and medical diagnoses were obtained from records. Possible differences in HRQOL, controlled for age, gender, marital status, education, length of stay, and comorbidity, were examined by multiple linear regression analyses. RESULTS: The most common cancer diagnoses were breast cancer among women (20%) and prostate cancer among men (12%). More residents with cancer were married (P = .007), reported more bodily pain (P = .17) and scored lower on all other HRQOL subscales, except for role-emotional. General health was worse than that of the residents without cancer (P = .04) after adjusting for sociodemographic variables but not for comorbidity (P = .06). CONCLUSION: Cognitively intact NH residents with cancer reported more pain and worse general health but better role limitation related to emotional problems compared with residents without cancer. The difference in general health was partly due to comorbidity. IMPLICATIONS FOR PRACTICE: Nurses should pay attention to HRQOL among NH residents with cancer and especially observe and ensure pain treatment.


Assuntos
Cognição/fisiologia , Neoplasias/psicologia , Casas de Saúde , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Neoplasias/complicações , Neoplasias/enfermagem , Dor/etiologia
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