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Symptom relief during last week of life in neurological diseases

Ozanne, Anneli ; Sawatzky, Richard ; Håkanson, Cecilia ; Alvariza, Anette ; Fürst, Carl Johan LU ; Årestedt, Kristofer and Öhlén, Joakim (2019) In Brain and Behavior 9(8).
Abstract

Objectives: The aim of this study was to investigate symptom prevalence, symptom relief, and palliative care indicators during the last week of life, comparing them for patients with motor neuron disease (MND), central nervous system tumors (CNS tumor), and other neurological diseases (OND). Material & Methods: Data were obtained from the Swedish Register for Palliative Care, which documents care during the last week of life. Logistic regression was used to compare patients with MND (n = 419), CNS tumor (n = 799), and OND (n = 1,407) as the cause of death. Results: The most prevalent symptoms for all neurological disease groups were pain (52.7% to 72.2%) and rattles (58.1% to 65.6%). Compared to MND and OND, patients with CNS tumors... (More)

Objectives: The aim of this study was to investigate symptom prevalence, symptom relief, and palliative care indicators during the last week of life, comparing them for patients with motor neuron disease (MND), central nervous system tumors (CNS tumor), and other neurological diseases (OND). Material & Methods: Data were obtained from the Swedish Register for Palliative Care, which documents care during the last week of life. Logistic regression was used to compare patients with MND (n = 419), CNS tumor (n = 799), and OND (n = 1,407) as the cause of death. Results: The most prevalent symptoms for all neurological disease groups were pain (52.7% to 72.2%) and rattles (58.1% to 65.6%). Compared to MND and OND, patients with CNS tumors were more likely to have totally relieved pain, shortness of breath, rattles, and anxiety. They were also more likely to have their pain assessed with a validated tool; to receive symptom treatment for anxiety, nausea, rattles, and pain; to have had family members receive end-of-life discussions; to have someone present at death; and to have had their family members offered bereavement support. Both patients with CNS tumor and MND were more likely than patients with OND to receive consultation with a pain unit and to have had end-of-life discussions. Conclusions: The study reveals high symptom burden and differences in palliative care between the groups during the last week of life. There is a need for person-centered care planning based on a palliative approach, focused on improving symptom assessments, relief, and end-of-life conversations.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
amyotrophic lateral sclerosis, brain neoplasms, end of life, motor neuron disease, neurological disease, palliative care
in
Brain and Behavior
volume
9
issue
8
article number
e01348
publisher
John Wiley & Sons
external identifiers
  • scopus:85068665252
ISSN
2157-9032
DOI
10.1002/brb3.1348
language
English
LU publication?
yes
id
66e16bb9-d4af-4757-9af7-0cf911f826fe
date added to LUP
2019-07-25 08:39:34
date last changed
2020-01-15 09:38:28
@article{66e16bb9-d4af-4757-9af7-0cf911f826fe,
  abstract     = {<p>Objectives: The aim of this study was to investigate symptom prevalence, symptom relief, and palliative care indicators during the last week of life, comparing them for patients with motor neuron disease (MND), central nervous system tumors (CNS tumor), and other neurological diseases (OND). Material &amp; Methods: Data were obtained from the Swedish Register for Palliative Care, which documents care during the last week of life. Logistic regression was used to compare patients with MND (n = 419), CNS tumor (n = 799), and OND (n = 1,407) as the cause of death. Results: The most prevalent symptoms for all neurological disease groups were pain (52.7% to 72.2%) and rattles (58.1% to 65.6%). Compared to MND and OND, patients with CNS tumors were more likely to have totally relieved pain, shortness of breath, rattles, and anxiety. They were also more likely to have their pain assessed with a validated tool; to receive symptom treatment for anxiety, nausea, rattles, and pain; to have had family members receive end-of-life discussions; to have someone present at death; and to have had their family members offered bereavement support. Both patients with CNS tumor and MND were more likely than patients with OND to receive consultation with a pain unit and to have had end-of-life discussions. Conclusions: The study reveals high symptom burden and differences in palliative care between the groups during the last week of life. There is a need for person-centered care planning based on a palliative approach, focused on improving symptom assessments, relief, and end-of-life conversations.</p>},
  author       = {Ozanne, Anneli and Sawatzky, Richard and Håkanson, Cecilia and Alvariza, Anette and Fürst, Carl Johan and Årestedt, Kristofer and Öhlén, Joakim},
  issn         = {2157-9032},
  language     = {eng},
  number       = {8},
  publisher    = {John Wiley & Sons},
  series       = {Brain and Behavior},
  title        = {Symptom relief during last week of life in neurological diseases},
  url          = {http://dx.doi.org/10.1002/brb3.1348},
  doi          = {10.1002/brb3.1348},
  volume       = {9},
  year         = {2019},
}