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Symptom prevalence and management in older adult patients in Lebanon

Published online by Cambridge University Press:  21 September 2018

Huda Abu-Saad Huijer ,
Souha Fares ,
Rachele Bejjani ,
Suzanne Dhaini ,
Samar Noureddine  and
Husam Ghusn
Huda Abu-Saad Huijer*
Affiliation:
Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
Souha Fares
Affiliation:
Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
Rachele Bejjani
Affiliation:
Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
Suzanne Dhaini
Affiliation:
Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
Samar Noureddine
Affiliation:
Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
Husam Ghusn
Affiliation:
Medicine, Lebanese University, Beirut, Lebanon Geriatrics Department, Ain Wazein Medical Village, Beirut, Lebanon
*
Author for correspondence: Huda Abu-Saad Huijer, R.N., Ph.D., F.E.A.N.S., F.A.A.N., Hariri School of Nursing, American University of Beirut, Lebanon. E-mail: [email protected]
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Abstract

Objective

The purpose of this study is to explore symptoms and the effectiveness of their management in older adult palliative care candidates in Lebanon. The aims of this study were to: (1) determine symptom prevalence in Lebanese older adults who qualify for palliative care; (2) identify the severity and distress of symptoms; (3) identify the prevalence of symptom management and its efficacy; and (4) explore the relationship between overall symptom burden and its correlates.

Method

This study uses an observational cross-sectional design using convenience sampling (N = 203) to recruit older adults qualifying for palliative care from three major medical centers in Lebanon.

Result

The mean age of the sample was 78.61 years. The most prevalent symptoms were lack of energy (93.5%), worrying (83.2%), and pain (71.4%). Psychological symptoms had the highest mean scores, preceded only by the physical symptoms and lack of energy. The most treated symptoms were physical with pain having the highest treatment prevalence (91%). Although psychological symptoms were the most burdensome, they were poorly treated. Multiple regression analysis showed that symptom scores had significant positive associations with financial status, social functioning, and comorbidities; there was a negative association with age.

Significance of results

Lack of energy and psychological symptoms were the most prevalent, with the latter having the highest mean total symptom scores. Treatment was poor for psychological symptoms and effective for physical ones. Associations were found between age, comorbidity, financial problems, social functioning, and total physical and psychological mean symptom burden scores. More attention needs to be given to psychological symptoms and their management among older adults receiving palliative care.

Keywords

Older adultspalliative caresymptom prevalence and management
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 4 , August 2019 , pp. 464 - 471
Copyright
Copyright © Cambridge University Press 2018 

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References

Aaronson, NK, Ahmedzai, S, Bergman, B, et al. (1993) The European Organisation for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute 85, 365–376.Google Scholar
Abu-Saad Huijer, H, Abboud, S, and Doumit, M (2012) Symptom prevalence and management of cancer patients in Lebanon. Journal of Pain and Symptom Management 44(3), 386–399.Google Scholar
Abu-Saad Huijer, H, Sagherian, K, and Tamim, H (2013) Quality of life and symptom prevalence in children with cancer in Lebanon: The perspective of parents. Annals of Palliative Medicine 2(2), 59–70.Google Scholar
Abu-Saad Huijer, H, Sagherian, K, and Tamim, H (2013) Validation of the Arabic version of the EORTC quality of life questionnaire among cancer patients in Lebanon. Quality of Life Research 22(6), 1473–1481.Google Scholar
Abu-Saad Huijer, H, Sagherian, K, Tamim, H (2015) Validation of the Arabic version of the memorial symptom assessment scale among Lebanese cancer patients. Journal of Pain and Symptom Management 50(4), 559–565.Google Scholar
Alexander, K, Goldberg, J, and Korc-Grodzicki, B (2016) Palliative care and symptom management in older patients with cancer. Clinics in Geriatric Medicine 32, 45–62.Google Scholar
Bernardes, SF, Marques, S, Matos, M (2015) Old and in pain: Enduring and situational effects of cultural aging stereotypes on older people's pain experiences. European Journal of Pain 19(7), 994–1001.Google Scholar
Bischoff, K, Weinberg, V, and Rabow, MW (2013) Palliative and oncologic co-management: Symptom management for outpatients with cancer. Supportive Care in Cancer 21, 3031–3037.Google Scholar
Borgsteede, S, Deliens, L, Beentjes, B, et al. (2007) Symptoms in patients receiving palliative care: A study on patient-physician encounters in general practice. Journal of Palliative Medicine 21, 417–423.Google Scholar
Briggs, E (2008) Culture perspectives on pain management. Journal of Perioperative Practice 18(11), 468–471.Google Scholar
Combs, S, Kluger, BM, and Kutner, JS (2013) Research priorities in geriatric palliative care; nonpain symptoms. Journal of Palliative Medicine 16(9), 1001–1007.Google Scholar
Currow, DC, Allingham, S, Yates, P, et al. (2015) Improving national hospice/palliative care service symptom outcomes systematically through point of care data collection, structured feedback and benchmarking. Supportive Care in Cancer 23, 307–315.Google Scholar
Dale, B, Saevareid, HI, Kirkevold, M, et al. (2010) Older home nursing patients’ perception of social provisions and received care. Scandinavian Journal of Caring Sciences 24(3), 523–532.Google Scholar
Emanuel, LL, Alpert, HR, Emanuel, EE (2001) Concise screening questions for clinical assessments of terminal care: The needs near the end-of-life care screening tool. Journal of Palliative Medicine 4, 465–474.Google Scholar
Estabrooks, CA, Hoben, M, Poss, JW, et al. (2015) Dying in a nursing home: Treatable symptom burden and its link to modifiable features of work context. Journal of the American Medical Directors Association 16, 515–520.Google Scholar
Gestsdottir, B, Hjaltadottir, I, Gudmannsdottir, GD, et al. (2015) Symptoms and functional status of palliative care patients in Iceland. British Journal of Nursing 24(9), 478–483.Google Scholar
Gomez-Batiste, X, Porta-Sales, J, Espinosa-Rojas, J, et al. (2010) Effectiveness of palliative care services in symptom control of patients with advanced terminal cancer: A Spanish multicenter, prospective, quasi-experimental, pre-post study. Journal of Pain and Symptom Management 40(5), 652–660.Google Scholar
Hoben, M, Chamberlain, S, Knopp-Sihota, JA, et al. (2016) Impact of symptoms and care practices on nursing home residents at the end of life: A rating by front-line care providers. Journal of the American Medical Directors Association 17, 155–161.Google Scholar
Kamal, AH, Nipp, RD, Bull, J, et al. (2015) Symptom burden and performance status among community-dwelling patients with serious illness. Journal of Palliative Medicine 18(6), 542–544.Google Scholar
Khan, L, Kwong, J, Nguyen, J, et al. (2012) Comparing baseline symptom severity and demographics over two time periods in an outpatient palliative radiotherapy clinic. Supportive Care in Cancer 20, 549–555.Google Scholar
Kupensky, D, Hileman, B, Emerick, E, et al. (2015) Palliative medicine consultation reduces length of stay, improves symptom management, and clarifies advance directives in the geriatric trauma population. Journal of Trauma Nursing 22(5), 261–265.Google Scholar
Laugsand, EA, Jakobsen, G, Kaasa, S, et al. (2011) Inadequate symptom control in advanced cancer patients across Europe. Supportive Care in Cancer 19, 2005–2014.Google Scholar
McMillan, SC, Dunbar, SB, and Zhang, W (2007) The prevalence of symptoms in hospice patients with end stage heart disease. Journal of Hospice and Palliative Nursing 9(3), 124–131.Google Scholar
Oechsle, K, Goerth, K, Bokemeyer, C, et al. (2013) Symptom burden in palliative care patients: Perspectives of patients, their family caregivers, and their attending physicians. Supportive Care in Cancer 21, 1955–1962.Google Scholar
Ornstein, K, Wajnberg, A, Kaye-Kauderer, H, et al. (2013) Reduction in symptoms for homebound patients receiving home based primary and palliative care. Journal of Palliative Medicine 16(9), 1048–1054.Google Scholar
Polit, DF and Beck, CT (2004) Nursing research: Principles and methods, 7th ed. Philadelphia: Lippincott Williams & Wilkins.Google Scholar
Portenoy, RK, Thaler, HT, Kornblith, AB, et al. (1994) The Memorial Symptom Assessment Scale: An instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer 30a(9), 1326–1336.Google Scholar
Rodrigues, KL, Hanlon, JT, Perera, S, et al. (2010) A cross-sectional analysis of the prevalence of undertreatment of nonpain symptoms and factors associated with undertreatment in older nursing home hospice/palliative care patients. The American Journal of Geriatric Pharmacotherapy 8(3), 225–232.Google Scholar
Smedback, J, Ohlen, J, Arestedt, K, et al. (2017) Palliative care during the final week of life of older people in nursing homes: A register based study. Palliative & Supportive Care 15, 417–424.Google Scholar
Soo, KP and Larson, JL (2016) Multiple symptoms, functioning, and general health perception in people with severe COPD over time. Applied Nursing Research 29(1), 76–82.Google Scholar
Steindal, SA, Bredal, IS, Sørbye, LW, et al. (2011) Pain control at the end of life: A comparative study of hospitalized cancer and noncancer patients. Scandinavian Journal of Caring Sciences 25(4), 771–779.Google Scholar
Tai, S, Lee, CY, Wu, CY, et al. (2016) Symptom severity of patients with advanced cancer in palliative care unit: Longitudinal assessments of symptoms improvement. BMC Palliative Care 15, 32.Google Scholar
Terkawi, AS, Tsang, S, Alkahtani, GJ, et al. (2017) Development and validation of the Arabic version of the hospital anxiety and depression scale. Saudi Journal of Anaesthesia 11(Suppl 1), S11–S18.Google Scholar
United Nations Department of Economic and Social Affairs/Population Division (2017) World population prospects: The 2017 revision, key findings and advance tables. Available from https://esa.un.org/unpd/wpp/Publications/Files/WPP2017_KeyFindings.pdfGoogle Scholar
Van Lancker, A, Beeckman, D, Verhaeghe, S, et al. (2017) Symptom clustering in hospitalised older palliative cancer patients: A cross-sectional study. Journal of Advanced Nursing 73(6), 1455–1466.Google Scholar
Van Lancker, A, Velghe, A, Van Hecke, A, et al. (2014) Journal of Pain and Symptom Management 47(1), 90–104.Google Scholar
World Health Organization (2006) WHO definition of palliative care. Available from http://www.who.int/cancer/palliative/defintion/en/.Google Scholar
Yaacoub, N and Badre, L (2012) Population and housing characteristics in Lebanon. Statistics in Focus, Central Administration of Statistics, Lebanon. Issue 2.Google Scholar
Yong, DSP, Kwok, AOL, Wong, DML, et al. (2009) Symptom burden and quality of life in end stage renal disease: A study of 179 patients on dialysis and palliative care. Palliative Medicine 23, 111–119.Google Scholar
Zambroski, CH and Bekelman, DB (2008) Palliative symptom management in patients with heart failure. Progress in Palliative Care 16(5–6), 241–249.Google Scholar
Zigmond, AS and Snaith, RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67(6), 361–370.Google Scholar