4241 POSTER Efficacy of Relaxation Training Module for Health Care Professionals in Oncology?

Abstract

Background: Since 1 March 2010 “Galilee”, the first palliative home care unit in Hellas has been caring for patients with advanced cancer, enabling them to die at home, if they wished. This study presents prevalent reported symptoms of patients been cared in the last period of their life. Material and Methods: 23 cancer patients who were cared for until their death, by “Galilee” Palliative Home Care Unit, during the first year of the pilot unit’s operation were retrospectively studied. Data collection included patients’ demographic and clinical characteristics, their performance status measured by ECOG scale (0−4) and symptom severity assessment by Edmonton Symptom Assessment System Revised (ESAS-r), a series of nine visual analogue scales (0−10). Symptoms were evaluated at the time of referral to the service (T0), and at the last report before death (T1). Results: The majority of participants were female (60.9%) with a mean age 64.5 years and a poor mean performance status (3.39). Genital cancer was the most prevalent diagnosis (26.1%), followed by breast cancer (17.4%). About one third of patients received simultaneous aggressive treatment. The mean length of palliative home care was 78.87 days. The majority of patients died at home (65.2%). Their primary care giver was mainly the wife/husband (39.1%) or daughter (26.1%). Symptoms that scored >5 by the patients at their referral to the unit were depression (mean(T0) = 5.84), anxiety (mean(T0) = 5.60) and lack of appetite (mean(T0) = 5.32). Depression (mean(T1) = 5.46) and anxiety (mean(T1) = 5.38) followed by tiredness (mean(T1) = 5.14) were still the main prevalent symptoms at the last measurement before patients’ death. Contrary, nausea (mean(T0) = 0.85, mean(T1) = 0.93), and drowsiness (meanT0) = 1.90, mean(T1) = 1.54) were reported as the least prevalent symptoms. Although there was an improvement in all symptoms’ evaluations between the two measurements, except tiredness and nausea, there was no statistically significant difference (p > 0.050). None of patients’ demographic and clinical characteristics, nor symptoms evaluations was associated with the place of death (p > 0.050), except for depression and performance status. Patients who died at home reported less depression (p = 0.014) and had a worse performance status (p = 0.047) than those who died at hospital. Conclusion: Despite the small study sample these preliminary findings reveal that psychological symptoms play a significant role during the dying process. Further research is needed to better establish patients’ symptoms management by the palliative home care unit.