Abstract
This study describes the assessment of dyspnea, symptom distress, and quality of life measures in 163 hospice patients with cancer who reported dyspnea. Mean age of the hospice patient sample was 70.22 years and 61.86 for caregivers (65% were spouses). The majority of patients and caregivers were white: 87%, 63% of the patients were male while 78% of caregivers were female. Mean dyspnea intensity as reported by patients was 4.52 (SD 2.29) and caregivers, 4.39 (SD 2.93). Patients' and caregivers' ratings of the patient's dyspnea intensity revealed no significant differences in ratings thus verifying that caregivers can assess dyspnea severity accurately. Patients' perceived quality of life ratings were not significantly correlated with ratings of their caregivers' perceived quality of life. For patients, symptom distress and education were significant predictors of variance in quality of life (R2 = .35, p = .04). However, mastery, symptom distress, age, and education were found to be significant predictors of variance in quality of life of caregivers (R2 = .40, p = .02).
Highlights
Respiratory symptoms are often more difficult to treat in hospice patients with irreversible, end-stage cancer for a number of reasons
The results indicate that both significant others and health care providers can be useful sources of information about cancer patients' quality of life (QOL)
It is clear that caregivers can obtain ratings of dyspnea that are congruent with the patient's perceived symptoms
Summary
Respiratory symptoms are often more difficult to treat in hospice patients with irreversible, end-stage cancer for a number of reasons. Health and Quality of Life Outcomes 2003, 1 http://www.hqlo.com/content/1/1/9 assessments of patients with end-stage-lung disease did not include regular use of any of the preferred dyspnea measurement scales, such as the graphic rating scale or visual analog scale.[5] Nursing staff from the hospice study sites expressed a need for studies that tested which clinical interventions are most useful in alleviating dyspnea. Research Questions Severe dyspnea, whether acute or chronic, affects patients' functional status and quality of life as well as other psychosocial aspects of the patient's life.[6] Patients with severe dyspnea who are in hospice care most often manifest the associated symptoms and problems of anxiety, fatigue, and sleeplessness which in turn affect functional status and cognitive status, and subsequently decrease quality of life.[4] Based on previous studies,[4,6,7] a specific study aim was to explore the congruence of dyspnea ratings by caregivers with patients' ratings of dyspnea. The study addressed three specific research questions in hospice patients with end-stage lung cancer and their caregivers
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