Summary Uncontrolled studies have reported that fatigue is a common symptom among patients with advanced cancer. It is also a frequent complaint among the general population. Simply asking cancer patients whether or not they feel fatigued does not distinguish between the 'background' level of this symptom in the community and any 'excess' arising as a result of illness. The aim of this study was to determine the prevalence of fatigue among palliative care inpatients in comparison with a control group of age and sex-matched volunteers without cancer. In addition, the correlates of fatigue were investigated. The prevalence of 'severe subjective fatigue' (defined as fatigue greater than that experienced by 95% of the control group) was found to be 75%. Patients were malnourished, had diminished muscle function and were suffering from a number of physical and mental symptoms. The severity of fatigue was unrelated to age, sex, diagnosis, presence or site of metastases, anaemia, dose of opioid or steroid, any of the haematological or biochemical indices (except urea), nutritional status, voluntary muscle function, or mood. A multivariate analysis found that fatigue severity was significantly associated with pain and dypnoea scores in the patients, and with the symptoms of anxiety and depression in the controls. The authors conclude that subjective fatigue is both prevalent and severe among patients with advanced cancer. The causes of this symptom remain obscure. Further work is required in order to determine if the associations reported between fatigue and pain and between fatigue and dyspnoea are causal or coincidental.Keywords: fatigue; asthenia; neoplasms; palliative care; quality of life 1479British Journal of Cancer (1999) 79(9/10), 1479-1486 © 1999 Cancer Research Campaign Article no. bjoc.1998 Received SUBJECTS AND METHODSInpatients with advanced cancer were recruited from three palliative care units between April 1996 and January 1997. Radiotherapy or chemotherapy within the previous 4 weeks, clinically apparent confusion, poor English language skills, disability or pain affecting the non-dominant hand or an estimated prognosis of less than 2 weeks were all exclusion criteria. The principal investigator visited each of the participating units weekly and approached all patients identified as being eligible to enter the study. In the absence of the principal investigator, due to holidays or illness, recruitment was suspended. Thus, although the patient group did not represent a consecutive series of eligible patients (i.e. it was a convenience sample), there is no reason to suspect a systematic bias in patient selection. Control subjects were age and sex-matched volunteers without cancer. They were recruited from the 'League of Friends' at the respective units and were subjected to the same inclusion and exclusion criteria as the patients. The protocol was approved by the relevant Scientific and Ethics Committees.After informed consent had been obtained, the patients were asked to undergo a number of assessme...

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Background: Since 2012, education standards in medical faculties in Poland have allowed medical universities to introduce content related to multiculturalism. On the one hand, this creates a necessity to introduce new strategies, forms, and techniques of education aimed at the development of knowledge, skills, and attitudes in terms of multiculturalism. On the other hand, there is a need to evaluate their effects. The main goal of this study was to evaluate the cultural competence and cultural intelligence of master’s degree nursing students before the commencement of and two months after cultural education training in the form of the intercultural communication workshops included in the study program. Methods: The following questionnaires were used in the study: the Cross-Cultural Competence Inventory (CCCI) and the Cultural Intelligence Scale (CQS). Two consecutive classes (2019 and 2020) of master’s nursing students were tested twice (pre-test, post-test). The study was conducted at a leading medical university that educates nurses at a master’s level in Poland. In total, 130 master’s nursing students took part in this evaluative study: 64 individuals in 2019 (study 1) and 66 individuals in 2020 (study 2). Results: In comparison to the pre-test, the post-test showed that the surveyed students in both study 1 and study 2 obtained significantly higher overall results in terms of cultural intelligence (p = 0.001; p = 0.004, respectively) as well as in the behavioral (p = 0.001; p = 0.002) and cognitive (p = 0.001; p = 0.008, respectively) subscales. The cultural competence results were also higher overall, but the difference was insignificant. Conclusions: The study shows the efficiency of training/workshops in the development of culturally specific knowledge and cultural intervention skills. At the same time, it postulates the need to plan and organize cultural education programs in a form that aims to improve the development of culturally sensitive attitudes.

This study investigated the role of phenobarbitone at the end of life by retrospective analysis of case notes. During a 3-year period, of the 748 patients who died in a 32-bed palliative care unit, 60 received phenobarbitone during the last week of life. Fifty-nine patients had advanced cancer, 16 of whom had cerebral involvement. Phenobarbitone was used to control agitation and seizures. It was administered via subcutaneous infusion at a dose of 600-2400 mg/day. The mean time from starting phenobarbitone to death was 34.1 hours. Phenobarbitone was well tolerated and effective, controlling physical and psychological agitation. No further seizures occurred. This study suggests that phenobarbitone has a useful role in the management of distressing symptoms in the last few days of life.