Clinical problems at the end of life in a Swedish population, including the role of advancing age and physical and cognitive function

Jakobsson, Eva; Gaston‐Johansson, Fannie; Öhlén, Joakim; Bergh, Ingrid

doi:10.1177/1403494807085375

Cited by 18 publications

(12 citation statements)

References 23 publications

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“…There is a significant correlation between the prevalence of UI and FI and physical and cognitive functional decline. Fifty‐six percent of people experience UI in the last 3 months of their lives, and this rises to 72% for those who are ADL dependent and 71% for those with cognitive impairment (Jakobsson, Gaston‐Johansson, Ohlén, & Bergh, ).…”

Section: Care Recipient Factorsmentioning

confidence: 99%

A conceptual model of the risk of elder abuse posed by incontinence and care dependence

Ostaszkiewicz

2017

Int J Older People Nursing

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Section: Care Recipient Factorsmentioning

confidence: 99%

A conceptual model of the risk of elder abuse posed by incontinence and care dependence

Ostaszkiewicz

2017

Int J Older People Nursing

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“…Sleep disturbance is common among patients with advanced cancer (2–5) and negatively impacts patients’ and family members’ quality of life (2, 4–8). Less is known about the burden of sleep disturbance among patients with other types of terminal illness (9, 10). In particular, the trajectory of sleep disturbance throughout hospice enrollment is not well described.…”

Section: Introductionmentioning

confidence: 99%

Sleep Quality and Its Association With Delirium Among Veterans Enrolled in Hospice

Slatore

Goy

O’Hearn

et al. 2012

The American Journal of Geriatric Psychiatry

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Objectives The objectives of this study were to describe sleep quality and evaluate the association of sleep quality with delirium onset amongst patients enrolled in hospice. Design The study utilized secondary data from a prospective, observational, longitudinal study. Setting Veterans enrolled in hospice were recruited from the Portland Veterans Affairs Medical Center, Portland, Oregon. Participants The cohort consisted of 105 patients, of whom 73% had at least one sleep measurement. Measurements Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Delirium was measured with the Confusion Assessment Method. Other important variables were recorded from the medical record and/or longitudinal interviews with patients and their caregivers. Cox regression was used to estimate hazard ratios (HR) to measure the association between sleep quality and delirium onset. Results Of the patients who could be assessed, 44% had poor average sleep quality and 58% reported at least one episode of poor sleep. Overall, sleep quality did not appear to worsen as patients neared death although an increasing number of patients were unable to report on sleep quality. Poor sleep quality was associated with an increased risk of developing delirium, with a HR of 2.37 (95% CI 1.50 – 3.74), for every one point worsening in the sleep quality score on a four point scale. Conclusions Poor sleep quality was common amongst Veteran patients enrolled in hospice. These findings may help guide decision making between clinicians, patients, and families regarding the likely impact of sleep disturbance and may help identify patients at higher risk of developing delirium.

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“…Providing high‐quality care at the end of life in hospital settings is reported to be a great challenge, although this is the most common place of death (Cohen et al., ; Jayaraman & Joseph, ; Murray, Wilson, Kryworuchko, Stacey, & O'Connor, ). In Sweden, almost every second person dies at a hospital (Håkanson, Öhlén, Morin, & Cohen, ), where they mostly do not receive care designed to address their palliative care needs (Jakobsson, Gaston‐Johansson, Öhlén, & Bergh, ). One reason to explain this might be the lack of identification of dying and, consequently, reorientation of care in daily clinical healthcare practices.…”

mentioning

confidence: 99%

Differences in Symptom Distress Based on Gender and Palliative Care Designation Among Hospitalized Patients

Falk

Henoch

Ozanne

et al. 2016

J of Nursing Scholarship

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Purpose: To explore patient-reported symptom distress in relation to documentation of symptoms and palliative care designation in hospital inpatients. Design: This cross-sectional study analyzed data from 710 inpatients at two large hospitals in Sweden using the Edmonton Symptom Assessment Scale and the Memorial Symptom Assessment Scale. Chart reviews focused on nurses' and physicians' symptom documentation and palliative turning point. Methods: Descriptive statistics were calculated for all variables and provided summaries about the sample. Patients were grouped according to gender, age, palliative care designation, and symptom documentation. The t test and chisquare test were used to calculate whether symptom distress varied between groups. A two-way analysis of variance was conducted for multiple comparisons to explore the impact of gender and age on mean symptom distress. Findings: Females reported higher levels of symptom distress than did males related to pain, fatigue, and nausea. When comparing symptom distress between males and females with documentation pertaining to symptoms, there were significant differences implying that females had to report higher levels of symptom distress than males in order to have their symptoms documented. Conclusions: Females need to report higher levels of symptom distress than do males for healthcare professionals to identify and document their symptoms. It can be hypothesized that females are not receiving the same attention and symptom alleviation as men. If so, this highlights a serious inequality in care that requires further exploration. Clinical Relevance: Considering that common reasons why people seek health care are troublesome symptoms of illness, and that the clinical and demographic characteristics of inpatients are changing towards more advanced ages with serious illnesses, inadequate symptom assessment and management are a serious threat to the care quality.

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Clinical problems at the end of life in a Swedish population, including the role of advancing age and physical and cognitive function

Cited by 18 publications

References 23 publications

A conceptual model of the risk of elder abuse posed by incontinence and care dependence

A conceptual model of the risk of elder abuse posed by incontinence and care dependence

Sleep Quality and Its Association With Delirium Among Veterans Enrolled in Hospice

Differences in Symptom Distress Based on Gender and Palliative Care Designation Among Hospitalized Patients

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