Symptom burden in the last week of life

Klinkenberg, Marianne; Willems, Dick L.; Wal, Gerrit van der; Deeg, D.J.H.

doi:10.1016/j.jpainsymman.2003.05.008

Cited by 103 publications

(72 citation statements)

References 18 publications

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“…These symptoms have been found as being typical for the last weeks of life in other studies too [18,19]. Six percent of the patients who died during the study period could not be included in the study because they were physically or mentally unable to give informed consent.…”

Section: Discussionmentioning

confidence: 74%

The last 3 days of life in three different care settings in The Netherlands

Veerbeek

Zuylen

Swart³

et al. 2007

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Introduction Little is known about the characteristics of dying in different care settings, such as the hospital, the nursing home, or the home-care setting. Materials and methods We measured the burden of symptoms, medical and nursing interventions, and aspects of communication during the last 3 days of life within each of these settings. We included 239 of 321 patients (74%) who died in one of these settings in the southwest of The Netherlands, between November 2003 and February 2005. After the patient's death, a nurse filled in a questionnaire. Results Pain and shortness of breath were more severe in hospital patients as compared to nursing home and homecare patients, whereas incontinence was less severe in hospital patients. Several medical interventions, such as a syringe driver, vena punctures or lab tests, radiology or ECG, antibiotics, and drainage of body fluids were more often applied during the last 3 days of life to hospital patients than to nursing home and home-care patients. This also holds for the measurement of body temperature and blood pressure. In the hospital setting, the patient and the family were more often informed about the imminence of death of the patient than elsewhere. The general practitioner and other professional caregivers were less often informed about the imminence of death of hospital patients than of other patients. Discussion We conclude that pain and shortness of breath were more severe among hospital patients, whereas incontinence was more severe among nursing home and home-care patients. Hospital patients relatively often receive medical interventions and standard controls during the last 3 days of life. In hospital, communication about impending death seems to take place more often shortly before death.

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Section: Discussionmentioning

confidence: 74%

The last 3 days of life in three different care settings in The Netherlands

Veerbeek

Zuylen

Swart³

et al. 2007

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“…These reports support the idea that this tumor animal model may present behavioral depression. Depression is one of the major symptoms commonly found in cancer patients, and reported to worsen survival of the patients (Goodwin et al, 2004;Klinkenberg et al, 2004). However, the brain mechanism by which cancer induces depression in the patients is not known.…”

Section: R Esults and Discussion 5-htt Expressionmentioning

confidence: 99%

“…It has been reported that serum concentrations of tryptophan, 5-HT precursor, are significantly decreased in cancer patients (Brown et al, 1989;1991), and that this decrease correlates with depressive symptoms in cancer patients undergoing cytokine therapy (Capuron et al, 2002). Depression is one of the major symptoms commonly found in cancer patients, and reported to worsen survival of the patients (Goodwin et al, 2004;Klinkenberg et al, 2004). However, the mechanism by which cancer induces depression in the patients is largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Serotonin transporter mRNA expression in the dorsal raphe nucleus of a tumor bearing mouse

Jahng

Choi²,

Joo³

et al. 2005

Exp Mol Med

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“…In this study a larger proportion of the patients appeared to be experiencing the most reported refractory symptoms, possibly providing a reflection of the symptom burden in the last week of life. 27 Euthanasia is fundamentally different from palliative sedation. Dutch law defines euthanasia as the ending of life of a patient, at their explicit request due to unbearable and lasting suffering, performed by a physician who fulfils strictly-defined requirements.…”

Section: Strengths and Limitationsmentioning

confidence: 99%