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Symptom relief during last week of life in neurological diseases.
Göteborgs universitet.
Göteborgs universitet & Kanada.
Sophiahemmet högskola.
Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Capio Palliativ vård Dalen.
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2019 (English)In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, article id e01348Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: The aim of this study was to investigate symptom prevalence, symptom relief, and palliative care indicators during the last week of life, comparing them for patients with motor neuron disease (MND), central nervous system tumors (CNS tumor), and other neurological diseases (OND).

MATERIAL & METHODS: Data were obtained from the Swedish Register for Palliative Care, which documents care during the last week of life. Logistic regression was used to compare patients with MND (n = 419), CNS tumor (n = 799), and OND (n = 1,407) as the cause of death.

RESULTS: The most prevalent symptoms for all neurological disease groups were pain (52.7% to 72.2%) and rattles (58.1% to 65.6%). Compared to MND and OND, patients with CNS tumors were more likely to have totally relieved pain, shortness of breath, rattles, and anxiety. They were also more likely to have their pain assessed with a validated tool; to receive symptom treatment for anxiety, nausea, rattles, and pain; to have had family members receive end-of-life discussions; to have someone present at death; and to have had their family members offered bereavement support. Both patients with CNS tumor and MND were more likely than patients with OND to receive consultation with a pain unit and to have had end-of-life discussions.

CONCLUSIONS: The study reveals high symptom burden and differences in palliative care between the groups during the last week of life. There is a need for person-centered care planning based on a palliative approach, focused on improving symptom assessments, relief, and end-of-life conversations.

Place, publisher, year, edition, pages
2019. article id e01348
Keywords [en]
amyotrophic lateral sclerosis, brain neoplasms, end of life, motor neuron disease, neurological disease, palliative care
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-7690DOI: 10.1002/brb3.1348PubMedID: 31287226OAI: oai:DiVA.org:esh-7690DiVA, id: diva2:1344161
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-20Bibliographically approved

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