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Spirituality and religious coping for cancer patients and providers: An ‘Almighty’ belief for palliative care
abstracts
Annals of Oncology 1608P
Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
1607P
V. Pareek, R. Bhalavat, M. Chandra Radiation Oncology, Jupiter Hospital, Mumbai, India
Deprescribing potentially inappropriate medication in cancer patients
S.B. Reuter, T.S. Petersen Department of Clinical Pharmacology, Bispebjerg Hospital, Copenhagen, Denmark
Table: 1607P Breast (n ¼ 3,959)/prostate cancer (n ¼ 3,535) (total n ¼ 7,494)
Lung (n ¼ 2,824)/pancreatic cancer (n ¼ 617) (n ¼ 3,441)
52% 65 (12)
50% 70 (10)
Background: Spiritual distress is prevalent in advanced disease, but often neglected, resulting in unnecessary suffering. Religion and/or spirituality have increasingly been recognized as key elements in patients’ experience of advanced illness. This study aims to explore spiritual care needs, experiences, preferences and examine the association between religious coping and quality of life among patients with advanced cancer. Methods: Structured interviews were conducted with 135 patients in advanced cancer patients and their primary informal caregivers. Patients completed measures of QOL (McGill QOL questionnaire), religious coping (Brief Measure of Religious Coping [RCOPE] and Multidimensional Measure of Religion/ Spirituality), self-efficacy (General Self-Efficacy Scale), and sociodemographic variables. Both positive and negative religious coping and multiple dimensions of QOL (physical, physical symptom, psychological, existential, and support) were studied. Results: The median age of the population was 60.2 years and majority of the subjects were Hindus. The study revealed greater use of positive religious coping was associated with better overall QOL as well as higher scores on the existential and support QOL dimensions and was also related to more physical symptoms. However, greater use of negative religious coping was related to poorer overall QOL. Most patients believed it was important for health care professionals to consider patient spiritual concerns within the medical setting. Spiritual care was reportedly lacking, primarily due to staff members’ de-prioritisation and lack of time. Conclusions: This study demonstrates that spiritual concerns are common among advanced cancer patients, and that they are associated with poorer psychological wellbeing. Spiritual care is an essential but neglected component of care, according to patients and their caregivers across a range of countries. The findings of the present study support the relationship between spirituality and health outcomes. Legal entity responsible for the study: Vibhay Pareek. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
1609P
Is there a difference of palliative care problems and needs between cancer and non-cancer hospitalized elderly patients?
I. Chatzi1, E. Patiraki2, P. Sourtzi2, I. Tsatsou3, A. Tsompanoglou1, S. Katsaragakis2 Department, General Hospital Konstantopoulio-Agia Olga, Athens, Greece, Department, National and Kapodistrian University of Athens, Athens, Greece, y Day Unit, Hellenic AirForce General Hospital, Athens, Greece The elderly (above 65 years) have become the leading population of our Their multitude of healthcare chronic problems demands palliative care and Palliative Care problems and needs (PCPN) assessment. A quantitative study using structured questionnaires [PNPC, Mini – Mental Examination (MMSE), demographic and clinical characteristics] was conducted December 2018 – February 2019, at internal medicine wards of a public general Patients with MMSE<24, at the end of life and with recent surgery were A translated in Hellenic language short-form version of PCPN used assessing Care Problems and Need for Professional Care. The PCPN is a 33 items 3Likert type scale that covers 8 domains: Activities of daily living (ADL/IADL), symptoms (PS), Autonomy (A), Social (SI), Psychological (PI), Spiritual issues Financial problems (FP) and Need for information (NI). The level of statistical was set at 0.05. Sample consisted of 150 patients (51% men) with mean age 75.6 years old ¼ 10.1). The cancer diagnosis was 40% mostly colon cancer (38%) and for nonpatients hypertension (62.2%). No statistical differences were found between and non cancer patients for the demographic and clinical characteristics > 0.05). The mean MMSE scare was 27.2 (SD ¼ 2) in patients with cancer and 27.6 ¼ 1.9) in patients with no cancer (p ¼ 0.313). Significantly greater scores were on the ADL/IADL (p¼.012 - p¼.001), A (p¼.050 - p¼.002), SI (p¼.007 .004) and Sp (p¼.014 - p¼.001) in the cancer group for both problems and needs care. Additionally, the cancer patients reported statistically significant higher need professional care for FP (p¼.022). No statistically significant differences were found PS, PI and NI (p>.050). Elderly hospitalized cancer patients have more palliative care problems needs for care at daily living, social, spiritual and financial issues than those with no Hence, nurses should focus on meeting these needs, based on the principles of entity responsible for the study: The authors. Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
v664 | Palliative Care
All authors have declared no conflicts of interest.
Volume 30 | Supplement 5 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz261.010/5576481 by guest on 26 November 2019
Background: Due to their advanced age many cancer patients with unfavorable prognosis suffer from comorbidities, and thus the risk of consuming potentially inappropriate medication (PIM). It is vital to deprescribe drugs with potential harmful effects or no short-term benefit for lowering pill. Hence, we examined the degree of deprescription of potentially inappropriate medication (PIM) in patients suffering from cancer. Methods: Retrospective, register-based study of all patients with newly diagnosed breast, prostate, pancreatic, and lung cancer, diagnosed at a hospital in the Capital Region of Denmark (1.8 million inhabitants) from 2012-2014. Patients with insufficient staging information or other malignancy except non-melanoma skin-cancer were excluded. Information about medication, comorbidity and mortality was extracted from the electronic health records. PIM were defined as: acetylsalicylic acid, calcium channel blockers, statins, thiazides, and bisphosphonates. The study was approved by the Danish Patient Safety Authority (No. 3-3013-1884/1/) and the Danish Data Protection Agency (No. BFH-2016-058). Results:
Gender (Women) Age mean (sd)
Spirituality and religious coping for cancer patients and providers: An ‘Almighty’ belief for palliative care
Annals of Oncology 1608P
Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
1607P
V. Pareek, R. Bhalavat, M. Chandra Radiation Oncology, Jupiter Hospital, Mumbai, India
Deprescribing potentially inappropriate medication in cancer patients
S.B. Reuter, T.S. Petersen Department of Clinical Pharmacology, Bispebjerg Hospital, Copenhagen, Denmark
Table: 1607P Breast (n ¼ 3,959)/prostate cancer (n ¼ 3,535) (total n ¼ 7,494)
Lung (n ¼ 2,824)/pancreatic cancer (n ¼ 617) (n ¼ 3,441)
52% 65 (12)
50% 70 (10)
Background: Spiritual distress is prevalent in advanced disease, but often neglected, resulting in unnecessary suffering. Religion and/or spirituality have increasingly been recognized as key elements in patients’ experience of advanced illness. This study aims to explore spiritual care needs, experiences, preferences and examine the association between religious coping and quality of life among patients with advanced cancer. Methods: Structured interviews were conducted with 135 patients in advanced cancer patients and their primary informal caregivers. Patients completed measures of QOL (McGill QOL questionnaire), religious coping (Brief Measure of Religious Coping [RCOPE] and Multidimensional Measure of Religion/ Spirituality), self-efficacy (General Self-Efficacy Scale), and sociodemographic variables. Both positive and negative religious coping and multiple dimensions of QOL (physical, physical symptom, psychological, existential, and support) were studied. Results: The median age of the population was 60.2 years and majority of the subjects were Hindus. The study revealed greater use of positive religious coping was associated with better overall QOL as well as higher scores on the existential and support QOL dimensions and was also related to more physical symptoms. However, greater use of negative religious coping was related to poorer overall QOL. Most patients believed it was important for health care professionals to consider patient spiritual concerns within the medical setting. Spiritual care was reportedly lacking, primarily due to staff members’ de-prioritisation and lack of time. Conclusions: This study demonstrates that spiritual concerns are common among advanced cancer patients, and that they are associated with poorer psychological wellbeing. Spiritual care is an essential but neglected component of care, according to patients and their caregivers across a range of countries. The findings of the present study support the relationship between spirituality and health outcomes. Legal entity responsible for the study: Vibhay Pareek. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
1609P
Is there a difference of palliative care problems and needs between cancer and non-cancer hospitalized elderly patients?
I. Chatzi1, E. Patiraki2, P. Sourtzi2, I. Tsatsou3, A. Tsompanoglou1, S. Katsaragakis2 Department, General Hospital Konstantopoulio-Agia Olga, Athens, Greece, Department, National and Kapodistrian University of Athens, Athens, Greece, y Day Unit, Hellenic AirForce General Hospital, Athens, Greece The elderly (above 65 years) have become the leading population of our Their multitude of healthcare chronic problems demands palliative care and Palliative Care problems and needs (PCPN) assessment. A quantitative study using structured questionnaires [PNPC, Mini – Mental Examination (MMSE), demographic and clinical characteristics] was conducted December 2018 – February 2019, at internal medicine wards of a public general Patients with MMSE<24, at the end of life and with recent surgery were A translated in Hellenic language short-form version of PCPN used assessing Care Problems and Need for Professional Care. The PCPN is a 33 items 3Likert type scale that covers 8 domains: Activities of daily living (ADL/IADL), symptoms (PS), Autonomy (A), Social (SI), Psychological (PI), Spiritual issues Financial problems (FP) and Need for information (NI). The level of statistical was set at 0.05. Sample consisted of 150 patients (51% men) with mean age 75.6 years old ¼ 10.1). The cancer diagnosis was 40% mostly colon cancer (38%) and for nonpatients hypertension (62.2%). No statistical differences were found between and non cancer patients for the demographic and clinical characteristics > 0.05). The mean MMSE scare was 27.2 (SD ¼ 2) in patients with cancer and 27.6 ¼ 1.9) in patients with no cancer (p ¼ 0.313). Significantly greater scores were on the ADL/IADL (p¼.012 - p¼.001), A (p¼.050 - p¼.002), SI (p¼.007 .004) and Sp (p¼.014 - p¼.001) in the cancer group for both problems and needs care. Additionally, the cancer patients reported statistically significant higher need professional care for FP (p¼.022). No statistically significant differences were found PS, PI and NI (p>.050). Elderly hospitalized cancer patients have more palliative care problems needs for care at daily living, social, spiritual and financial issues than those with no Hence, nurses should focus on meeting these needs, based on the principles of entity responsible for the study: The authors. Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
v664 | Palliative Care
All authors have declared no conflicts of interest.
Volume 30 | Supplement 5 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz261.010/5576481 by guest on 26 November 2019
Background: Due to their advanced age many cancer patients with unfavorable prognosis suffer from comorbidities, and thus the risk of consuming potentially inappropriate medication (PIM). It is vital to deprescribe drugs with potential harmful effects or no short-term benefit for lowering pill. Hence, we examined the degree of deprescription of potentially inappropriate medication (PIM) in patients suffering from cancer. Methods: Retrospective, register-based study of all patients with newly diagnosed breast, prostate, pancreatic, and lung cancer, diagnosed at a hospital in the Capital Region of Denmark (1.8 million inhabitants) from 2012-2014. Patients with insufficient staging information or other malignancy except non-melanoma skin-cancer were excluded. Information about medication, comorbidity and mortality was extracted from the electronic health records. PIM were defined as: acetylsalicylic acid, calcium channel blockers, statins, thiazides, and bisphosphonates. The study was approved by the Danish Patient Safety Authority (No. 3-3013-1884/1/) and the Danish Data Protection Agency (No. BFH-2016-058). Results:
Gender (Women) Age mean (sd)
Spirituality and religious coping for cancer patients and providers: An ‘Almighty’ belief for palliative care