European journal of oncology nursing : the official journal of European Oncology Nursing Society
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Palliative sedation at the end of life to handle unmanageable symptoms has been much debated. A systematic literature review in three phases including a content analysis of 15 articles published between the years 1990 and 2005 has been conducted. The aim was to describe the phenomenon of 'palliative sedation at the end of life' from a nursing perspective. ⋯ It is usually given because of the patient's pain, agitation and/or dyspnoea. Professionals usually have positive attitudes towards it and their view differs from that of the public's view regarding it as continuously deep sedation, whereas the public regards it as being close to euthanasia. Studies focusing on nursing care during palliative sedation are hard to find and this underlines the importance of further research in this area to elucidate the nurses' role during palliative sedation.
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We report an adolescent cancer pathway from referral, through diagnosis and treatment, to follow-up in France. All cases of cancer among 15-19 years, diagnosed from 1988 to 1997, recorded by nine French population-based cancer registries (10% of French population) were included. The management of adolescent cancer by paediatricians was rare. ⋯ The inclusion rate changes according to the diagnosis, higher for acute lymphoblastic leukaemia (39%), non-Hodgkin's lymphomas (NHL) (27%), and acute non-lymphoblastic leukaemia (20%). Only 4% of adolescent cancers were managed on shared adult/paediatric departments, especially for soft-tissue sarcomas (14.9%), malignant bone tumours (13.4), central nervous system tumours (6.2%), and NHL (4.4%). Whatever the reasons for lack of participation in clinical trials, an ideal model requiring communication and cooperation between all adult and paediatric specialists involved in adolescent cancer treatment should reduce the large gap in access to cooperative groups.
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Oral mucositis associated with cancer therapy often has devastating impact on patients' quality of life (QoL), affecting multiple spheres of daily and psychosocial functioning. This descriptive cross-sectional study aimed at describing the severity and distress of oral mucositis, as well as QoL of Hong Kong Chinese patients treated with cancer therapy, and identifying the extent to which oral mucositis correlated with QoL. A convenience sample of 38 in-patients and 50 out-patients with solid tumors and during the peak phase of oral mucositis was recruited. ⋯ Subjects receiving radiotherapy reported a lower range of total social/family, emotional, and functional subscale scores than that of those receiving chemotherapy or chemo-radiotherapy, but these differences were not statistically significant (P>0.05). In conclusion, QoL, especially the functional sphere, was compromised for patients with oral mucositis. The data also support the correlations between oral mucositis and the physical sphere of QoL, as well as oral mucositis and the emotional sphere of QoL.
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Editorial Comment
Evidence based cancer policy: the needs of teenagers and young adults.