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Paulino Pereira NR, Groot OQ, Verlaan JJ, Bongers MER, Twining PK, Kapoor ND, van Dijk CN, Schwab JH, Bramer JAM. Quality of Life Changes After Surgery for Metastatic Spinal Disease: A Systematic Review and Meta-analysis. Clin Spine Surg 2022; 35:38-48. [PMID: 34108371 DOI: 10.1097/bsd.0000000000001213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 04/14/2021] [Indexed: 11/25/2022]
Abstract
STUDY DESIGN This was a systematic review and meta-analysis. OBJECTIVE A systematic review and meta-analysis was conducted to assess the quality of life (QoL) after open surgery for spinal metastases, and how surgery affects physical, social/family, emotional, and functional well-being. SUMMARY OF BACKGROUND DATA It remains questionable to what extent open surgery improves QoL for metastatic spinal disease, it would be interesting to quantify the magnitude and duration of QoL benefits-if any-after surgery for spinal metastases. MATERIALS AND METHODS Included were studies measuring QoL before and after nonpercutaneous, open surgery for spinal metastases for various indications including pain, spinal cord compression, instability, or tumor control. A random-effect model assessed standardized mean differences (SMDs) of summary QoL scores between baseline and 1, 3, 6, or 9-12 months after surgery. RESULTS The review yielded 10 studies for data extraction. The pooled QoL summary score improved from baseline to 1 month (SMD=1.09, P<0.001), to 3 months (SMD=1.28, P<0.001), to 6 months (SMD=1.21, P<0.001), and to 9-12 months (SMD=1.08, P=0.001). The surgery improved physical well-being during the first 3 months (SMD=0.94, P=0.022), improved emotional (SMD=1.19, P=0.004), and functional well-being (SMD=1.08, P=0.005) during the first 6 months, and only improved social/family well-being at month 6 (SMD=0.28, P=0.001). CONCLUSIONS The surgery improved QoL for patients with spinal metastases, and rapidly improved physical, emotional, and functional well-being; it had minimal effect on social/family well-being. However, choosing the optimal candidate for surgical intervention in the setting of spinal metastases remains paramount: otherwise postoperative morbidity and complications may outbalance the intended benefits of surgery. Future research should report clear definitions of selection criteria and surgical indication and provide stratified QoL results by indication and clinical characteristics such as primary tumor type, preoperative Karnofsky, and Bilsky scores to elucidate the optimal candidate for surgical intervention.
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Affiliation(s)
- Nuno R Paulino Pereira
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam-Zuidoost
| | - Olivier Q Groot
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jorrit-Jan Verlaan
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michiel E R Bongers
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam-Zuidoost
| | - Peter K Twining
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Neal D Kapoor
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Cornelis N van Dijk
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam-Zuidoost
| | - Joseph H Schwab
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jos A M Bramer
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam-Zuidoost
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Westermann L, Eysel P, Luge H, Olivier A, Oikonomidis S, Baschera D, Zarghooni K. Quality of life and functional outcomes after surgery for spinal metastases: Results of a cohort study. Technol Health Care 2020; 28:303-314. [DOI: 10.3233/thc-191727] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Leonard Westermann
- Centre of Orthopedic and Trauma Surgery, University Medical Centre, 50937 Cologne, Germany
| | - Peer Eysel
- Centre of Orthopedic and Trauma Surgery, University Medical Centre, 50937 Cologne, Germany
| | - Hannah Luge
- Centre of Orthopedic and Trauma Surgery, University Medical Centre, 50937 Cologne, Germany
| | - Alain Olivier
- Centre of Orthopedic and Trauma Surgery, University Medical Centre, 50937 Cologne, Germany
| | - Stavros Oikonomidis
- Centre of Orthopedic and Trauma Surgery, University Medical Centre, 50937 Cologne, Germany
| | - Dominik Baschera
- Department of Neurosurgery, Kantonsspital Winterthur, 8401 Winterthur, Switzerland
| | - Kourosh Zarghooni
- Centre of Orthopedic and Trauma Surgery, University Medical Centre, 50937 Cologne, Germany
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A prospective research study to investigate the impact of complementary therapies on patient well-being in palliative care. Complement Ther Clin Pract 2018; 31:118-125. [DOI: 10.1016/j.ctcp.2018.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 02/01/2018] [Indexed: 11/22/2022]
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Wang X, Huang Y, Radha Krishna L, Puvanendran R. Role of the Nasogastric Tube and Lingzhi (Ganoderma lucidum) in Palliative Care. J Pain Symptom Manage 2016; 51:794-799. [PMID: 26891608 DOI: 10.1016/j.jpainsymman.2015.11.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 11/23/2015] [Accepted: 11/27/2015] [Indexed: 11/17/2022]
Abstract
Decision-making on behalf of an incapacitated patient at the end of life is a complex process, particularly in family-centric societies. The situation is more complex when attempts are made to accommodate Eastern concepts of end-of-life care with more conventional Western approaches. In this case report of an incapacitated 74-year-old Singaporean man of Malay descent with relapsed Stage 4 diffuse large B cell lymphoma who was without an established lasting power of attorney, we highlight the difficult deliberations that ensue when the patient's family, acting as his proxy, elected to administer lingzhi through his nasogastric tube (NGT). Focusing on the questions pertaining to end-of-life decision-making in Asia, we consider the issues surrounding the use of NGT and lingzhi in palliative care (PC) and the implementation of NGT for administering lingzhi in a PC setting, particularly in light of a dearth of data on such treatment measures among PC patients.
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Affiliation(s)
- Xiaohui Wang
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Youyi Huang
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Lalit Radha Krishna
- Duke-NUS Graduate Medical School, Singapore, Singapore; National Cancer Centre, Singapore, Singapore
| | - Rukshini Puvanendran
- Duke-NUS Graduate Medical School, Singapore, Singapore; KK Women's and Children's Hospital, Singapore, Singapore.
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Fischer HF, Junne F, Witt C, von Ammon K, Cardini F, Fønnebø V, Johannessen H, Lewith G, Uehleke B, Weidenhammer W, Brinkhaus B. Key issues in clinical and epidemiological research in complementary and alternative medicine--a systematic literature review. ACTA ACUST UNITED AC 2014; 19 Suppl 2:51-60. [PMID: 23883945 DOI: 10.1159/000343126] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the last 2 decades there has been a large increase in publications on complementary and alternative medicine (CAM). However, CAM research methodology was heterogeneous and often of low quality. The aim of this systematic review was to investigate scientific publications with regards to general issues, concepts and strategies. We also looked at research priorities and methods employed to evaluate the clinical and epidemiological research of CAM in the past to identify the basis for consensus-based research strategies. METHODS We performed a systematic literature search for papers published between 1990 and 2010 in 7 electronic databases (Medline, Web of Science, PsychArticles, PsycInfo, CINAHL, EMBASE and Cochrane Library) on December 16 and 17, 2010. In addition, experts were asked to nominate relevant papers. Inclusion criteria were publications dealing with research methodology, priorities or complexities in the scientific evaluation of CAM. All references were assessed in a multistage process to identify relevant papers. RESULTS From the 3,279 references derived from the search and 98 references contributed by CAM experts, 170 papers fulfilled the criteria and were included in the analysis. The following key issues were identified: difficulties in past CAM research (e.g., randomisation, blinding), utility of quantitative and qualitative research methods in CAM, priority setting in CAM research and specific issues regarding various CAM modalities. CONCLUSIONS Most authors vote for the use of commonly accepted research methods to evaluate CAM. There was broad consensus that a mixed methods approach is the most suitable for gathering conclusive knowledge about CAM.
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Affiliation(s)
- H Felix Fischer
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany.
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Effects of back massage on chemotherapy-related fatigue and anxiety: Supportive care and therapeutic touch in cancer nursing. Appl Nurs Res 2013; 26:210-7. [DOI: 10.1016/j.apnr.2013.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 07/12/2013] [Accepted: 07/23/2013] [Indexed: 11/23/2022]
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Paley CA, Bennett MI, Johnson MI. Acupuncture for cancer-induced bone pain? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:671043. [PMID: 21799687 PMCID: PMC3136818 DOI: 10.1093/ecam/neq020] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 02/22/2010] [Indexed: 12/13/2022]
Abstract
Bone pain is the most common type of pain in cancer. Bony metastases are common in advanced cancers, particularly in multiple myeloma, breast, prostate or lung cancer. Current pain-relieving strategies include the use of opioid-based analgesia, bisphosphonates and radiotherapy. Although patients experience some pain relief, these interventions may produce unacceptable side-effects which inevitably affect the quality of life. Acupuncture may represent a potentially valuable adjunct to existing strategies for pain relief and it is known to be relatively free of harmful side-effects. Although acupuncture is used in palliative care settings for all types of cancer pain the evidence-base is sparse and inconclusive and there is very little evidence to show its effectiveness in relieving cancer-induced bone pain (CIBP). The aim of this critical review is to consider the known physiological effects of acupuncture and discuss these in the context of the pathophysiology of malignant bone pain. The aim of future research should be to produce an effective protocol for treating CIBP with acupuncture based on a sound, evidence-based rationale. The physiological mechanisms presented in this review suggest that this is a realistic objective.
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Affiliation(s)
- Carole A Paley
- Faculty of Health, Leeds Metropolitan University, Leeds, UK
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Belletti M, Mallia L, Lucidi F, Reichmann S, Mastroianni C, De Marinis MG, Casale G. Complementary therapy and support services for formal and informal caregivers in Italian palliative care hospices: an exploratory and descriptive study. Support Care Cancer 2010; 19:1939-47. [PMID: 21058049 DOI: 10.1007/s00520-010-1034-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Accepted: 10/22/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE The present study is aimed to assess the availability and use of complementary medicine (CM) therapies in Italian palliative care hospices, and the support services available to caregivers and hospice staff. METHODS A national sample of 30 hospices meeting study criteria provided data by means of telephone interviews. RESULTS All hospices offered spiritual assistance and at least one other form of CM, with the most common being massage therapy (n = 24) and relaxation therapy (n = 10). When offered complementary therapies, 65% or more of the patients accepted them. Twenty-nine hospices provided spiritual and psychological support to caregivers during patient stays, but only 12 offered support at home. All hospices offered support services to their staff, both in individual and group formats. CONCLUSIONS Despite limited empirical support, CM has become an important part of palliative care for end-of-life patients in Italy, as in many other countries.
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Smith TC, Smith B, Ryan MAK. Prospective investigation of complementary and alternative medicine use and subsequent hospitalizations. Altern Ther Health Med 2008; 8:19. [PMID: 18462505 PMCID: PMC2394513 DOI: 10.1186/1472-6882-8-19] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 05/08/2008] [Indexed: 11/19/2022]
Abstract
Background The prevalence of complementary and alternative medicine (CAM) use has been estimated to be as high as 65% in some populations. However, there has been little objective research into the possible risks or benefits of unmanaged CAM therapies. Methods In this prospective study of active duty US Navy and Marine Corps personnel, the association between self-reported practitioner-assisted or self-administered CAM use and future hospitalization was investigated. Cox regression models were used to examine risk of hospitalization due to any cause over the follow-up period from date of questionnaire submission, until hospitalization, separation from the military, or end of observation period (June 30, 2004), whichever occurred first. Results After adjusting for baseline health, baseline trust and satisfaction with conventional medicine, and demographic characteristics, those who reported self-administering two or more CAM therapies were significantly less likely to be hospitalized for any cause when compared with those who did not self-administer CAM (HR = 0.38; 95% CI = 0.17, 0.86). Use of multiple practitioner-assisted CAM was not associated with a significant decrease or increase of risk for future hospitalization (HR = 1.86; 95 percent confidence interval = 0.96-3.63). Conclusion While there were limitations to these analyses, this investigation utilized an objective measure of health to investigate the potential health effects of CAM therapies and found a modest reduction in the overall risk of hospitalization associated with self-administration of two or more CAM therapies. In contrast, use of practitioner-assisted CAM was not associated with a protective effect.
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Burden B, Herron-Marx S, Clifford C. The increasing use of reiki as a complementary therapy in specialist palliative care. Int J Palliat Nurs 2005; 11:248-53. [PMID: 15944500 DOI: 10.12968/ijpn.2005.11.5.248] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Palliative medicine and complementary therapies (CTs) have developed within the NHS as parallel philosophies of care. As a result, the last decade has seen an increase in the integration and usage of CTs, as adjunct therapies to conventional medical treatment. Documented benefits of relaxation, decreased perception of pain, reduced anxiety and improved sense of wellbeing have been shown to enable an enhanced quality of life, where curative treatment is no longer an option. Reiki is a more recent addition to the range of CTs available to cancer patients. As an energy-healing intervention it has gained in popularity as a non-invasive and non-pharmacological approach. Anecdotal evidence suggests that the profound relaxation effect has a positive impact on alleviating anxiety, stress, perception of pain and promotes a feeling of wellbeing particularly relating to the nature of psychospiritual wellbeing. However, there is very little evidence to support its application within clinical practice, and none within the specific field of specialist palliative care (SPC). This article will consider the position of reiki as an emerging CT within SPC. The function of the hospice movement, the role of CTs together with an understanding of energy healing will also be explored. Within this context, the rise in popularity of reiki and its potential benefits for SPC patients will be discussed. These considerations will then form the basis of the justification for further research in SPC.
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Taylor E, Ismail S, Hills H, Ainsworth S. Multicomponent psychosocial support for newly diagnosed cancer patients: participants’ views. Int J Palliat Nurs 2004; 10:287-95. [PMID: 15284624 DOI: 10.12968/ijpn.2004.10.6.13271] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The diagnosis and treatment of cancer carries a heavy psychological burden, particularly in the first year after diagnosis. The purpose of this study was to investigate and report qualitatively on patients who had completed a 10-session programme consisting of education, social interaction, psychological support, exercise and complementary therapies for newly diagnosed cancer patients. A thematic analysis of data obtained from purposefully selected focus groups revealed that peer support was the most highly valued aspect of the service and that a variety of needs were being met. The relaxed atmosphere, sensitivity of staff and complementary therapies were particularly appreciated. The findings also indicated that patients would like the option of diversional activities and a period of structured group therapy in addition to the services offered and that the revision of information-giving procedures would enhance psychological support. Opportunities for staff development are identified.
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Affiliation(s)
- Elizabeth Taylor
- East Lancashire Integrated Health Care Centre, Cribden House, Rossendale Hospital, Rossendale, Lancashire, BB4 6NE, UK.
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