Interventions for fatigue and weight loss in adults with advanced progressive illness
ABSTRACT Fatigue and unintentional weight loss are two of the commonest symptoms experienced by people with advanced progressive illness and can be of great concern to those affected and of even greater concern to formal and informal caregivers. No robust information currently exists on optimal interventions to manage fatigue and/or weight loss in any advanced progressive illness. This overview presents what we know from research held within Cochrane systematic reviews on treatments to manage these symptoms in non curative illnesses such as advanced cancer, heart failure, lung failure, cystic fibrosis, multiple sclerosis, motor neuron disease, Parkinson's disease, dementia and acquired immune deficiency syndrome (AIDS). The treatment approaches for managing fatigue were pharmacological treatments including eicosapentaenoic acid (EPA), amantadine, carnitine and non pharmacological interventions including exercise and physical training, medically assisted hydration, psychosocial interventions including self management education programmes, occupational therapy and professional support services and dietary interventions including nutritional support. The treatment approaches for managing weight loss were pharmacological treatments including eicosapentaenoic acid (EPA), megestrol acetate and anabolic steroids and non pharmacological interventions including nutritional support, progressive resistive exercise and aerobic exercise. More research is required to determine which interventions help to manage these symptoms for those who are living with advanced illness. Researchers need to consider how they can reduce the variability of study design and outcome measurements to allow for meaningful comparisons across future studies.
Full-textDOI: · Available from: Cathy Payne, Aug 26, 2015
- SourceAvailable from: Augusto Fusco
[Show abstract] [Hide abstract]
- "At the same time, rehabilitation has become an integrative part of the clinical care of people after BC surgery, both for the treatments of motor and for health-related QoL aspects . In fact, exercise interventions are fundamental to improve the motor and psychological sequelae during treatment and in the post treatment rehabilitation period, as recently highlighted by recent Cochrane reviews on this topic   . A multidisciplinary educational treatment was found to be effective in improving functional abilities and wellbeing and also during the follow-up period after BC surgery . "
ABSTRACT: In breast cancer survivors, own body image may change due to physical and psychological reasons, worsening women's living. The aim of the study was to investigate whether body image may affect the functional and quality of life outcomes after a multidisciplinary and educational rehabilitative intervention in sixty women with primary nonmetastatic breast cancer who have undergone conservative surgery. To assess the quality of life was administered The European Organization for Research and Treatment of Cancer Study Group on Quality of Life core questionnaire, while to investigate the psychological features and self-image were administered the following scales: the Body Image Scale, the Hamilton Rating Scale for Depression, and the State-Trait Anxiety Inventory. To assess the recovery of the function of the shoulder were administered: the Disabilities of the Arm, Shoulder, and Hand Questionnaire and the Constant-Murley Score. Data were collected at the baseline, at the end of the intervention, and at 3-month follow-up. We found a general improvement in the outcomes related to quality of life, and physical and psychological features after treatment (P < 0.001). During follow-up period, a higher further improvement in women without alterations in body image in respect of those with an altered self-perception of their own body was found (P = 0.01). In conclusion, the body image may influence the efficacy of a rehabilitative intervention, especially in the short term of follow-up.10/2014; 2014:451935. DOI:10.1155/2014/451935
[Show abstract] [Hide abstract]
- "In contrast, health-care professionals sometimes see fatigue as a diagnostically non-specific state (Sharpe & Wilks, 2002). Consequently, although fatigue has a major impact on daily life, it often goes unnoticed and underdiagnosed (Payne, Wiffen, & Martin, 2012). "
ABSTRACT: Fatigue has been found to be the most frequent and bothersome symptom after myocardial infarction (MI), influencing health-related quality of life negatively. Moreover, fatigue after MI has been described as incomprehensible due to its unpredictable occurrence and lack of relationship to physical effort. The aim of this study is therefore to explore persons' experiences of consequences of fatigue and their strategies for dealing with it 2 months after MI. In total, 18 informants, aged 42-75 years, participated in the study. Interviews were conducted and analysed using constructivist grounded theory methodology. Grounded in the data, the main consequence of fatigue, as illustrated in the core category, was: I've lost the person I used to be. It indicates a sense of reduced ability to manage daily life due to experiences of fatigue. The core category was developed from the four categories: involuntary thoughts, certainties replaced with question marks, driving with the handbrake on and just being is enough. Furthermore, attempts to relieve fatigue were limited. These findings indicate that patients with symptoms of fatigue should be supported in developing relief strategies, for example, rest and sleep hygiene as well as physical activity. In conclusion, the results show that fatigue can be understood in light of the concepts "comprehensibility" and "manageability." They also indicate that, working from a person-centered perspective, health-care professionals can support patients experiencing post-MI fatigue by giving them opportunities to straighten out the question marks and by inviting them to discuss involuntary thoughts and feelings of being restricted in their daily life functioning.International Journal of Qualitative Studies on Health and Well-Being 06/2013; 8:20836. DOI:10.3402/qhw.v8i0.20836 · 0.93 Impact Factor
International journal of nursing studies 06/2012; 49(7):773-4. DOI:10.1016/j.ijnurstu.2012.05.007 · 2.90 Impact Factor
- "This overview reported 26 of the 27 included CDSR reviews were of a high methodological quality using the AMSTAR. However, it was difficult to assess the methodological quality of one of the included SRs because this particular SR did not have any included studies (Payne et al., 2012). In contrast, our recent overview of SRs in the area of radiation dermatitis in cancer patients demonstrated high variability in methodological quality amongst all the included SRs (Chan et al., 2012). "