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What palliative care–related problems do patients with drug-resistant or drug-susceptible tuberculosis experience on admission to hospital? A cross-sectional self-report study
BACKGROUND: The new World Health Organization’s ‘End TB’ strategy specifies palliative care within its strategic pillars. Limited data on patient-reported problems are available to inform an effective care response. AIM: We aimed to (1) identify most burdensome problems, (2) compare intensity of pro...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021214/ https://www.ncbi.nlm.nih.gov/pubmed/27468913 http://dx.doi.org/10.1177/0269216316637240 |
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author | Harding, Richard Defilippi, Kath Cameron, David |
author_facet | Harding, Richard Defilippi, Kath Cameron, David |
author_sort | Harding, Richard |
collection | PubMed |
description | BACKGROUND: The new World Health Organization’s ‘End TB’ strategy specifies palliative care within its strategic pillars. Limited data on patient-reported problems are available to inform an effective care response. AIM: We aimed to (1) identify most burdensome problems, (2) compare intensity of problems for drug-susceptible and drug-resistant tuberculosis and (3) identify predictors of problem identifiers. DESIGN: Cross-sectional self-report quantitative study. SETTING/PARTICIPANTS: Self-report palliative care problems (physical, psychological, social and spiritual) were collected among patients on admission to a general district hospital with tuberculosis and multidrug-resistant tuberculosis wards in South Africa. RESULTS: Totally, 114 patients were recruited. The items with worst score responses were worry (60.5%), pain (42.1%), help and advice to plan for the future (35.1%), symptoms (29.0%) and ability to share feelings (25.1%). In ordinal logistic regression, age was predictive of a higher (worse) score for total Palliative Outcome Scale total score (0.058, 95% confidence interval = 0.0018–0.099, p = 0.005) and Factor 2 (interpersonal wellbeing: 0.038, 95% confidence interval = 0.003–0.073, p = 0.031). Interestingly, multidrug-resistant tuberculosis was predictive of lower (better) score for both total Palliative Outcome Scale score and Factor 1 (physical and psychological wellbeing). Weight, human immunodeficiency virus status and prior treatment were not significantly associated with any of the three. CONCLUSION: Currently, patients with drug-susceptible tuberculosis are only admitted to hospital with complications, explaining their worse scores. The high burden of physical and psychosocial problems experienced by our sample provides strong evidence of the need for palliative care alongside potentially curative options. |
format | Online Article Text |
id | pubmed-5021214 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-50212142016-09-22 What palliative care–related problems do patients with drug-resistant or drug-susceptible tuberculosis experience on admission to hospital? A cross-sectional self-report study Harding, Richard Defilippi, Kath Cameron, David Palliat Med Short Report BACKGROUND: The new World Health Organization’s ‘End TB’ strategy specifies palliative care within its strategic pillars. Limited data on patient-reported problems are available to inform an effective care response. AIM: We aimed to (1) identify most burdensome problems, (2) compare intensity of problems for drug-susceptible and drug-resistant tuberculosis and (3) identify predictors of problem identifiers. DESIGN: Cross-sectional self-report quantitative study. SETTING/PARTICIPANTS: Self-report palliative care problems (physical, psychological, social and spiritual) were collected among patients on admission to a general district hospital with tuberculosis and multidrug-resistant tuberculosis wards in South Africa. RESULTS: Totally, 114 patients were recruited. The items with worst score responses were worry (60.5%), pain (42.1%), help and advice to plan for the future (35.1%), symptoms (29.0%) and ability to share feelings (25.1%). In ordinal logistic regression, age was predictive of a higher (worse) score for total Palliative Outcome Scale total score (0.058, 95% confidence interval = 0.0018–0.099, p = 0.005) and Factor 2 (interpersonal wellbeing: 0.038, 95% confidence interval = 0.003–0.073, p = 0.031). Interestingly, multidrug-resistant tuberculosis was predictive of lower (better) score for both total Palliative Outcome Scale score and Factor 1 (physical and psychological wellbeing). Weight, human immunodeficiency virus status and prior treatment were not significantly associated with any of the three. CONCLUSION: Currently, patients with drug-susceptible tuberculosis are only admitted to hospital with complications, explaining their worse scores. The high burden of physical and psychosocial problems experienced by our sample provides strong evidence of the need for palliative care alongside potentially curative options. SAGE Publications 2016-07-28 2016-10 /pmc/articles/PMC5021214/ /pubmed/27468913 http://dx.doi.org/10.1177/0269216316637240 Text en © The Author(s) 2016 http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Short Report Harding, Richard Defilippi, Kath Cameron, David What palliative care–related problems do patients with drug-resistant or drug-susceptible tuberculosis experience on admission to hospital? A cross-sectional self-report study |
title | What palliative care–related problems do patients with drug-resistant or drug-susceptible tuberculosis experience on admission to hospital? A cross-sectional self-report study |
title_full | What palliative care–related problems do patients with drug-resistant or drug-susceptible tuberculosis experience on admission to hospital? A cross-sectional self-report study |
title_fullStr | What palliative care–related problems do patients with drug-resistant or drug-susceptible tuberculosis experience on admission to hospital? A cross-sectional self-report study |
title_full_unstemmed | What palliative care–related problems do patients with drug-resistant or drug-susceptible tuberculosis experience on admission to hospital? A cross-sectional self-report study |
title_short | What palliative care–related problems do patients with drug-resistant or drug-susceptible tuberculosis experience on admission to hospital? A cross-sectional self-report study |
title_sort | what palliative care–related problems do patients with drug-resistant or drug-susceptible tuberculosis experience on admission to hospital? a cross-sectional self-report study |
topic | Short Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021214/ https://www.ncbi.nlm.nih.gov/pubmed/27468913 http://dx.doi.org/10.1177/0269216316637240 |
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