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Original research
Physiotherapy in palliative medicine: patient and caregiver wellness
  1. Máximo Bernabeu-Wittel1,2,
  2. Lourdes Moreno-Gaviño1,
  3. Dolores Nieto-Martín1,
  4. Julia Lanseros-Tenllado1,
  5. Ana Sáenz-Santamaría3,
  6. Olga Martínez-Pérez3,
  7. Carmen Aguilera-Gonzalez1,
  8. Manuel Pereira-Domínguez4 and
  9. Manuel Ollero-Baturone1
  10. FISEA-Project Team
    1. 1 Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Sevilla, Spain
    2. 2 Department of Medicine, University of Seville, Sevilla, Spain
    3. 3 Department of Internal Medicine, Hospital Universitario Virgen Macarena, Sevilla, Spain
    4. 4 Psychosocial Team of Seville. DomusVI. Fundación La Caixa, Barcelona, Spain
    1. Correspondence to Dr Máximo Bernabeu-Wittel, Internal Medicine, Hospital Universitario Virgen del Rocio, 41013 Sevilla, Spain; wittel{at}cica.es

    Abstract

    Objectives Despite the demonstrated efficacy of physiotherapy in palliative care programmes, there are scarce data of its real-life impact on patients’ and caregivers’ wellness and stress. Our aim was to assess effectiveness of a 30-day physiotherapy programme in psychological wellness and health-related quality of life (HRQoL) of patients with advanced chronic diseases or cancer and in their caregivers’ stress.

    Methods Quasiexperimental before–after study applying personalised kinesitherapy, exercise with curative effects, respiratory physiotherapy, therapeutic massages and ergotherapy. Psychological wellness, HRQoL and caregiver’s strain outcomes were measured.

    Results 207 patients (60% men, with a mean age of 73.6±12 years) were included; 129 (62.3%) with advanced cancer, and the remaining 78 with advanced chronic diseases. Psychological wellness (Emotional Stress Detection Tool decreased from 12.4±3 to 11±3; p<0.0001), caregiver’s strain (Caregiver Strain Index decreased from 8.5±3.2 to 7.9±3.5; p<0.0001) and HRQoL (WHO-BREF physical health domain increased from 8.3±2.6 to 9.4±2.9; p<0.0001) showed a significant improvement after the physiotherapy programme. Global satisfaction with the physiotherapy intervention was also high (Client Satisfaction Questionnaire-8 of 28.3±3.3 points).

    Conclusions A personalised physiotherapy programme incorporated to integral palliative care improved psychological wellness, HRQoL and caregivers’ strain of patients with advanced chronic diseases and cancer.

    • quality of life
    • rehabilitation
    • psychological care
    • supportive care

    Data availability statement

    Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Data wiil be available on reasonable request of readers and investigators, during a period of 24 months after publication. For this purpose, please contact MB-W (https://orcid.org/0000-0003-4574-4110I).

    https://doi.org/10.1136/bmjspcare-2020-002826

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      Data availability statement

      Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Data wiil be available on reasonable request of readers and investigators, during a period of 24 months after publication. For this purpose, please contact MB-W (https://orcid.org/0000-0003-4574-4110I).

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      Footnotes

      • Twitter @MximoWittel

      • Collaborators Members of the FISEA-Project Team: Alegre Herrera S (Internal Medicine Department, University Hospital Virgen Macarena, Seville, Spain), Ancizu I (DomusVI Foundation, Spain), Aresté Vilanova V (Psychosocial Team of Lleida, DomusVI Foundation, Spain), Barón Franco B (Internal Medicine Department, University Hospital Virgen del Rocío, Seville, Spain), Barranco Moreno E (Internal Medicine Department, University Hospital Virgen Macarena, Seville, Spain), Boceta Osuna J (Internal Medicine Department, University Hospital Virgen Macarena, Seville, Spain), Fernández López A (Internal Medicine Department, University Hospital Virgen del Rocío, Seville, Spain), Fernandez Rendón L (Internal Medicine Department, University Hospital Virgen Macarena, Seville, Spain), Galindo Ocaña F J (Internal Medicine Department, University Hospital Virgen del Rocío, Seville, Spain), Gómez Camacho E (Internal Medicine Department, University Hospital Virgen del Rocío, Seville, Spain), Gutierrez Rivero S (Internal Medicine Department, University Hospital Virgen del Rocío, Seville, Spain), Jimenez de Juan C (Internal Medicine Department, University Hospital Virgen del Rocío, Seville, Spain), Martín Sanz V (Internal Medicine Department, University Hospital Virgen del Rocío, Seville, Spain), Palacios Gómez C (Emergency Departament, University Hospital Virgen del Rocío, Seville, Spain), Prior Venegas R (Psychosocial Team of Seville, DomusVI Foundation, Spain), Ramirez Duque N (Internal Medicine Department, University Hospital Virgen del Rocío, Seville, Spain), Rivero Rivero L (Internal Medicine Department, University Hospital Virgen del Rocío, Seville, Spain) and Rodriguez Gonzalez F (Internal Medicine Department, University Hospital Virgen Macarena, Seville, Spain).

      • Contributors All authors have contributed substantially to the work and approve the content and form of the present manuscript.

      • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

      • Competing interests None declared.

      • Provenance and peer review Not commissioned; externally peer reviewed.