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Pain, physical symptoms and functional assessment in progressive neurological disease in palliative care
  1. Radka Bužgová1,
  2. Radka Kozáková1 and
  3. Michal Bar2
  1. 1Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
  2. 2Neurology Clinic, University Hospital Ostrava, Ostrava, Czech Republic
  1. Correspondence to Dr Radka Bužgová, Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, 700 30 Ostrava, Czech Republic; radka.buzgova{at}osu.cz

Abstract

Objectives The aim of the research was to identify the most frequent symptoms of patients with progressive neurological disease (PND) in relation to their functional state. Another objective was to determine the effects of consultations with a multidisciplinary palliative team on mitigating the symptoms burden, subjective evaluation of health, disease progression and improvement of the functional state.

Methods The interventional control study included 151 patients with PND (98 patients in the intervention group, 53 patients in the control group). The intervention group was provided with consultations of a multidisciplinary palliative team. The symptoms scale of the progressive neurological diseases quality of life was used to collect data. The patients completed the questionnaire before the provided intervention and 3 months after that.

Results Pain and fatigue were identified as the symptoms that trouble the patients the most. After the intervention, there was a determined statistically significant improvement in the evaluation of 9 out of 11 symptoms (except excretion and urination) among the patients from the intervention group compared with the control group. When assessed again, the patients from the intervention group showed an improvement with respect to six symptoms (pain, fatigue, tremor, stiffness, cramps, excretion), while the patients from the control group had six symptoms that deteriorated (drowsiness, dyspnoea, stiffness, swallowing, salivation, excretion). There was not any confirmed positive impact of the intervention on the cognitive functions of the patients.

Conclusion The provision of consultations with the multidisciplinary palliative team to patients with PND in an advanced stage of disease resulted in decreasing their symptoms burden and improving their functional state.

  • neurological conditions
  • symptoms and symptom management
  • end-of-life care
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Footnotes

  • Contributors RB and RK contributed to study design and drafted the article. RB, RK and MB performed the searches and contributed to data collection and data analysis. RB undertook the statistical analysis. All authors were responsible for approval of the final report.

  • Funding This work was supported by the Ministry of Health of the Czech Republic (grant no: 17-29447A).

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval Prior to the study, the approval was obtained from the ethics committee of the University Hospital Ostrava (no: 486/2016).

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

  • Data availability statement Data are available on reasonable request. The data that support the findings of this study are available from the corresponding author, on reasonable request.

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