Weakness & Fatigue. Introduction. Assessment
|
|
- Candice Rice
- 6 years ago
- Views:
Transcription
1 Weakness & Fatigue Introduction Fatigue is a persistent, subjective feeling of tiredness, weakness or lack of energy related to advanced chronic illness. It has many contributory causes though the exact aetiology is poorly understood. Patients may use many terms to describe their experience of fatigue. Fatigue is a common symptom in progressive chronic disease. The severity and impact of fatigue may change in the course of the disease trajectory. It is frequently regarded as more distressing than pain by patients. It is often under-recognised by professionals. Fatigue may be unrelated to level of activity and not fully alleviated by rest or sleep. It is multidimensional affecting physical function, cognitive ability, social, emotional and spiritual wellbeing. Reduced physical function limits participation in preferred activities and activities of daily living. Cognitive involvement limits activities such as reading, driving and social interaction. Fatigue can influence the patient s decision-making regarding future treatment and may lead to refusal of potentially beneficial treatment. It is important to recognise that towards the end of life there will be a time point when intervention is no longer appropriate and may be distressing. At this stage, fatigue may provide protection and shielding from suffering for the patient. Assessment All palliative care patients should be assessed for fatigue and its effects. Explore the person s experience and understanding of fatigue. Acknowledge and validate the reality and significance of the symptoms. Be aware that patients may have multi-morbidities impacting on fatigue, eg cardiac/respiratory disease, renal or hepatic impairment, malignancy, hypothyroidism, hypogonadism, adrenal insufficiency, neurological conditions. Consider: o Symptom pattern, duration o Severity: mild, moderate or severe Patient-rated assessment on a 0-10 scale o Impact on function and quality of life, eg everyday activities can seem impossible o Impact on family or carers o Contributing factors: o General factors: patient/family roles and responsibilities sleep disturbance nutrition diet, absorption deconditioning due to reduced activity levels, fitness and/or muscle wasting over-exertion psychological factors, eg anxiety, fear depression. o Condition-related factors: Copyright 2014 NHS Scotland Page 1 of 5
2 o metabolic abnormalities consider checking sodium, potassium, calcium, magnesium, glucose, renal function, C-reactive protein, albumin anaemia infection Disease recurrence or progression. If weakness present, exclude malignant spinal cord compression (MSCC) Anorexia/cachexia skeletal muscle wasting may be mediated by tumour necrosis factor, cytokines or both Poorly controlled symptoms, eg pain. Treatment factors: dialysis biological therapy, eg interferon surgery prescribed medication, eg beta-blockers, sedating drugs, corticosteroids, opioids over-the-counter medications cancer treatments radiotherapy, chemotherapy, hormone therapy. Management A combination of person-centred approaches in partnership with the individual using the multidisciplinary team will be required to maximise potential. Treat potentially reversible factors if appropriate, eg blood transfusions may be helpful for some patients. Other symptoms and co-morbidities should be managed, and all medications reviewed. Non-pharmacological management Diary - an activity/fatigue diary may help to identify precipitants and timing of symptoms. Energy conservation/restoration o consider a self-management plan set priorities, delegate tasks o pace activities and attend to one activity at a time o schedule activities at times of peak energy and conserve energy for valued activities o eliminate non-essential activities o occupational therapy referral for advice on minimising energy expenditure and appropriate aids/equipment. Physical activity and exercise o An appropriate level of exercise can reduce fatigue and should be recommended. o Consider physiotherapy referral to ensure exercises are tailored to individual needs particularly for those patients who have advanced disease or are experiencing effects of treatments, eg anaemia, osteoporosis/bone metastases, falls. Psychosocial interventions Consider: o Stress/anxiety management o Relaxation/complementary therapy o Sleep pattern advice, eg hot drink at night, avoid stimulants. o Offer appropriate verbal and written information Copyright 2014 NHS Scotland Page 2 of 5
3 Pharmacological management For patients with anorexia/cachexia-related fatigue, see Anorexia guideline There is currently insufficient evidence to recommend pharmacological treatment, including the use of psychostimulants by non-specialists. Practice Points As an invisible symptom, fatigue is often misunderstood by patients, family, friends, colleagues and healthcare professionals. Open discussion should be encouraged. Often patients feel guilty about being no longer able to contribute fully to family life and this should be acknowledged. People who have fatigue will have limited energy and may find it difficult to do simple everyday things that are usually taken for granted. The basis of managing fatigue is to ensure that the best levels of energy are available and used in the most efficient way. The Macmillan Get Active, Feel Good resource may be helpful. For many patients, fatigue will be part of their experience of living with their illness. Through awareness and acknowledgement of the symptoms, consideration of lifestyle and the use of particular techniques, it is possible to manage fatigue and take steps to reduce the impact it has on daily life. Resources Macmillan Cancer Support Macmillan Cancer Support, Coping with fatigue Macmillan Cancer Support, Get Active, Feel Good Cancer Research UK Cancer Research UK, Tiredness with cancer (fatigue) National Cancer Institute, Fatigue Marie Curie Cancer Care Chest Heart and Stroke Scotland British Lung Foundation British Heart Foundation NHS Inform, Long term health conditions and mental health NHS Inform, Palliative care My Condition, My Terms, My Life Self Management Epsom and St Helier University Hospitals NHS Trust, Chronic Fatigue Service Copyright 2014 NHS Scotland Page 3 of 5
4 References Cramp, F. and Byron-Daniel, J Exercise for the management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews [Online]. Available: Finnegan-John, J., Molassiotis, A., Richardson, A. and Ream, E A systematic review of complementary and alternative medicine interventions for the management of cancer-related fatigue. Integrative Cancer Therapies, 12(4), pp Goedendorp Martine, M., Gielissen Marieke, F. M., Verhagen Constantijn, A. and Bleijenberg, G Psychosocial interventions for reducing fatigue during cancer treatment in adults. Cochrane Database of Systematic Reviews [Online]. Available: Hauser, K., Rybicki, L. and Walsh, D What's in a Name? Word descriptors of cancerrelated fatigue. Palliative Medicine, 24(7), pp Hawthorn, M Fatigue in patients with advanced cancer. International Journal of Palliative Nursing, 16(11), pp Johnson, R. L., Amin, A. R. and Matzo, M Cancer-related fatigue. American Journal of Nursing, 112(4), pp Lerdal, A., Bakken, L. N., Kouwenhoven, S. E., Pedersen, G., Kirkevold, M., Finset, A. and Kim, H. S Poststroke fatigue--a review. Journal of Pain & Symptom Management, 38(6), pp Mcgeough, E., Pollock, A., Smith Lorraine, N., Dennis, M., Sharpe, M., Lewis, S. and Mead Gillian, E Interventions for post-stroke fatigue. Cochrane Database of Systematic Reviews [Online]. Available: Minton, O., Richardson, A., Sharpe, M., Hotopf, M. and Stone, P Drug therapy for the management of cancer-related fatigue. Cochrane Database of Systematic Reviews [Online]. Available: Minton, O., Strasser, F., Radbruch, L. and Stone, P Identification of factors associated with fatigue in advanced cancer: a subset analysis of the European palliative care research collaborative computerized symptom assessment data set. Journal of Pain & Symptom Management, 43(2), pp Mishra Shiraz, I., Scherer Roberta, W., Snyder, C., Geigle Paula, M., Berlanstein Debra, R. and Topaloglu, O Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database of Systematic Reviews [Online]. Available: Mitchell, S. A. and Berger, A. M Cancer-related fatigue: the evidence base for assessment and management. Cancer Journal, 12(5), pp Payne, C., Wiffen Philip, J. and Martin, S Interventions for fatigue and weight loss in adults with advanced progressive illness. Cochrane Database of Systematic Reviews Copyright 2014 NHS Scotland Page 4 of 5
5 [Online]. Available: Peuckmann-Post, V., Elsner, F., Krumm, N., Trottenberg, P. and Radbruch, L Pharmacological treatments for fatigue associated with palliative care. Cochrane Database of Systematic Reviews [Online]. Available: Radbruch, L., Strasser, F., Elsner, F., Goncalves, J. F., Loge, J., Kaasa, S., Nauck, F., Stone, P. and Research Steering Committee of the European Association for Palliative, C Fatigue in palliative care patients -- an EAPC approach. Palliative Medicine, 22(1), pp Whitehead, L The measurement of fatigue in chronic illness: a systematic review of unidimensional and multidimensional fatigue measures. Journal of Pain & Symptom Management, 37(1), pp Copyright 2014 NHS Scotland Page 5 of 5
Sue Johnson May Fatigue in Palliative Care
Sue Johnson May 2017 Fatigue in Palliative Care Why fatigue? Palliative care patients identify fatigue as a significant symptom. Fatigue is one of the most complex symptoms experienced by cancer patients
More informationFatigue Bigorio Professor Paddy Stone
Fatigue Bigorio 2013 Professor Paddy Stone Overview What is fatigue? How can fatigue be assessed? How can fatigue be treated? Guidelines? Fatigue is a subjective, unpleasant symptom which incorporates
More informationFatigue in MSA. Introduction. What is fatigue? Recognising fatigue
Introduction What is fatigue? Recognising fatigue What causes fatigue Managing fatigue Further support Fatigue in MSA Introduction We know that fatigue is a symptom that affects a lot of people living
More informationSunil Nagpal MD Director, Thoracic Oncology West Michigan Cancer Center
Sunil Nagpal MD Director, Thoracic Oncology West Michigan Cancer Center Disclosures No disclosures Definition of Cancer Related Fatigue Cancer related fatigue is a distressing, persistent, subjective sense
More informationRegional Breathlessness Audit - Case Note Survey. 1. Introduction. Regional Breathlessness Audit - Case Note Survey. 2.
Regional Breathlessness Audit - Case te Survey 1. Introduction Please complete this form for your case note review. Cases used may be PROSPECTIVE AND/OR RETROSPECTIVE. Please log as many cases as you can.
More informationWhy am I so Tired? Cancer Related Fatigue. Rose Bell, PhD, ARNP, AOCNP Northwest Medical Specialties
Why am I so Tired? Cancer Related Fatigue Rose Bell, PhD, ARNP, AOCNP Northwest Medical Specialties Cancer Related Fatigue (CRF) Significantly different in quality and severity Unrelieved by sleep or rest
More informationFATIGUE: PHARMACOLOGICAL AND NON-PHARMACOLOGICAL TREATMENT. Fausto Roila Medical Oncology Division, Terni, Italy
FATIGUE: PHARMACOLOGICAL AND NON-PHARMACOLOGICAL TREATMENT Fausto Roila Medical Oncology Division, Terni, Italy CONFLICT OF INTERESTS NO CONFLICT FATIGUE: DEFINITION (ASCO, NCCN) Cancer-related fatigue
More informationSurvivorship Guidelines. September 2013 (updated August 2015)
Survivorship Guidelines September 2013 (updated August 2015) CONTENTS Contents 1 Introduction... 3 2 Background... 3 3 Recommendations and Rationale... 4 Appendix 1: Holistic Needs Assessment... 9 Appendix
More informationAL amyloidosis and fatigue
AL amyloidosis and fatigue This Infosheet explains what fatigue is, what causes it in AL amyloidosis, how it is treated and some tips for self-management. What is fatigue? Fatigue is a feeling of near
More informationPromoting Excellence: A framework for all health and social services staff working with people with Dementia, their families and carers
Promoting Excellence: A framework for all health and social services staff working with people with Dementia, their families and carers Mapped to the NHS Knowledge and Skills Framework () Background and
More informationThe CFS/ME Service. for
The CFS/ME Service for South Yorkshire and North Derbyshire by Anne Nichol, Clinical Services Coordinator. 1 Contents Summary Background Diagnosis Investigations Management principles The CFS/ME Service
More informationNational Cancer Action Team. Rehabilitation Care Pathway Brain CNS
National Cancer Action Team Rehabilitation Care Pathway Brain CNS Rehabilitation Care Pathway Brain CNS Diagnosis & Care Planning Drop Down Pathways Dysphagia Mobility/ loss of function Intervention D1
More information2018 OCN Keywords January 22, 2018 Subject Area Weight Keywords
Subject Area Weight Keywords Care Continuum 19% Care Continuum Coordination of Care Navigation Psychosocial Symptom Management Health Promotion/Screening and Early Detection Disease Prevention High-Risk
More information20/11/2013. Dr. Sinead Maguire Neurology Registrar 22 nd November 2013
Dr. Sinead Maguire Neurology Registrar 22 nd November 2013 The active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and psychological,
More informationBoosting your energy. Information about managing weakness and fatigue
Information about managing weakness and fatigue Weakness and fatigue can be a problem if you re living with a terminal illness and may affect you in different ways. If you re feeling tired, there are some
More informationThey are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:
Chronic fatigue syndrome myalgic encephalomyelitis elitis overview bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated
More informationPatient Clinic Leaflet. chronic fatigue syndrome (CFS) myalgic encephalomyelitis or myalgic encephalopathy (ME)
Patient Clinic Leaflet Basic information on your illness and the treatments we can offer you for chronic fatigue syndrome (CFS) also known as myalgic encephalomyelitis or myalgic encephalopathy (ME) Chronic
More informationCANCER REHABILITATION PATHWAY - HAEMATOLOGY
CANCER REHABILITATION PATHWAY - HAEMATOLOGY Statement: To be used in conjunction with Brain and CNS Rehabilitation Care Pathway as appropriate Diagnosis and Care Planning: The following symptom pathways
More informationThe World Health Organization has developed and has widely accepted an algorithm for treatment of cancer pain. This is described as the three-step lad
Hello. My name is Cynthia Abarado. I m an Advanced Practice Nurse at the Department of Genitourinary Medical Oncology at The University of Texas MD Anderson Cancer Center. I am going to present to you
More informationHorizon Scanning Centre November Enobosarm (Ostarine) for cachexia in patients with advanced non-small cell lung cancer first line
Horizon Scanning Centre November 2012 Enobosarm (Ostarine) for cachexia in patients with advanced non-small cell lung cancer first line SUMMARY NIHR HSC ID: 5206 This briefing is based on information available
More informationSouth Tees Hospitals NHS Foundation Trust. Excellence in dementia care across general hospital and community settings. Competency framework
South Tees Hospitals NHS Foundation Trust Excellence in dementia care across general hospital and community settings. Competency framework 2013-2018 Written and compiled by Helen Robinson-Clinical Educator
More informationClinical guideline Published: 27 April 2011 nice.org.uk/guidance/cg122
Ovarian cancer: recognition and initial management Clinical guideline Published: 27 April 2011 nice.org.uk/guidance/cg122 NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).
More informationMarie Curie Research Grants Scheme Call for outline applications Themes of call
Marie Curie Research Grants Scheme 2016 Call for outline applications Themes of call 1. Aim Marie Curie, the Chief Scientist Office (CSO) and the Motor Neurone Disease Association (MND Association) recognise
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Chronic obstructive pulmonary disease: the management of adults with chronic obstructive pulmonary disease in primary and secondary
More informationSpecialist Palliative Care Service Referral Criteria and Guidance
Specialist Palliative Care Service Referral Criteria and Guidance Specialist Palliative Care Service Referrals These guidelines cover referrals for patients with progressive terminal illness, whether
More informationCANCER-RELATED Fatigue. Nelson Byrne, Ph.D., C.Psych. Krista McGrath, MRT(T), HBSc.
CANCER-RELATED Fatigue Nelson Byrne, Ph.D., C.Psych. Krista McGrath, MRT(T), HBSc. Faculty/Presenter Disclosure Faculty: Nelson Byrne, Ph.D., C.Psych. and Krista McGrath, MRT(T), HBSc. with the Mississauga
More informationThis talk will cover
, pain and fatigue: complications of myeloma and side-effects of treatment Caroline Overvoorde Myeloma/Lymphoma Clinical Nurse Specialist, Leeds Teaching Hospitals NHS Trust This talk will cover Pain Take
More informationLiving well with and beyond cancer Information, support and practical advice to help you through treatment and beyond
Living well with and beyond cancer Information, support and practical advice to help you through treatment and beyond Exceptional healthcare, personally delivered Introduction to this booklet Receiving
More informationFatigue after stroke. A patient and carer s guide
Fatigue after stroke A patient and carer s guide What is post-stroke fatigue? Tiredness affects everyone, and there are many reasons why you might feel tired, such as lack of sleep or a busy day. Usually
More informationSpecialist palliative care for patients with heart failure. Dr Katie Taylor Consultant in Palliative Medicine
Specialist palliative care for patients with heart failure Dr Katie Taylor Consultant in Palliative Medicine Objectives Identify which patients to refer to hospice Review symptom management Think about
More informationNational Breast Cancer Audit next steps. Martin Lee
National Breast Cancer Audit next steps Martin Lee National Cancer Audits Current Bowel Cancer Head & Neck Cancer Lung cancer Oesophagogastric cancer New Prostate Cancer - undergoing procurement Breast
More informationOxford Kidney Unit A guide to conservative kidney management. Information for Healthcare Professionals
Oxford Kidney Unit A guide to conservative kidney management Information for Healthcare Professionals What is conservative kidney management? Some people with advanced kidney disease (chronic kidney disease
More information8/29/2013. Discuss Relation of Fatigue to Sleep Disturbance. Assessing and Treating Factors Contributing to Fatigue and Sleep Disturbance
Timothy Pearman, Ph.D. Director, Supportive Oncology Robert H. Lurie Comprehensive Cancer Center Associate Professor of Medical Social Sciences and Psychiatry Northwestern University Feinberg School of
More informationSpecialist Palliative Care Referral for Patients
Specialist Palliative Care Referral for Patients This guideline covers referrals for patients with progressive terminal illness, whether due to cancer or other disease. For many patients in the late stages
More informationUpdate on Management of Malignant Spinal Cord Compression. Heino Hugel Consultant in Palliative Medicine University Hospital Aintree
Update on Management of Malignant Spinal Cord Compression Heino Hugel Consultant in Palliative Medicine University Hospital Aintree Current Guidelines The symptoms of MSCC may be subtle and therefore careful
More informationBreathlessness in advanced disease. February 2017
Breathlessness in advanced disease February 2017 Breathlessness Managing breathlessness in primary care Chronic breathlessness Acute exacerbation of breathlessness Breathlessness at end of life Breathlessness
More informationFoundations of Palliative Care Series
Foundations of Palliative Care Series Developed by: Tim Sakaluk MD, Ingrid See CPL, Tammy Dyson SW, Sharon Salomons SCP!!!!!! This course was developed in collaboration with the UBC Learning Circle to
More informationBREATHLESSNESS MANAGEMENT
Guideline Name: Breathlessness BACKGROUND Breathlessness is a common symptom in patients with cancer, end-stage heart failure and end-stage chronic obstructive pulmonary disease (COPD). There are many
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Constipation: the diagnosis and management of idiopathic childhood constipation in primary and secondary care 1.1 Short title
More informationCancer-related fatigue: where next? Cambridge Pancreatic Cancer Symposium 2013 Anna Spathis, Consultant in Palliative Medicine
Cancer-related fatigue: where next? Cambridge Pancreatic Cancer Symposium 2013 Anna Spathis, Consultant in Palliative Medicine A distressing, persistent, subjective sense of physical, emotional and/or
More informationNational Asthma Educator Certification Board Detailed Content Outline
I. THE ASTHMA CONDITION 9 20 1 30 A. Pathophysiology 4 6 0 10 1. Teach an individual with asthma and their family using simple language by illustrating the following with appropriate educational aids a.
More informationObjectives. Survivors. Survivorship in Cancer 7/20/2018. Over 15 million survivors in the U.S. Over 32 million worldwide. Oncology Survivorship Care
Survivorship in Cancer Oncology Survivorship Care Kathleen Martin, FNP-BC, AOCNP Objectives Define population of survivors of cancer Define the need for survivorship care Explain the purpose of survivorship
More informationGUIDELINES AND AUDIT IMPLEMENTATION NETWORK
GUIDELINES AND AUDIT IMPLEMENTATION NETWORK General Palliative Care Guidelines The Management of Pain at the End Of Life November 2010 Aim To provide a user friendly, evidence based guide for the management
More informationFatigue and Myeloma. information sheet
Fatigue and Myeloma Cancer related fatigue (CRF) is defined as a distressing, persistent and subjective feeling of physical, mental or emotional tiredness related to cancer and/or cancer treatment interfering
More informationFatigue after stroke. What is post-stroke fatigue? Who is affected by post-stroke fatigue?
Call the Stroke Helpline: 0303 3033 100 or email: info@stroke.org.uk Fatigue after stroke Fatigue affects half of all stroke survivors, but the signs of fatigue are not always obvious to other people and
More informationCommunity and Mental Health Services. Palliative Care. Criteria and
Community and Mental Health Services Specialist Palliative Care Service Referral Criteria and Guidance November 2018 Specialist Palliative Care Service Referrals These guidelines cover referrals for patients
More informationCase studies: palliative care in Vital Signs 2014: The State of Safety and Quality in Australian Health Care
University of Wollongong Research Online Australian Health Services Research Institute Faculty of Business 2014 Case studies: palliative care in Vital Signs 2014: The State of Safety and Quality in Australian
More informationRenal Supportive Care. Renal Supportive Care Symposium 2013 Elizabeth Josland CNC
Renal Supportive Care. Renal Supportive Care Symposium 2013 Elizabeth Josland CNC Outline Background of Renal Supportive Care Conservative Management Symptom overview Reading What does conservative management
More informationPalliative care for patients with brain cancer
Palliative care for patients with brain cancer Lyn Cave Clinical Nurse Specialist Palliative Care Hospital2Home (H2H) Dr Jayne Wood Clinical Lead Palliative Care The Royal Marsden and Royal Brompton Palliative
More informationImproving diagnostic pathways for patients with vague symptoms
Improving diagnostic pathways for patients with vague symptoms Executive summary Accelerate, Coordinate, Evaluate (ACE) Programme An early diagnosis of cancer initiative supported by: NHS England, Cancer
More informationMulti-Professional Breast Cancer Pre-habilitation: Education and Self-Empowerment. Gillian McCollum Lymphoedema Lead Belfast HSC Trust
Multi-Professional Breast Cancer Pre-habilitation: Education and Self-Empowerment Gillian McCollum Lymphoedema Lead Belfast HSC Trust Overview Background to the pathway Aims of the pathway How the pathway
More informationSkull Base Tumour Service. The Multi-Disciplinary Team (MDT) Explained. Jan 2018 v1
Skull Base Tumour Service The Multi-Disciplinary Team (MDT) Explained Jan 2018 v1 Skull base tumours grow in the bones of the skull that form the bottom of the head and the body ridge between the nose
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE
DRAFT NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Chronic obstructive pulmonary disease: the management of adults with chronic obstructive pulmonary disease in primary
More informationSpinal cord compression: what it means and how it can be treated
Spinal cord compression: what it means and how it can be treated Patient Information Oncology Department Author ID: Acute Oncology Nurse Specialist Leaflet Number: CC 036 Version: 2.1 Name of Leaflet:
More informationSERVICE SPECIFICATION 6 Conservative Management & End of Life Care
SERVICE SPECIFICATION 6 Conservative Management & End of Life Care Table of Contents Page 1 Key Messages 2 2 Introduction & Background 2 3 Relevant Guidelines & Standards 2 4 Scope of Service 3 5 Interdependencies
More information(RGN, BN,FETC,MA,Independent Prescriber)
Nicola West (RGN, BN,FETC,MA,Independent Prescriber) Consultant Nurse/ Lecturer Cardiff Breast Unit University Health Board Wales School of Healthcare Sciences Cardiff University Quality of Life-The patients
More informationDudley End of Life and Palliative Care Strategy Implementation Plan 2017
Dudley End of Life and Palliative Care Strategy Implementation Plan 2017 End of Life and Palliative Care Strategy 2017 1 Contents Page What is a strategy plan? 3 Terminology 3 Demographics 3 Definitions
More informationUnderstanding bone metastases and XGEVA
Understanding bone metastases and XGEVA Contents About bone metastases 3 About XGEVA 5 Dealing with common side effects of XGEVA 8 FAs about living with bone metastases 9 Notes 10 About bone metastases
More informationWhat is Palliative Care? DEFINITIONS PALLIATIVE CARE. Palliative & End of Life Care Services N E Lincs 28/09/2017 1
What is Palliative Care? 1 DEFINITIONS Palliative Care: is the active holistic care of patients with advanced progressive illness. The goal of palliative care is achievement of the best quality of life
More informationPalliative & End of Life Care Plan
Palliative & End of Life Care Plan 2018-2023 Contents 1. Palliative Care Definition Page 1 2. Our Vision Page 2 3. Key Aims Page 2 4. Planned Actions Page 3-5 5. Priorities Page 6-7 6. Appendix 1 HSCP
More informationUnmet palliative care needs in heart failure heart failure. Dr Claire Hookey
Unmet palliative care needs in heart failure heart failure Dr Claire Hookey Discomfort was not necessarily greatest in those dying from cancer; patients dying of heart failure, or renal failure, or both,
More informationDementia care - working together to support complex needs
Dementia care - working together to support complex needs Rachel Thompson Professional & Practice Development Lead for Admiral Nursing February 2015 Dementia - everyone s business 850,000 people in the
More informationThe Palliative Care Journey. By Sandra O Sullivan Clinical Nurse Manager 1 St Luke's home
The Palliative Care Journey By Sandra O Sullivan Clinical Nurse Manager 1 St Luke's home Aims 1. To provide an overview of what palliative care involves. 2. Identify, at what stage should Dementia be acknowledged
More informationUniversal Precautions and Opioid Risk. Assessment. Questions: How often do you screen your patients for risk of misuse when prescribing opioids?
Learning objectives 1. Identify the contribution of psychosocial and spiritual factors to pain 2. Incorporate strategies for identifying and mitigating opioid misuse 3. Incorporate non-pharmaceutical modalities
More informationThe Health Problem: Guidelines: NHS Priority:
PRIORITY BRIEFING The purpose of this briefing paper is to aid Stakeholders in prioritising topics to be taken further by PenCLAHRC as the basis for a specific evaluation or implementation research project.
More informationCertified Breast Care Nurse (CBCN ) Test Content Outline (Effective 2018)
Certified Breast Care Nurse (CBCN ) Test Content Outline (Effective 2018) I. Coordination of Care - 26% A. Breast health, screening, early detection, risk assessment and reduction 1. Issues related to
More informationAssessment and diagnosis of chronic fatigue syndrome myalgic encephalomyelitis
Assessment and diagnosis of chronic fatigue syndrome myalgic A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways
More informationCholestatic jaundice Chronic kidney disease Iron deficiency +/-anaemia. Hepatoma Diabetes Leukaemia
Pruritis Introduction Pruritis can cause discomfort, frustration, poor sleep, anxiety and depression. Itch may be localised or due to systemic disease. Pruritis in systemic disease is often worse at night.
More informationHERTS VALLEYS CCG PALLIATIVE AND END OF LIFE CARE STRATEGY FOR ADULTS AND CHILDREN
HERTS VALLEYS CCG PALLIATIVE AND END OF LIFE CARE STRATEGY FOR ADULTS AND CHILDREN 2016-2021 1 1. Introduction Herts Valleys Palliative and End of Life Care Strategy is guided by the End of Life Care Strategic
More informationPalliative Care Asking the questions that matter to me
Palliative Care Asking the questions that matter to me THE PALLIATIVE HUB Adult This booklet has been developed by the Palliative Care Senior Nurses Network and adapted with permission from Palliative
More informationWhat needs to happen in England
What needs to happen in England We ve heard from over 9,000 people across the UK about what it is like to live with diabetes and their hopes and fears for the future. Over 6,000 of them live in England;
More informationNATIONAL INSTITUTE FOR CLINICAL EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE 1 Guideline title SCOPE Chronic fatigue syndrome/myalgic encephalomyelitis: diagnosis and management of chronic fatigue syndrome/myalgic encephalomyelitis in
More informationChronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis/Encephalopathy (ME)
Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis/Encephalopathy (ME) This intervention (and hence this listing of competences) assumes that practitioners are familiar with, and able to deploy,
More informationSurvivorship After Allogeneic Stem Cell Transplantation: Monitoring, Management and Quality of Life
1 Survivorship After Allogeneic Stem Cell Transplantation: Monitoring, Management and Quality of Life Stephanie J. Lee, MD, MPH Fred Hutchinson Cancer Research Center April 16, 2016 (40 min) Hematopoietic
More informationPhysical activity in teenagers and young adults with cancer TYAC best practice statement for health professionals
Physical activity in teenagers and young adults with cancer TYAC best practice statement for health professionals Authors: Nicola Chesman Laura Jeffrey David Wright in association with the TYAC service
More informationNEUROPATHIC CANCER PAIN STANDARDS AND GUIDELINES
NEUROPATHIC CANCER PAIN STANDARDS AND GUIDELINES GENERAL PRINCIPLES Neuropathic pain may be relieved in the majority of patients by multimodal management A careful history and examination are essential.
More informationHigh dose (radical) radiotherapy to the lung or bronchus
The Clatterbridge Cancer Centre NHS Foundation Trust High dose (radical) radiotherapy to the lung or bronchus Radiotherapy A guide for patients and carers Contents When radiotherapy is given... 1 Chemotherapy
More information12/6/2016. Objective PALLIATIVE CARE IN THE NURSING HOME. Medical Care in the US. Palliative Care
Objective PALLIATIVE CARE IN THE NURSING HOME Deborah Morris, M.D., M.H.S. Assistant Professor of Medicine The Glennan Center for Geriatrics and Gerontology Eastern Virginia Medical School Describe program
More informationPublic Dissemination
1. THE ASTHMA CONDITION 9 18 3 30 A. Pathophysiology 4 6 0 10 1. Teach an individual with asthma and their family using simple language by illustrating the following with appropriate educational aids a.
More informationResponsibilities for diabetes care. What care to expect and how to prepare for a consultation?
Responsibilities for diabetes care. What care to expect and how to prepare for a consultation? People with diabetes should expect to get the best of care to keep them in good health. In order to do this,
More informationCBT in the Treatment of Persistent Insomnia in Patients with Cancer
CBT in the Treatment of Persistent Insomnia in Patients with Cancer Colin A Espie University of Glasgow Sleep Centre Sackler Institute of Psychobiological Research University of Glasgow Scotland UK Outline
More informationCriteria and Guidance for Referral to Specialist Palliative Care Services
Criteria and Guidance for Referral to Specialist Palliative Care Services March 2014 Introduction This guidance is for health professionals caring for patients who may need referral to specialist palliative
More informationNutritional Screening Assessment in Palliative Care Standard Operating Procedure
Nutritional Screening Assessment in Palliative Care Standard Operating Procedure DOCUMENT CONTROL: Version: 1 Ratified by: Clinical Quality and Standards Group Date ratified: 5 January 2016 Name of originator/author:
More informationCondensed Clinical Practice Guideline Treatment Of Patients With Schizophrenia
Condensed Clinical Practice Guideline Treatment Of Patients With Schizophrenia I. Key Points a. Schizophrenia is a chronic illness affecting all aspects of person s life i. Treatment Planning Goals 1.
More informationPalliative care competencies: is it for all? Khon Kaen International Conference in Palliative Care 2018
Palliative care competencies: is it for all? Khon Kaen International Conference in Palliative Care 2018 Definition Competence The ability to do something successfully or efficiently For us it means reaching
More informationMetastatic Spinal Cord Compression (MSCC) Clinical guidelines and pathway
Metastatic Spinal Cord Compression (MSCC) Clinical guidelines and pathway Version 2: May 2012 To be read in conjunction with NICE CG75 Developed by consensus by: Dr Peter Robson, Consultant Oncologist,
More informationLiving Well with Bone Marrow Failure Diseases
Living Well with Bone Marrow Failure Diseases ISABEL SCHUERMEYER, MD DIRECTOR OF PSYCHO-ONCOLOGY CLEVELAND CLINIC JUNE 22, 2013 Overview What do we know about symptoms & quality of life for bone marrow
More informationSymptom Control in Heart Failure. Dr Claire L Hookey
Symptom Control in Heart Failure Dr Claire L Hookey Heart Failure symptoms Class III/IV CHF, mean 67.1 years, mean EF 22.3% Most prevalent symptoms:- lack of energy (66%) dry mouth (62%) shortness of breath
More informationHomelessness is associated with poorer physical and mental health, and higher mortality rates 3.
Marie Curie Response Scottish Parliament s Local Government Committee Inquiry into Homelessness Marie Curie believes everyone has the right to palliative care. We believe that there are homeless 1 people
More informationFatigue following Subarachnoid Haemorrhage
Fatigue following Subarachnoid Haemorrhage Kate Hayward Occupational Therapist National Hospital for Neurology and Neurosurgery Life after Subarachnoid Haemorrhage Brain and Spine Foundation 5 th November
More informationParkinson s for Care Staff
Unit 28: Understand Parkinson s for Care Staff Unit reference number: A/616/7339 Level: 3 Unit type: Optional Credit value: 2 Guided learning hours: 14 Unit summary Parkinson s is a progressive neurological
More informationFrailty and falls assessment and intervention tool
Frailty and falls assessment and intervention tool Contents Frailty and falls 4 Social circumstances 5 Mental health 6 Environment 7 Nutrition 8 Dizziness or blackout 9 Medications 10 Mobility and balance
More informationUniversity College Hospital
University College Hospital Haematology Psychology and Counselling Service (for patients with blood cancer, red cell disorders and other non-cancer conditions) 1 If you would like this document in another
More information1. E-learning: NHIVNA HIV modules on the NHIVNA website
Vers Jan 18 E LEARNING sessions to complete for STIF NHIVNA Core Competency 1. E-learning: NHIVNA HIV modules on the NHIVNA website http://www.nhivna.org/nhivna-hiv-nursing-modules.aspx The NHIVNA HIV
More informationCancer-Related Fatigue
Clinical in Oncology Cancer-Related Fatigue V.1.2009 Continue www.nccn.org Panel Members * Ann M. Berger, PhD, RN, AOCN # UNMC Eppley Cancer Center at The Nebraska Medical Center Amy Pickar Abernethy,
More informationIntegrative Pain Treatment Center Programs Scope of Services
Integrative Pain Treatment Center Programs Scope of Services The Integrative Pain Treatment Center at Marianjoy Rehabilitation Hospital, part of Northwestern Medicine, offers two specialized 21-day outpatient
More informationAdolescent Bipolar Service (ABS)
Adolescent Bipolar Service (ABS) The Adolescent Bipolar Service (ABS) is a specialist tertiary provision accepting referrals from across the United Kingdom The Adolescent Bipolar Service (ABS) is a specialist
More informationA GLOBAL PERSPECTIVE: MEANING, COPING, AND HEALTH OF YOUNGER AND OLDER WOMEN WITH BREAST CANCER
A GLOBAL PERSPECTIVE: MEANING, COPING, AND HEALTH OF YOUNGER AND OLDER WOMEN WITH BREAST CANCER Kathleen Sternas, Ph.D, MSN, BSN, RN Seton Hall University, College of Nursing, South Orange, NJ, USA Acknowledgements
More informationSurvivorship 101: Late effects from Cancer, Survivorship Care Planning
Survivorship 101: Late effects from Cancer, Survivorship Care Planning Debra Loacker, RN BSN Survivorship Clinic, Seattle Cancer Care Alliance Survivorship Program, Fred Hutchinson Cancer Research Center
More information