The primary objective of care for dying patients is to improve their quality of life (001). There are major gaps, however, in knowledge regarding all issues related to end of life (EOL) care, including how to enhance the QOL for dying individuals. The few studies that are available have primarily focused on hospice patients, but less than twenty percent of individuals in the United States experience the EOL receiving hospice care. Many patients near the EOL, such as advanced lung cancer patients are actively seeking treatment for either prolongation of life or palliation of symptoms. A high number of uncontrolled symptoms and a great deal of physical and psychological distress have been reported for patients who are nearing the EOL. Little is known about the 001 of these individuals. The work to date on QOL in lung cancer patients has measured QOL in a limited manner, such as functional status or symptom distress. Results of these studies suggest that advanced lung cancer patients have significant symptom distress, which is associated with decreased survival, decreased functional status, and increased emotional distress. Research with a focus on identifying determinants of dying patients' QOL, viewed as a multi-dimensional concept, is needed. This project seeks to increase understanding of QOL at the EOL.
The specific aims are: (1) to describe the QOL of advanced lung cancer patients near the EOL; (2) to examine symptom frequency, symptom severity, symptom distress, functional status, anxiety, and depression in advanced lung cancer patients near the EOL; (3) to identify determinants of 001 of advanced lung cancer patients; and (4) to determine what interventions advanced lung cancer patients near the EOL perceive as helpful in enhancing QOL. Understanding the determinants of QOL will direct future intervention research that will have as its goal the improvement of QOL of dying patients. The sample of 50 newly diagnosed stage IIIB or IV lung cancer patients will be drawn from a cancer center for this longitudinal study. Data will be collected from patients about symptom frequency, symptom severity, symptom distress, functional status, anxiety, depression, and QOL at study entry (baseline) and at 2 months and 4 months after the baseline. Standard methods will be used to test for statistical significance of individual correlation coefficients and construct 95 percent confidence intervals. Methods for testing dependent correlations will be used to compare correlation coefficients with each other.
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