ESPEN guidelines on nutrition in cancer patients

https://behandelaar.pijnbijkanker.nl/sites/behandelaar.pijnbijkanker.nl/files/publicaties/van%20den%20Beuken%20et%20al.%20Prevalence%20cancer%20pain.%20Ann%20Oncol%202007.pdf

Prevalence of pain in patients with cancer: a systematic review of the past 40 years

The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress

A significant relation between religion and better health has been demonstrated in a variety of healthy and patient populations. In the past several years, there has been a focus on the role of spirituality, as distinct from religion, in health promotion and coping with illness. Despite the growing interest, there remains a dearth of well-validated, psychometrically sound instruments to measure aspects of spirituality. In this article we report on the development and testing of a measure of spiritual well-being, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp), within two samples of cancer patients. The instrument comprises two sub scales—one measuring a sense of meaning and peace and the other assessing the role of faith in illness. A total score for spiritual well-being is also produced. Study 1 demonstrates good internal consistency reliability and a significant relation with quality of life in a large, multiethnic sample. Study 2 examines convergent validity with 5 other measures of religion and spirituality in a sample of individuals with mixed early stage and metastatic cancer diagnoses. Results of the two studies demonstrate that the FACIT-Sp is a psychometrically sound measure of spiritual well-being for people with cancer and other chronic illnesses.

Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy--Spiritual Well-being Scale (FACIT-Sp).

Little research has been conducted documenting the reliability and validity of the Karnofsky Performance Status (KPS) scale, and guidelines based on empirical data do not exist to govern its use. Two hundred ninety-three cancer patients completed a questionnaire that assesses their physical and psychosocial difficulties. Physicians rated patients on the KPS and a subsample of 75 patients was used to evaluate interrater reliability. Analyses were conducted to evaluate the interrater reliability and construct validity of the KPS. The KPS was shown to have good reliability and validity. Detailed examination of the reliability data suggested areas in which physicians err in their judgments. Multiple regression techniques were used to empirically identify seven behaviorally based questions that would be helpful in predicting KPS scores. The seven variables included weight loss, weight gain, reduced energy, difficulty walking, driving, grooming, and working part time. An interview approach with behaviorally based guidelines is presented using these variables to obtain relevant data and make more accurate KPS ratings. With the approach suggested and the guidelines presented, oncologists may train themselves to use the KPS in a standard way, which should increase reliability and validity of the KPS and has implications for patients and research studies that use KPS as a stratifying variable.

Karnofsky performance status revisited: reliability, validity, and guidelines.

The Karnofsky Performance Status Scale (KPS) was designed to measure the level of patient activity and medical care requirements. It is a general measure of patient independence and has been widely used as a general assessment of patients with cancer. Although there is a long history of use of the KPS for judging cancer patients, its reliability and validity have been assumed without formal investigation. The interrater reliability of the KPS was investigated in two ways, both of which gave evidence of moderately high reliability. The patients evaluated in their home were usually assigned a lower KPS score compared with a similar evaluation at the same time done in the outpatient clinic. Construct validity of the KPS was demonstrated by strong correlation with several variables relating to physical function. Onstudy KPS scores accurately predicted early death, but high initial KPS scores did not necessarily predict long survival. Patient deterioration with subsequent death within a few months could be predicted to a limited extent by a rapidly dropping KPS. These results suggest that the KPS has considerable validity as a global indicator of the functional status of patients with cancer and might be helpful for following other patients with chronic disease. Cancer 45:2220-2224, 1980. ITH THE INCREASE in clinical trials designed to W evaluate chemotherapeutic agents in the treatment of cancer, it became evident that some method of quantifying patients’ status relative to degree of independence in carrying out normal activities and selfcare was needed. In 1948, Karnofsky and Burchena15 described a numerical scale for this purpose. This has subsequently become known as the Karnofsky Performance Status Scale (KPS). Although the KPS is widely used for assessment of patients with cancer, its reliability and validity have generally been assumed without formal investigation. In this paper we evaluate the reliability and validity of the KPS and its usefulness as a clinical tool. An earlier study from this institution of patients on chronic hemodialysis demonstrated lower performance scores for patients when seen in the home as compared with the clinic.3 The conclusion was that a more realistic appraisal of activity was possible in the home. Concurrent home and clinic evaluations were planned as a part of this study.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/1097-0142%2819800415%2945%3A8%3C2220%3A%3AAID-CNCR2820450835%3E3.0.CO%3B2-Q

Evaluation of patients with advanced cancer using the karnofsky performance status

Data on religious belief, activity, and connections, and ratings of happiness, life satisfaction, and pain level were obtained periodically from 71 patients with advanced cancer. Religious belief showed substantial positive correlation with life satisfaction, and religious activity and connections were significantly correlated with both happiness and life satisfaction. Religious patients also reported significantly lower levels of pain, even though they were no less likely to report the presence of pain. Data from the 36 patients who have since died show no correlation between the religion variables and duration of survival. In general, the patients showed little change in religious belief over time. Religion seems to be an important source of support for many patients.

F. Patrick McKegney

Papers

Evaluation of patients with advanced cancer using the karnofsky performance status

Religion in patients with advanced cancer

Prediction and management of pain in patients with advanced cancer

Evaluative research in consultation-liaison psychiatry. Review of the literature: 1970-1981.

The use of DSM-III in a general hospital consultation-liaison service.