The role of physiotherapy in terminal care
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Introduction Terminal patients require proper care standards and professional team of doctors, physiotherapists, social workers, educators, psychologists and clergy directly involved in mitigating the suffering of a dying person. A physiotherapist as a member of such a team should be focused on sustaining the patient’s quality of life until the end at the level relevant to the patient’s health state. This quality of life should be perceived integrally as a combination of procedures reducing pain and physical suffering as well as improving physical fitness and mental well-being. Material and methods The aim of the research was to define the role of physiotherapy in assessing mental and physical state of terminal patients; to determine the applicability of ADLs, GDS and BDI in diagnosing the validity and usefulness of tiresome physiotherapeutic procedures for terminal patients and to assess the applied tests in predicting terminal patients’ survival time. The research was carried out on the turn of 2012 and 2013 in the group of 103 subjects (74 females - 71.8% and 29 males – 28.2%) For the research the following methods were used: - Activity of Daily Living scale (ADL)- - Beck Depression Inventory (BDI) - Geriatric Depression Scale (GDS) - Questionnaire regarding their willingness to participate in physiotherapeutic procedures. Results In the research the range of diagnostic possibilities of the applied scales and tests, correlations between theses scales and tests as well as correlations between them and subjects’ age and survival time were assessed. Additionally, a questionnaire survey was carried out which assessed the willingness to participate in physiotherapeutic procedures. Strong stress, terminal state of the patient and generalisation of symptoms brought about the fact that only 14.6% of patients declared their willingness to participate in physiotherapeutic procedures. Conclusions 1.Implementing physiotherapeutic and psychological diagnostic tests in everyday terminal care makes it easier to assess survival time of terminal patients and significantly improves their life and dying with dignity 2. Proper understanding of the symptoms of dying must serve as a basis for organising adequate activities compliant with the progress of a disease of a terminal patient without disturbing the process of dying. 3. Modern physiotherapy in terminal care should limit the range of physiotherapeutic procedures and physical therapy while increasing psychological care in this population.
- Hindmarch J, Lehfeld H, de Jongh P. Erzigkeit H. The Bayer Activities of Daily Living Scale (B-ADL) Dementia and Geriatric Cognitive Disorders. 1998;9 Suppl. 2:17-24.
- Katz S, Ford A, Moskowitz R, Jackson B, Jaffe M. Studies of illness in the aged. The Index of ADL: A standardized Measure of Biological and Psychosocial FunctioN. JAMA. 1963;185 (12):914-919.
- Beck A. Depression: Causes and Treatment. University of Pensylvania Press. Philadelphi 2006: 123-138.
- Jongenelis K, Pot A, Eisses A, Gerritsen D, Derknes M, Beekman A, Kluiter H, Ribbe M. Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursering home patients. Inter. Jou Geriatric Psychiatry. 2005; 20:1067-1074.
- McDowell C, Newell B. Przewodnik po skalach i kwestionariuszach. Oxford University Press. NY 1996: 37-56.
- Yesavage J, Brink T, Rose T, Lum O, Huang I. Adey M, Leirer V. Opracowanie i walidacja Geriatrycznej Skali Depresji. Jou. of Psychiatric. 1983;5:17-25.
- Guse L, Masesar M. Quality of life and successful aging in long-term care. Health. Nurs 2009:527-539.
- Dudek D. Zaburzenia depresyjne i jakość życia pacjentów ( in polish). Wyd. Uniwersytet Jagieloński. Kraków 2006.
- Cassel E. The nature of suffering and the goals of medicine. Oxford University Press. NY 1991.
- Salmon J, Polivka L; “ Consumer views of Quality of Life in long term care “Gerontology Center, 1998; London: 34-47.
- Elias N. „ The loneliness of the Dying” Inter. Publishing Group Inc. London 1985.
- Segal D, Qualls S, Smyer M. Aging and Mental Health Wyd. Wiley2010.
- Collana M. Final Journeys: A Practical Guide for Bringing care and comfort at their end of life Batman Books. NY 2008.
- Sonn U. Longitudinal studies of dependence in daily life activities among elderly persons . Scand. Jou. of Rehabilitation Medicine. Suppl. 1996;34:1-35.
- Pużyński S. Depresja i zaburzenia afektywne.( in polish) Wyd. PZWL Warszawa 2005: 79-96.
- Gadecka W., Piskorz-Ogórek K., Regin K.J., Kowalski I.M.. Social competence of mental health nurses. Pol. Ann. Med. 2015;22(2): 47-51.
- Regin K.J., Gadecka W, Kowalski P.M., Kowalski I.M., Galkowski T. Generational transfer of psychological resilience. Pol Ann Med. doi:10.1016/j.poamed.2016.02.001
- Katon C, Livingston G. Depression in elderly age. Wyd. Via Medica Gdańsk 2003:34-4.
- Speck P. Teamwork in Palliative Care . Fulfilling or Frustrating. Oxford University Press London 2006.
- Ellershaw J, Wilkinson S. Care of the dying; Apathway to excellence. Oxford University Press London 2010: 57-78.
- Kinzbrunner B, Policzer J. End of life Care. A Practical Guide. Mc Graw. Hill. 2011.
- De Walden D, Gałuszko K. Podstawy opieki paliatywnej. Wyd. PZWL. Warszawa 2006.
- Fisher B, Specht D. Successful Aging and creativity in later life. Jou. of Aging Studies. 1999;(13)4.
- Gilley J. Intymacy and terminal care. Sage Publications. London. New Delhi 2000:24-37.
- Salmon P. Psychologia w medycynie. Wyd. GWP Gdańsk 2003.
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