Supervisors info:
Ελισάβετ Πατηράκη, Καθηγήτρια, Νοσηλευτική, ΕΚΠΑ
Μαργαρίτα Γιαννακοπούλου, Αναπληρώτρια Καθηγήτρια, Νοσηλευτική, ΕΚΠΑ
Στυλιανός Κατσαραγάκης, Λέκτορας, Νοσηλευτική, Πανεπιστήμιο Πελοποννήσου
Summary:
Overview: Terminally ill patients face numerous physical, psychological and social symptoms due to their disease, its therapies and the knowledge of imminent death. Palliative care for these patients aims at providing holistic care respecting the patient’s wishes and personal characteristics. Physiotherapy interventions contribute to the appropriate management of both the physical and psychological symptom that these patients face.
Aim: The purpose of the present study was to investigate the effectiveness of the physiotherapy interventions in palliative care for terminally ill patients.
Material - Method: There was an extensive research of publications relevant to palliative care and physiotherapy interventions through valid data basis (Pubmed, Iatrotek, Cinahl and then followed the assortment and process of the collected information based on the needs of the present study. In the present review, 22 studies were included. The inclusion criteria was the reference to physiotherapeutic interventions and palliative care, while the exclusion criteria included studies concerning patients <18 years of age. The studies were rated based on the disease due to the heterogeneity of the kind of studies as well as the patients they included.
Results: A variety of studies with significant heterogeneity of the under study patients was found since most studies concerned cancer and COPD patients and two studies had mixed populations with malignant diseases. A variety of interventions was also found which contributed to the improvement of the total quality of life or of individual symptoms mainly dyspnea and pain. The tools for the evaluation of patients’ quality of life were different. It was found that physiotherapy interventions are effective in managing terminally ill patients through controlling pain, shortness of breath, function and mobility as well as managing the psychological impact of the symptoms and the disease. The interventions found to be most effective were exercise, respiratory physiotherapy, massaging and patient education. The interventions should be individualized and combined with the conventional management of terminally ill patients. Regarding the reasons for lack of participation in physiotherapy interventions the most important ones were: lack of physiotherapy services, lack of knowledge about the effectiveness of the intervention on the part of health professionals and patients alike, lack of interest from the patients, fatigue, the required time of transport and lack of support.
Conclusion: Physiotherapy interventions are necessary for the holistic management of terminally ill patients and their inclusion in all palliative settings should be promoted.
Key Words: Terminally ill patients, palliative care, physiotherapy interventions.
