Exploring skin disorders in palliative care: a systematic review
, 13, 124, 124, 15
Abstract
Introduction: Skin disorders present significant challenges in palliative care settings, often complicating symptom management and diminishing the quality of life for patients facing life-limiting illnesses. Despite their prevalence and impact, there remains a dearth of comprehensive research synthesizing the landscape of skin disorders within palliative care.
Methods: This systematic review aims to elucidate the spectrum of skin disorders manifested in individuals receiving palliative care, providing a comprehensive understanding essential for effective clinical management and improved patient outcomes. A thorough literature search was conducted across b-on, PubMed, Web of Science, and Scopus, focusing on studies involving human participants aged 18 years or over in palliative care settings. Inclusion criteria encompassed randomized controlled trials, observational studies, and quantitative studies published in peer-reviewed journals, specifically addressing skin disorders as a primary focus or significant aspect of palliative care.
Results: From an initial 347 articles, 17 studies met the inclusion criteria. The most common skin disorders identified include pruritus, pressure ulcers, and dermatitis, significantly impacting patients’ physical comfort, emotional well-being, and social interactions. The findings highlight the intricate nature of managing skin disorders in palliative care, necessitating interdisciplinary collaboration and tailored interventions to address the multifaceted needs of this population.
Conclusions: This review underscores the importance of recognizing, assessing, and managing skin disorders to enhance the quality of life of palliative care patients. Future research should focus on developing and implementing targeted strategies to alleviate the burden of skin disorders in this vulnerable group, ultimately improving patient care and outcomes.
Keywords: skin disorderspalliative carequality of lifepruritussystematic review
References
- Ferrell BR, Twaddle ML, Melnick A, et al. National consensus project clinical practice guidelines for quality palliative care guidelines, 4th edition. J Palliat Med. 2018; 21(12): 1684–1689.
- Organization WH. National cancer control programmes: policies and managerial guidelines. World Health Organization; 2002. https://iris.who.int/handle/10665/42494 (12.06.2024).
- Ferrell BR, Temel JS, Temin S, et al. Integration of palliative care into standard oncology care: american society of clinical oncology clinical practice guideline update. J Clin Oncol. 2017; 35(1): 96–112.
- Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration, 2008 .
- Ouzzani M, Hammady H, Fedorowicz Z, et al. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016; 5(1): 210.
- Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372: n71.
- Abraham NS, Barkun JS, Barkun AN. Palliation of malignant biliary obstruction: a prospective trial examining impact on quality of life. Gastrointest Endosc. 2002; 56(6): 835–841.
- Shawn ER, Campbell L, Mnguni MB, et al. The spectrum of symptoms among rural South Africans with HIV infection. J Assoc Nurses AIDS Care. 2005; 16(6): 12–23.
- Madar H, Gilad G, Elenhoren E, et al. Dialysis nurses for palliative care. J Ren Care. 2007; 33(1): 35–38.
- Murtagh FEM, Addington-Hall JM, Edmonds PM, et al. Symptoms in advanced renal disease: a cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managed without dialysis. J Palliat Med. 2007; 10(6): 1266–1276.
- Hansra NK, Berger TG, O'Sullivan P, et al. Skin findings in palliative care patients. J Palliat Med. 2008; 11(6): 834–837.
- Jakobsson E, Gaston-Johansson F, Ohlén J, et al. Clinical problems at the end of life in a Swedish population, including the role of advancing age and physical and cognitive function. Scand J Public Health. 2008; 36(2): 177–182.
- Murphy EL, Murtagh FEM, Carey I, et al. Understanding symptoms in patients with advanced chronic kidney disease managed without dialysis: use of a short patient-completed assessment tool. Nephron Clin Pract. 2009; 111(1): c74–c80.
- Yong DSP, Kwok AOL, Wong DML, et al. Symptom burden and quality of life in end-stage renal disease: a study of 179 patients on dialysis and palliative care. Palliat Med. 2009; 23(2): 111–119.
- Wakeham K, Harding R, Bamukama-Namakoola D, et al. Symptom burden in HIV-infected adults at time of HIV diagnosis in rural Uganda. J Palliat Med. 2010; 13(4): 375–380.
- Murtagh FE, Addington-Hall J, Edmonds P, et al. Symptoms in the month before death for stage 5 chronic kidney disease patients managed without dialysis. J Pain Symptom Manage. 2010; 40(3): 342–352.
- Mercadante S, Porzio G, Valle A, et al. Orphan symptoms in advanced cancer patients followed at home. Support Care Cancer. 2013; 21(12): 3525–3528.
- Beynon T, Selman L, Radcliffe E, et al. 'We had to change to single beds because I itch in the night': a qualitative study of the experiences, attitudes and approaches to coping of patients with cutaneous T-cell lymphoma. Br J Dermatol. 2015; 173(1): 83–92.
- Wakeham K, Harding R, Levin J, et al. The impact of antiretroviral therapy on symptom burden among HIV outpatients with low CD4 count in rural Uganda: nested longitudinal cohort study. BMC Palliat Care. 2017; 17(1): 8.
- Siriwardana AN, Hoffman AT, Brennan FP, et al. Impact of renal supportive care on symptom burden in dialysis patients: a prospective observational cohort study. J Pain Symptom Manage. 2020; 60(4): 725–736.
- Jawed A, Moe SM, Moorthi RN, et al. Increasing nephrologist awareness of symptom burden in older hospitalized end-stage renal disease patients. Am J Nephrol. 2020; 51(1): 11–16.
- Bonilla-Sierra P, Vargas-Martínez AM, Leon-Larios F, et al. The suffering of advanced chronic renal patients and their relationship with symptoms in loja, ecuador. Int J Environ Res Public Health. 2021; 18(10): 5284.
- Wang X, Shi Q, Mo Y, et al. Palliative care needs and symptom burden in younger and older patients with end-stage renal disease undergoing maintenance hemodialysis: a cross-sectional study. Int J Nurs Sci. 2022; 9(4): 422–429.
- Podder I, Mondal H, Kroumpouzos G. Nocturnal pruritus and sleep disturbance associated with dermatologic disorders in adult patients. Int J Womens Dermatol. 2021; 7(4): 403–410.
- Sinikumpu SP, Jokelainen J, Tasanen K, et al. Association between pruritus and psychosocial well-being: a population-based study among 6,809 subjects. Acta Derm Venereol. 2023; 103: adv00837.
- Hui D, Bruera E. The edmonton symptom assessment system 25 years later: past, present, and future developments. J Pain Symptom Manage. 2017; 53(3): 630–643.
- Portenoy RK, Thaler HT, Kornblith AB, et al. The memorial symptom assessment scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer. 1994; 30A(9): 1326–1336.
