Palliative care aims to alleviate suffering and prioritize the quality of life of patients facing serious and fatal diseases, such as cancer. Cancer patients, especially in advanced stages, often have many difficult-to-control symptoms, such as pain, fatigue, dyspnea, anxiety, and depression, requiring the attention of a multidisciplinary team highly trained in palliative care and end-of-life management. Pain, dyspnea, nausea, and vomiting are the focus of symptomatic assessment in palliative care, but patients experience other equally important symptoms that do not receive as much attention and are often overlooked, which negatively impacts the quality of life of these patients. One of the main aims of palliative care is to provide patients with the best possible quality of life through adequate symptom control, teamwork, and psychosocial support based on the principles, values, and wishes of the patient and family. In this review, the authors summarize the management of common symptoms in patients in oncology and palliative care, as well as present a brief reflection on quality of life in this context.

To identify Missed Nursing Care (MNC) and related factors, as well as analyze the influence of nurses' decision-making and personality traits on MNC in two Portuguese hospitals dedicated to cancer care. A cross-sectional, multicentric, descriptive-correlational study was conducted using a convenience sample of 298 nurses working in two hospitals dedicated to cancer care. Data were collected in the first semester of 2023 using a questionnaire that included sociodemographic and professional questions and the Portuguese versions of the MISSCARE Survey, the Nursing Decision-Making Instrument (NDMI-PT), and the Ten-Item Personality Inventory (TIPI-P). Nurses missed care occasionally, namely in the dimensions related to Patient empowerment/autonomy care and Efficacy of feeding and medication. Staffing, Patient volume and acuity, and Management and organization were moderate to significant reasons for MNC. The flexible decision-making style was predominant (81.5%). The most prevalent personality traits were Conscientiousness, Agreeableness, and Openness to experience. Significant correlations were found between the four stages of the decision-making process and the personality traits and several dimensions of MNC. Data collection to assess a patient's condition was negatively correlated with Team communication and Material resources. Similarly, the Emotional stability trait was negatively correlated with Team communication and Patient volume and acuity. This study identified MNC and factors that can influence the quality of care. It is crucial to promote nurses' training and specialization within healthcare teams, with a particular focus on enhancing some of their personality traits to make them more effective and efficient therapeutic agents.

Introduction: Cancer patients in palliative care frequently experience psychological distress, encompassing cognitive, behavioral, and emotional dimensions. This distress can significantly affect their capacity to accept the inevitability of death. Commonly, such distress manifests as sadness, depression, anxiety, and fear, which may culminate in an existential crisis. Objectives: The purpose of this study was to analyze the psychometric properties of the Edmonton Symptom Assessment System (ESAS) and the Palliative Outcome Scale (POS) among hospitalized cancer patients receiving palliative care in a Portuguese palliative care unit. Methods: Data were collected from psychological screening instruments (ESAS and POS) used in oncology patients admitted to an oncology palliative service. The study period spanned from January 2021 to March 2021. Results: The study included a convenience sample of 60 patients diagnosed with advanced cancer who were sequentially admitted to a palliative care unit. The most frequently reported primary oncological diagnoses were gastrointestinal (41.7%) and head/neck (20%) tumors. The majority of the patients were male (n = 37; 61.7%), with a median age of 72 years (range: 43–94 years). Key findings from the analysis indicated the following associations: anxiety and self-reported symptoms (higher levels of patient anxiety related to illness or treatment were strongly correlated with increased self-reported anxiety (p < 0.01)); emotional sharing and perceived meaning of life (patients who shared their feelings less frequently with family and friends were significantly less likely to find meaning in life (p < 0.01) and were more likely to report a poorer self-perception (p < 0.05)); understanding the importance of life and self-perception (a diminished understanding of the importance of life was associated with worsened self-perception (p < 0.01)); anxiety and depressive symptoms (greater anxiety related to the disease or its treatment correlated with an increased severity of depressive symptoms (p < 0.01)). Discussion and conclusion: There are numerous validated instruments available for measuring emotional distress. Among these, the ESAS and POS complement each other as practical and easy-to-use tools for evaluating emotional distress in patients admitted to palliative care settings. Findings revealed that anxiety and concerns related to the disease and its treatment, as measured by the POS, served as predictors of the risk for self-reported anxiety and depression identified by the ESAS. Furthermore, the items within the POS that evaluate the emotional component demonstrated strong internal correlation, supporting their combined use for a comprehensive assessment of this dimension.

Introduction: Uncontrolled symptoms are widely recognized as one of the main challenges in oncology palliative care patients. The central aim of palliative care is to improve the patient’s quality of life. In recent years, there has been a growing use of patient-reported outcome measures in palliative care, particularly to evaluate symptoms, quality of care, and well-being. Aim: To evaluate the sociodemographic and clinical profile, symptom distress, and perceived quality of life in oncology palliative care patients admitted to a specialized palliative care unit in Portugal. Methods: This study was cross-sectional, descriptive, and correlational, carried out in the inpatient setting of the palliative care unit at a tertiary oncology hospital (at admission). The evaluated protocol included a sociodemographic and clinical questionnaire, as well as two measurement instruments: the Edmonton Symptom Assessment Scale (ESAS) and the Palliative Care Outcome Scale (POS), both filled out by the patients. Data analysis was conducted using IBM SPSS^® Statistics version 25.0, with a significance level set at 5% (p < 0.05). Results: The majority of participants in this sample were male (61.7%), with a mean age of around 72 years. More than half of the patients admitted (n = 34; 56.7%) were being monitored in outpatient care. Digestive and head and neck cancers were the most commonly found in the sample (41.7% and 20%, respectively). A significant correlation was found between high symptom intensity and poorer quality of life and care (p < 0.01). This association was particularly pronounced for symptoms such as pain, weakness, depression, anxiety, and anorexia. Conclusions: This study revealed a positive correlation between overall symptom severity and a perceived deterioration in quality of life, well-being, and quality of care. Future studies should consider utilizing alternative assessment tools for evaluating symptoms and quality of care. Additionally, including non-cancer palliative patients in similar studies may provide further valuable insights.

Background: The sanitary measures imposed by COVID-19 intensified challenges in the pain management of cancer patients. Methods: A descriptive study was conducted in a chronic pain unit of an oncological hospital aiming to explore the experiences of cancer patients with chronic pain and their caregivers during the pandemic period, as well as identify strategies to improve care in chronic pain management. An electronic questionnaire was developed containing sociodemographic variables, the Depression, Anxiety and Stress Scale-21, and open-ended questions exploring the experiences and circumstances of pain management. Results: A total of 30 patients and 13 caregivers filled in the questionnaire. Patients revealed a higher level of depression, anxiety, and stress than caregivers, without statistically significant differences. Both groups mentioned having experienced difficulties in self-care, particularly in relation to sleep, nutrition, and recreation. In total, 83.7% patients needed pain relief medication related to uncontrolled pain. Both mentioned that they would have benefited from a digital application to ease the communication with the healthcare professionals of the chronic pain unit, as well as non-pharmacological interventions, such as therapeutic massage. Conclusions: Recognizing that chronic pain leads to significant limitations, it is essential to implement and anticipate objective and effective responses in pain management.

Enquadramento: Os cuidados de enfermagem omissos (CEO) s?o uma problem?tica existente nos contextos da pr?tica cl?nica. O conhecimento contextual das raz?es subjacentes a esta problem?tica convida os gestores a implementar diretrizes minimizadoras de CEO, redesenhando as pr?ticas dos enfermeiros. Objetivos: Identificar estrat?gias percecionadas pelos enfermeiros de um hospital de oncologia como minimizadoras de CEO. Metodologia: Estudo explorat?rio, descritivo, transversal de natureza qualitativa assente em pressupostos do estudo caso. Amostra de meio, constitu?da por 10 enfermeiros das especialidades m?dicas de um hospital oncol?gico, com aplica??o de entrevista semiestruturada, entre setembro e outubro de 2018. Obtido consentimento informado dos participantes. Resultados: Os participantes identificaram como ferramentas pass?veis de minimizar os CEO e melhorar a qualidade dos cuidados de enfermagem a Conscientiza??o do erro, a Forma??o, a Comunica??o, a Adequa??o de recursos e a Mudan?a da cultura organizacional. Conclus?o: Os CEO comprometem a qualidade do atendimento e aumentam a vulnerabilidade dos doentes. A ado??o das estrat?gias identificadas poder? constituir uma mais-valia para a organiza??o estudada e melhorar a qualidade dos cuidados prestados.