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Zeitschrift für Palliativmedizin 2012; 13(03): 134-141
DOI: 10.1055/s-0031-1292882
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Typische Krisen und Bedürfnisse von Patienten mit COPD oder Lungenkrebs im letzten Lebensjahr – eine Literaturübersicht[1]

Typical Crises and Needs in Patients with Advanced Chronic Obstructive Pulmonary Disease (COPD) or Lung Cancer in their Last Year of Life – A Scoping Literature Review
C. Ramsenthaler
1   King’s College London, Cicely Saunders Institute, London/UK
2   ipac – Institut für Palliative Care, Oldenburg (BMBF 16KT0951)
,
C. Bausewein
1   King’s College London, Cicely Saunders Institute, London/UK
2   ipac – Institut für Palliative Care, Oldenburg (BMBF 16KT0951)
,
C. Scheve
2   ipac – Institut für Palliative Care, Oldenburg (BMBF 16KT0951)
3   Palliativzentrum am Evangelischen Krankenhaus, Oldenburg
,
J. Cortis
4   Klinik für Innere Medizin, Pius-Hospital, Oldenburg
,
B. Kannenberg-Otremba
2   ipac – Institut für Palliative Care, Oldenburg (BMBF 16KT0951)
5   Onkologische Praxis Oldenburg-Delmenhorst, Oldenburg
,
J. Mühlenbrock
4   Klinik für Innere Medizin, Pius-Hospital, Oldenburg
,
B. Otremba
5   Onkologische Praxis Oldenburg-Delmenhorst, Oldenburg
,
R. Prenzel
4   Klinik für Innere Medizin, Pius-Hospital, Oldenburg
,
A. Wagner-Neidig
2   ipac – Institut für Palliative Care, Oldenburg (BMBF 16KT0951)
3   Palliativzentrum am Evangelischen Krankenhaus, Oldenburg
,
S. T. Simon
1   King’s College London, Cicely Saunders Institute, London/UK
2   ipac – Institut für Palliative Care, Oldenburg (BMBF 16KT0951)
6   Zentrum für Palliativmedizin und Klinisches Studienzentrum Palliativmedizin, Uniklink Köln, Köln
› Author Affiliations
Further Information

Publication History

Publication Date:
16 May 2012 (online)

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Zusammenfassung

Hintergrund: Um Krisen bei Patienten mit fortgeschrittener COPD oder Lungenkarzinom (LK) effektiv erkennen, bewältigen und vorbeugen zu können, soll ermittelt werden, welche Krisen und belastenden Situationen bei diesen Patienten auftreten und in der wissenschaftlichen Literatur beschrieben werden.

Methodik: Begrenzte Literaturrecherche in den Datenbanken MEDLINE, PsycINFO, CINAHL, Cochrane Library unter Nutzung von Suchbegriffen fuer Krise/crisis und COPD oder Lungenkrebs/lung cancer. Einschlusskriterien: wissenschaftliche Studien oder Übersichtsarbeiten, die Krisen (im Sinne von Problemsituationen, die sich so zuspitzen können, dass externe Hilfe benötigt wird) bei fortgeschrittener COPD oder Lungenkrebs beschreiben.

Ergebnisse: Aus einer Gesamtzahl von 11 810 ermittelten Artikeln wurden 268 für diese Literaturübersicht ausgewertet. Der Begriff „Krise“ wird in der Literatur nur selten verwendet. Als alternative Begriffe wurden „Distress“ und „Notfall“ ermittelt. Patienten mit COPD oder LK zeigten bezüglich Krisen im letzten Lebensjahr Gemeinsamkeiten aber auch Unterschiede auf. Beide Krankheiten sind charakterisiert durch eine hohe Prävalenz der Atemnot neben einer hohen generellen Symptomlast (Schwäche, Schmerz etc.). Die Exazerbation wird als Krise bei COPD-Patienten mit dem hohem Risiko eines Krankenhausaufenthaltes und plötzlichen Versterbens beschrieben. Diagnosemitteilung und Auseinandersetzung mit der eigenen Endlichkeit sind existenzielle Krisen bei LK. Zudem fühlen sich LK-Patienten v. a. durch die Therapienebenwirkungen stark beeinträchtigt.

Schlussfolgerung: Nicht nur körperliche Symptome (v. a. Atemnot), sondern besonders auch psychosoziale Probleme führen bei beiden Patientengruppen zu Krisen im letzten Lebensjahr und bedürfen eines koordinierten Krisenmanagements.

Abstract

Background: Crises are common in patients with advanced diseases. In order to effectively identify, manage and prevent crisis in advanced chronic obstructive pulmonary disease (COPD) and lung cancer patients, the current evidence about typical crises in these patients with emphasis on the patientsʼ and carersʼ needs is reviewed.

Methods: Scoping literature review in MEDLINE, PsycINFO, CINAHL and the Cochrane Library using a search strategy of crisis and COPD or lung cancer. Selection criteria: studies of any design examining crisis (the (sudden) occurrence and escalation of a problematic situation necessitating external help) in advanced COPD or lung cancer patients.

Results: The term „crisis“ is uncommon in the literature. Alternatively, the terms „distress“ or „emergency“ are used by authors. COPD and lung cancer patients experience crises common to both diseases as well as crises caused by the specific trajectory of the disease. Breathlessness and other symptoms (fatigue, pain) are highly prevalent and cause crises both in patients with COPD or lung cancer. In COPD, the acute exacerbation is an important crisis bearing a high risk of hospitalisation and sudden death. In patients with lung cancer, receiving the diagnosis of a malignancy and being confronted with impending death are experienced as existential crises. Moreover, side effects of treatment contribute significantly to the burden of these patients.

Conclusion: Not only physical symptoms (especially dyspnoea) but also psycho-social problems cause crises in patients with advanced COPD or lung cancer and need to be considered for the prevention and management of crises.

Schlüsselwörter

Krise - Lungenkrebs - COPD

Keywords

crisis - lung cancer - COPD

1 Veröffentlicht als Abstract in:
Ramsenthaler C, Scheve C, Bausewein C, Simon S. Typical Crises and Needs in Patients with Advanced Chronic Obstructive Pulmonary Disease (COPD) or Lung Cancer in their Last Year of Life – A Literature Scoping Exercise. Palliative Medicine 2011 (Abstract)
Ramsenthaler C, Scheve C, Bausewein C, Simon S, für das PAALliativ Konsortium. Der Begriff „Krise“ bei Patienten mit fortgeschrittenen Erkrankungen – eine systematische Literaturübersicht. Zeitschrift für Palliativmedizin 11 (5): V12_1. (Abstract)


 

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