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Terminal Dehydration: The Development of a Symptom Distress Scale for Use in Dying Patients.

Chidgey, Jayne M. (1999) Terminal Dehydration: The Development of a Symptom Distress Scale for Use in Dying Patients. Doctoral thesis, University of Surrey (United Kingdom)..

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Abstract

Terminal dehydration, a condition that may affect dying cancer patients, may contribute significantly to symptom distress. This in turn may affect the quality of life and suffering experienced by the dying person. A survey was carried out to investigate the attitudes of doctors and nurses towards terminal dehydration and its treatment with artificial hydration therapies. Differing perceptions towards terminal dehydration were found. These were attributed to differing philosophical approaches, whereby specialist palliative care clinicians support the belief that greater benefit for dying patients is gained by treating the symptoms of terminal dehydration, in contrast, to other clinicians who perceive that there is more benefit from preventing or correcting the state of terminal dehydration. An empirical investigation of symptom distress, with particular reference to symptoms related to terminal dehydration, led to the development of a Physical Symptom Distress Scale (PSDS) and in conjunction with the established Rotterdam Symptom Checklist (RSCL), a clinimetric framework was used to evaluate it. It was found to be valid, reliable and feasible for both clinical and research use and, although a quantitative tool, the researcher argues that it may be used as a starting point for meaning-centred assessment of symptoms thus contributing to more holistic patient care. Severe fatigue, presence of other distressing symptoms, and impaired cognitive functioning frequently precluded the use of self-assessment scales. Consequently, a study investigating nurses' use of behavioural indicators of distress as an alternative to self-assessment was carried out. Although this failed to yield a reliable and valid instrument it provides a useful foundation for further developmental work in this important area. The development of the PSDS has provided an instrument that may be used in future studies to evaluate what interventions comprise optimal care for dehydrated dying patients. Suggestions for further research are offered.

Item Type: Thesis (Doctoral)
Divisions : Theses
Authors : Chidgey, Jayne M.
Date : 1999
Additional Information : Thesis (Ph.D.)--University of Surrey (United Kingdom), 1999.
Depositing User : EPrints Services
Date Deposited : 30 Apr 2019 08:08
Last Modified : 20 Aug 2019 15:33
URI: http://epubs.surrey.ac.uk/id/eprint/851507

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