Oral care in palliative care settings - actual situation of oral problems and issues from the viewpoint of “total pain”

Abstract

Purpose: Oral management plays an important role in supportive care for advanced cancer. In this study, we focused on oral management in palliative care settings, from the recurrence of cancer to the terminal stage. Various types of physical and psychosocial pain occur during this period. Specifically, such oral problems as stomatitis, dry mouth, and oral candidiasis represent important issues that need to be improved. The purpose of this study was to survey the actual situation regarding oral problems in patients in palliative care settings and to investigate oral problems from the viewpoint of "total pain". Method(s): Advanced cancer patients in palliative care settings hospitalized during the last two years participated in this study. The following two points were retrospectively investigated: 1. We divided the patients into two groups according to the status of oral food intake (more or less than 30%). We compared the frequency and severity of dry mouth and the presence of other complicating oral problems. 2. We extracted the details of suffering experienced by patients, as well as their family, whose eating ability had progressively declined, and the changes in their mental condition after interventions, including oral care. Result(s): The group with favorable oral food intake consisted of 115 patients, and the group with poor oral intake comprised 158. 1. Dry mouth occurred in 38.3 and 81.0% in the favorable and poor oral intake groups, respectively (p < 0.0001). The severity of dry mouth was significantly higher in the poor oral intake group (p < 0.0001). 2. Under these conditions, the patients and families expressed different forms of distress. After interventions, including oral care, their attitude and feelings became positive and forward-looking. Conclusion(s): The provision of oral care for advanced cancer patients in palliative care settings is useful for improving the oral environment as well as playing an important role in "alleviation of total pain" and "family care".