Browsing by Author "Pérez Cruz, Pedro"

Now showing 1 - 20 of 28
  • Thumbnail Image
    Item
    Accurate prognostic awareness is associated with increased emotional distress in Latino patients with advanced cancer
    (2025) Pérez Cruz, Pedro; Martín, María Jesus San; Palacios, Josefa; Tupper Satt, Laura; González Otaiza, Marcela; Repetto Lisboa, Paula Beatriz
    Objectives To describe the frequency of prognostic awareness (PA) in a population of advanced cancer patients in a Latino community and to explore the relationship between accurate PA with emotional distress and other covariates. Methods In this cross-sectional study performed in Puente Alto, Chile, advanced cancer patients in palliative care completed a survey that included a single question to assess PA (Do you believe your cancer is curable? yes/no). Patients reporting that their cancer was not curable were considered as having accurate PA. Demographics, emotional distress, quality of life, and patient perception of treatment goals were also assessed. Analyses to explore associations between PA and patient variables were adjusted. Results A total of 201 patients were included in the analysis. Mean age was 65, 50% female. One hundred and three patients (51%) reported an accurate PA. In the univariate analysis, accurate PA was associated with not having a partner (p = 0.012), increased emotional distress (p = 0.013), depression (p = 0.003), and were less likely to report that the goal of the treatment was to get rid of the cancer (p < 0.001). In the multivariate analysis, patients with accurate PA had higher emotional distress or depression, were less likely to have a partner, and to report that the goal of the treatment was to get rid of the cancer. Significance of results Half of a population of Latino advanced cancer patients reported an accurate PA. Accurate PA was associated with increased emotional distress, which is similar to what has been reported in other countries. Weaknesses in prognostic disclosure by clinicians, local cultural factors, or higher motivation to seek prognostic information among distressed cancer patients could explain this association. Strategies to emotionally support patients when discussing prognostic information should be implemented.
  • Thumbnail Image
    Item
    Advantages and disadvantages across the life course and health status in old age among women in Chile
    (2019) Madero Cabib, Ignacio; Azar Denecken, Ariel Ricardo; Pérez Cruz, Pedro
  • Thumbnail Image
    Item
    Are cannabinoids an alternative for cachexia-anorexia syndrome in patients with advanced cancer?
    (2017) Cabeza, Claudia; Corsi, Oscar; Pérez Cruz, Pedro
  • Thumbnail Image
    Item
    Clinical Signs of Impending Death in Cancer Patients
    (2014) Hui, David; Dos Santos, Renata; Chisholm, Gary B.; Bansal, Swati; Silva, Thiago Buosi; Kilgore, Kelly; Crovador, Camila de Sousa; Yu, Xiaoying; Swart, Michael D.; Pérez Cruz, Pedro
  • Thumbnail Image
    Item
    Decisional control preferences among patients with advanced cancer: An international multicenter cross-sectional survey
    (2018) Yennurajalingam, Sriram; Rodrigues, Luis Fernando; Shamieh, Omar M.; Tricou, Colombe; Filbet, Marilene; Naing, Kyaw; Ramaswamy, Akhileshwaran; Pérez Cruz, Pedro; Bautista, Mary Jocylyn S.; Bunge, Sofia; Muckaden, Mary Ann; Fakrooden, Sar
  • Thumbnail Image
    Item
    Escalas de Estado Funcional (o performance satus) en Cáncer
    (2014) Pérez Cruz, Pedro; Acevedo Claros, Francisco Nicolás
  • Thumbnail Image
    Item
    Factors Associated With Attrition in a Multicenter Longitudinal Observational Study of Patients With Advanced Cancer
    (2018) Pérez Cruz, Pedro; Shamieh, Omar; Paiva, Carlos Eduardo; Kwon, Jung Hye; Muckaden, Mary Ann; Bruera, Eduardo; Hui, David
  • Thumbnail Image
    Item
    Influencia de los síntomas físicos, y la funcionalidad, en la relación entre la conciencia pronóstica y el malestar emocional, en pacientes con cáncer avanzado
    (2019) San Martín Frías, María Jesús; Repetto Lisboa, Paula Beatriz; Pérez Cruz, Pedro; Pontificia Universidad Católica de Chile. Escuela de Psicología
    Introducción: La conciencia pronóstica se entiende como la capacidad de reconocer que la enfermedad terminal no tiene cura e implica un pronóstico de vida acotado. Cerca del 50% de las personas diagnosticadas con una enfermedad terminal no tiene una conciencia pronóstica ajustada a la realidad, lo que tiene implicancias importantes para la calidad de vida de estos pacientes y cercanos. En la literatura se han reportado resultados contradictorios respecto de la relación entre conciencia pronóstica y malestar emocional que podrían explicarse por diferencias culturales, junto con la influencia de variables físicas y funcionales de la persona. Métodos: Los participantes fueron 201 adultos. Un 49,8% eran mujeres, con un promedio de edad de 64,5 años (d.e=14,08, rango= 23-95). Se evaluó la conciencia pronóstica, el malestar emocional, la funcionalidad y los síntomas físicos. Se realizaron una serie de análisis descriptivos y de regresión para evaluar la relación existente entre cada una de las variables del estudio. Resultados: El 48,8% de la muestra no tendría conciencia pronóstica, aquellos con conciencia pronóstica presentaron puntajes más altos en el HADS-D. Ser mujer y presentar más síntomas físicos, se relacionaron con un mayor malestar emocional. Discusión: Existe un porcentaje importante de pacientes que no manifiestan conciencia pronóstica, en porcentajes similares a los descritos en estudios anteriores. La conciencia pronóstica se asocia con mayor malestar emocional, a diferencia de lo descrito en estudios anteriores. Diferencias culturales podrían estar influyendo en estos resultados y que sugieren la necesidad de estudios en otras poblaciones.
  • Thumbnail Image
    Item
    Is acetaminophen beneficial in patients with cancer pain who are on strong opioids? A randomized controlled trial
    (2023) Leiva, Ofelia; Letelier Saavedra, Luz María; Rojas Orellana, Luis; Viviani García, Paola; Castellano, Joel; González Candia, Antonio Felipe; Pérez Cruz, Pedro
    ContextPain is common among cancer patients. The evidence recommends using strong opioids in moderate to severe cancer pain. No conclusive evidence supports the effectiveness of adding acetaminophen to patients with cancer pain who are already using this regime.ObjectiveTo assess the analgesic efficacy of acetaminophen in hospitalized cancer patients with moderate to severe pain receiving strong opioids.MethodsIn this randomized blinded clinical trial, hospitalized cancer patients with moderate or severe acute pain managed with strong opioids were randomized to acetaminophen or placebo. The primary outcome was pain intensity difference between baseline and 48 hours using the Visual Numeric Rating Scales (VNRS). Secondary outcomes included change in morphine equivalent daily dose (MEDD), and patients’ perception of improved pain control.ResultsAmong 112 randomized patients, 56 patients received placebo, 56 acetaminophen. Mean (standard deviation (SD)) decrease in pain intensity (VNRS) at 48 hours were 2.7 (2.5) and 2.3 (2.3), respectively (95% Confidence Interval(CI) [-0.49;1.32];p=0.37). Mean (SD) change in MEDD was 13.9 (33.0) mg/day and 22.4 (57.7), respectively (95% CI [-9.24;26.1];p=0.35). The proportion of patients perceiving pain control improvement after 48 hours was 82% in the placebo and 80% in the acetaminophen arms (p=0.81).ConclusionAmong patients with cancer pain on strong opioid regime, acetaminophen may not improve pain control, or decrease total opioid use. These results add to the current evidence available suggesting not to use acetaminophen as an adjuvant for advanced cancer patients with moderate to severe cancer pain who are on strong opioids.
  • Thumbnail Image
    Item
    Is parenteral hydration beneficial in terminally ill cancer patients?
    (2018) Canihuante, José; Pérez Cruz, Pedro
  • Thumbnail Image
    Item
    Longitudinal temporal and probabilistic prediction of survival in a cohort of patients with advanced cancer
    (2014) Pérez Cruz, Pedro; Dos Santos, R.; Silva, T.; Crovador, C.; Nascimento, M.; Hall, S.; Fajardo, J.; Bruera, E.; Hui, D.
  • Thumbnail Image
    Item
    Methylphenidate and/or a nursing telephone intervention for fatigue in patients with advanced cancer : a randomized, placebo-controlled, phase II trial
    (2013) Bruera, Eduardo; Yennurajalingam, Sririam; Palmer, J. Lynn; Pérez Cruz, Pedro; Frisebee-Hume, Susan; Allo, Julo; Williams, J. L.; Cohen, M. Z.
  • Thumbnail Image
    Item
    Minimal Clinically Important Difference in the Physical, Emotional, and Total Symptom Distress Scores of the Edmonton Symptom Assessment System
    (2016) Hui, D.; Shamieh, O.; Paiva, C. E.; Khamash, O.; Pérez Cruz, Pedro; Kwon, J. H.; Muckaden, M. A.; Park, M.; Arthur, J.; Bruera, E.
  • Thumbnail Image
    Item
    Minimal clinically important differences in the Edmonton Symptom Assessment Scale in cancer patients : A prospective, multicenter study
    (2015) Hui, D.; Shamieh, O.; Paiva, C. E.; Pérez Cruz, Pedro; Kwon, J. H.; Muckaden, M. A.; Park, M.; Yennu, S.; Kang, J. H.; Bruera, E.
  • Thumbnail Image
    Item
    Objective burden, caregiver psychological distress, and patient religion and quality of life are associated with high-intensity burden of care among caregivers of advanced cancer patients in a Latino population
    (2023) Soto Guerrero, Sebastián; Palacios, Josefa; Langer, Paola; Carrasco, Cecilia; Tupper-Satt, Laura; González-Otaíza, Marcela; Rodríguez Núñez, Alfredo; Pérez Cruz, Pedro
    Objectives: Family caregivers (FCs) of cancer patients experience burden of care. The aims of this study are to describe the caregiving phenomenon among FCs of advanced cancer patients in a Latino community and to identify caregiver and atient characteristics associated with high-intensity subjective caregiver burden. Methods: In this cross-sectional study, advanced cancer patient–caregiver dyads assessed at a Palliative Care Unit in Santiago, Chile, enrolled in a longitudinal observational study were included. FCs completed questions to describe the caregiving phenomenon and surveys to assess burden of care, psychological distress, and perception of patients’ symptoms; patients completed surveys to assess physical distress and quality of life (QOL). We explored associations between high-intensity subjective caregiver burden with caregiver and patient variables. Results: Two hundred seven dyads were analyzed. FCs were on average 50 years old and 75% female. Thirty-two percent of FCs experienced high-intensity subjective burden of care. Eighty two percent of FCs took care of the patient daily and 31% took care of the patient alone. In univariate analysis, high-intensity caregiver burden was associated with caregiver depression (59% vs. 27%; p < 0.001), anxiety (86% vs. 67%; p = 0.003), caring for the patient alone (45% vs. 24%; p = 0.002), perception of patient symptom distress, patient religion, and worse patient QOL (mean [standard deviation] 58 [33] vs. 68 [27]; p = 0.03). In multivariate analysis, FC depression (OR [95% confidence interval] 3.07 [1.43–6.60]; p = 0.004), anxiety (3.02 [1.19–7.71]; p = 0.021), caring for the patient alone (2.69 [1.26–5.77]; p = 0.011), caregiver perception of patient’s fatigue (1.26 [1.01–1.58]; p = 0.04), and patient’s religion (3.90 [1.21–12.61]; p = 0.02) were independently associated with caregiver burden. Significance of results: FCs of advanced cancer patients in a Latino community frequently experience high-intensity burden of care and are exposed to measures of objective burden. High-intensity burden is associated with both caregiver and patient factors. Policies should aim to make interventions on patient–caregiver dyads to decrease caregiving burden among Latinos.
  • No Thumbnail Available
    Item
    Paracetamol como coadyuvante a opioides fuertes en dolor oncológico moderado a intenso: ¿es realmente efectivo?
    (Sociedad Medica de Santiago, 2021) Leiva, Ofelia; Pérez Cruz, Pedro
    Cancer related pain is one of the most frequent and relevant symptoms in patients with malignant tumors, causing a huge impact in their quality of life. According to the Chilean Public Health System Technical Report of the Cancer Pain Control and Palliative Care Program 2013-2014, 90% of cancer patients admitted to the Program experienced pain, being moderate or intense in 34%. International and local standards recommend the use of strong opioids (morphine, methadone, or fentanyl) associated with adjuvants such as paracetamol as an initial strategy for pain management. This recommendation assumes that the use of combined analgesics could allow the use of lower opioid doses to obtain similar analgesic effect, decreasing the occurrence of opioid side effects. However, this technical report also describes that there is uncertainty about the impact of paracetamol as an adjuvant in patients with cancer pain who are already receiving strong opioids. This review aims to describe the current state of the art regarding the role of paracetamol as a coadjuvant in cancer pain patients.
  • Thumbnail Image
    Item
    Past trends and future projections of palliative care needs in Chile: analysis of routinely available death registry and population data
    (2024) Léniz Martelli, Javiera; Domínguez, Angélica; Bone, Anna E.; Etkind, Simon; Pérez Cruz, Pedro; Sleeman, Katherine E.
    The number of people with palliative care needs is projected to increase globally. Chile has recently introduced legislation for universal access to palliative care services for patients with severe and terminal illnesses, including non-cancer conditions. We aimed to estimate the number of people afected by serious health-related suf‑fering and need for palliative care in Chile to 2050. We used data on all deaths registered in Chile between 1997-2019 and population estimates for 1997–2050. We used Poisson regression to model past trends in causes of death adjusted by age, sex and population estimates, to project the number of deaths for each cause from 2021 to 2050. We applied the Lancet Commission on Palliative Care and Pain Relief weights to these projections to identify decedents and non-decedents with palliative care needs. Population palliative care needs in Chile are projected to increase from 117 (95% CI 114 to 120) thousand people in 2021 to 209 (95% CI 198 to 223) thousand people in 2050, a 79% increase (IRR 1.79; 95% CI 1.78–1.80). This increase will be driven by non-cancer conditions, particularly dementia (IRR 2.9, 95% CI 2.85–2.95) and cardiovascular conditions (IRR 1.86, 95% CI 1.83–1.89). By 2050, 50% of those estimated to need palliative care will be non-decedents (not expected to die within a year). Chile will experience a large increase in palliative care needs, particularly for people with dementia and other non-cancer conditions. Improved availability of high-quality services, expanded clinician training and new sustainable models of care are urgently required to ensure universal access to palliative care. We aimed to estimate the number of people affected by serious health-related suffering and need for palliative care in Chile to 2050.
  • Thumbnail Image
    Item
    Patient perception of physician compassion after a more optimistic vs a less optimistic message : a randomized control trial
    (2015) Tanco, Kimberson; Rhondali, Wadih; Pérez Cruz, Pedro; Tanzi, Silvia; Chisholm, Gary B.; Baile, Walter; Frisbee Hume, Susan; Williams, Janet; Masino, Charles; Sisson, Amy; Arthur, Joseph; Bruera, Eduardo; Cantu, Hilda
  • Thumbnail Image
    Item
    Patient-physician communication about code status preferences. A Randomized Controlled Trial
    (2013) Rhondali, W.; Pérez Cruz, Pedro; Hui, D.; Chisholm, G.; Dalal, S.; Baile, W.; Chittenden, E.; Bruera, E.
  • Thumbnail Image
    Item
    Perception of Curability Among Advanced Cancer Patients : An International Collaborative Study
    (2018) Yennurajalingam, Sriram; Rodrigues, Luis Fernando; Shamieh, Omar; Tricou, Colombe; Filbet, Marilène; Naing, Kyaw; Ramaswamy, Akhileshwaran; Pérez Cruz, Pedro; Bautista, Mary Jocelyn S.; Bunge, Sofia; Muckaden, Mary Ann; Sewram, Vikash; Fakrooden, Sarah; Noguera-Tejedor, Antonio; Rao, Shobha S.; Liu, Diane; Park, Minjeong; Williams, Janet L.; Lu, Zhanni; Cantu, Hilda; Hui, David; Reddy, Suresh K.; Bruera, Eduardo