Symptom Relief From Tub Bathing in Terminal Cancer: A Multicenter, Controlled Observational Study.

Abstract

Previous studies have shown that bathing of terminal cancer patients led to significant immediate improvements in symptoms, but the earlier work had various limitations. This study aimed to determine the effects of bathing on physical and mental symptoms in terminal cancer patients in Japan. This was a prospective, controlled, observational study involving terminal cancer patients in palliative care wards at multiple institutions in Japan. In routine care, nurses assisted participants who wished to take a warm bath (at 40%-45°C) lasting about 10 minutes during the day. The severity of seven symptoms, including pain, fatigue, sleepiness, unpleasant sleepiness, mood, anxiety, and lack of appetite, was self-assessed on a scale of 0-10 (0: none, 10: unbearable distress) on the day before bathing, day of bathing, morning and evening of the following day, and 30 minutes after bathing on the day of bathing only. Patient background, physical condition, drug information, and care environment before and after hospitalization were evaluated. Differences in scores before and after bathing, changes the day before and the day after, and comparisons between the bathing and nonbathing groups were evaluated; effect sizes were calculated; and logistic regression analysis was performed. This study involved a within-subject comparison design, evaluating each patient on a bathing day and a corresponding nonbathing day. A total of 146 terminal cancer patients (86 men; median age 78.5 ± 12.3 years) were evaluated. Significant symptom relief was seen not only on the day of bathing, but also continuing to the following day, especially for fatigue and mood. Bathing is effective in ameliorating the symptoms of terminal cancer patients.