title: Signs, Symptoms, and Characteristics Associated With End of Life in People With a Hematologic Malignancy: A Review of the Literature.
abstract: Identifying people with hematologic cancer who are at risk of deteriorating and dying is essential to enable open, honest discussions, leading to appropriate decision making and effective end-of-life care. .
  
  
  
  PubMed, CINAHL®, PsycINFO, and the Cochrane Central Register of Controlled Trials were searched from January 2005 to December 2015 for descriptive observational studies. .
  
  
  
  Critique of the studies was guided by the Critical Appraisal Skills Programme Cohort Study Checklist. .
  
  
  
  Twelve studies were included. The majority of studies (n = 8) sampled patients from palliative populations, and most were retrospective (n = 11). A number of signs, symptoms, and characteristics associated with end of life in people with a hematolgic malignancy were identified, including pain, hematopoietic dysfunction, dyspnea, and reduced oral intake. .
  
  
  
  The studies described a clinical scenario of deterioration, largely in a palliative population. Findings indicate that people with a hematologic malignancy share certain clinical signs of deterioration with other populations and receive a high level of medical interventions at the end of life. .
  
  
  
  Nurses are well positioned to identify many of the signs, symptoms, and characteristics found in this review and can play a key role in identifying when a person is nearing the end of life.
authors.affiliation: Queensland University of Technology.
authors.forename: Elise
authors.initials: E
authors.lastname: Button
authors.affiliation: Queensland University of Technology.
authors.forename: Raymond
authors.initials: R
authors.lastname: Chan
authors.affiliation: Queensland University of Technology.
authors.forename: Shirley
authors.initials: S
authors.lastname: Chambers
authors.affiliation: Royal Brisbane and Women's Hospital.
authors.forename: Jason
authors.initials: J
authors.lastname: Butler
authors.affiliation: Queensland University of Technology.
authors.forename: Patsy
authors.initials: P
authors.lastname: Yates
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019337:Hematologic Neoplasms / Q000451:nursing* / Q000523:psychology*; D017051:Hospice Care / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009859:Oncology Nursing / Q000379:methods*; D012189:Retrospective Studies; D013727:Terminal Care / Q000523:psychology*
keywords: end of life; hematologic malignancies; identification; transition