Lovely Antony, Anu Savio Thelly, A. L. Srikanth, Alice Stella Verginia
Improving the quality of research reporting is crucial for addressing current challenges in palliative care, with academic journals playing a crucial role in promoting clear and comprehensive reporting through structured guidelines. These guidelines, such as Appraisal of Guidelines, Research, and evaluation, Consolidated Standards of Reporting Trials, Case Reports (CARE) guidelines, transparent reporting of evaluations with nonrandomized designs (TREND), transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD), meta-analysis of observational studies in epidemiology (MOOSE) Checklist, methods of researching end-of-life care Statement, Preferred Reporting Items for Systematic Reviews and Meta-analyses, Standards for Quality Improvement Reporting Excellence 2.0, Strengthening the Reporting of Observational Studies in Epidemiology, standard protocol items: recommendations for interventional trials (SPIRIT), template for intervention description and replication (TIDieR) Consolidated Criteria for Reporting Qualitative Research and Standards for Qualitative Research, are instrumental in ensuring transparency by furnishing essential details for comprehending, replicating and applying research findings in clinical decision-making and systematic reviews. The Enhancing the quality and transparency of health research (EQUATOR) network champions trustworthy health research literature globally by advocating for transparent and accurate reporting, thereby enhancing the reliability and utility of research outcomes research outcomes.
提高研究报告的质量对于应对姑息关怀领域当前的挑战至关重要，而学术期刊在通过结构化指南促进清晰、全面的报告方面发挥着至关重要的作用。这些指南包括：《指南、研究和评估的评估》（Appraisal of Guidelines, Research, and evaluation）、《试验报告综合标准》（Consolidated Standards of Reporting Trials）、《病例报告》（CARE）指南、《非随机设计评估的透明报告》（TREND）、《个人预后或诊断的多变量预测模型的透明报告》（TRIPOD）、《流行病学观察性研究的荟萃分析》（MOOSE）核对表、《生命末期关怀研究方法声明》（Methods of Researching End-of Life Care Statement）、《系统性综述和荟萃分析的首选报告项目》（Preferred Reporting Items for Systematic Reviews and Meta-analyses）、《卓越质量改进报告标准2.0》（Standards for Quality Improvement Reporting Excellence 2.0》、《加强流行病学中观察性研究的报告》、《标准方案项目：介入性试验建议》（SPIRIT）、《介入性描述和复制模板》（TIDieR）、《定性研究报告综合标准》和《定性研究标准》，通过提供在临床决策和系统性综述中理解、复制和应用研究结果的基本细节，有助于确保透明度。提高健康研究的质量和透明度（EQUATOR）网络通过倡导透明和准确的报告，在全球范围内倡导值得信赖的健康研究文献，从而提高研究成果的可靠性和实用性。
{"title":"Improving Palliative Care Research Reporting: A Guide to Reporting Guidelines","authors":"Lovely Antony, Anu Savio Thelly, A. L. Srikanth, Alice Stella Verginia","doi":"10.25259/ijpc_61_2024","DOIUrl":"https://doi.org/10.25259/ijpc_61_2024","url":null,"abstract":"Improving the quality of research reporting is crucial for addressing current challenges in palliative care, with academic journals playing a crucial role in promoting clear and comprehensive reporting through structured guidelines. These guidelines, such as Appraisal of Guidelines, Research, and evaluation, Consolidated Standards of Reporting Trials, Case Reports (CARE) guidelines, transparent reporting of evaluations with nonrandomized designs (TREND), transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD), meta-analysis of observational studies in epidemiology (MOOSE) Checklist, methods of researching end-of-life care Statement, Preferred Reporting Items for Systematic Reviews and Meta-analyses, Standards for Quality Improvement Reporting Excellence 2.0, Strengthening the Reporting of Observational Studies in Epidemiology, standard protocol items: recommendations for interventional trials (SPIRIT), template for intervention description and replication (TIDieR) Consolidated Criteria for Reporting Qualitative Research and Standards for Qualitative Research, are instrumental in ensuring transparency by furnishing essential details for comprehending, replicating and applying research findings in clinical decision-making and systematic reviews. The Enhancing the quality and transparency of health research (EQUATOR) network champions trustworthy health research literature globally by advocating for transparent and accurate reporting, thereby enhancing the reliability and utility of research outcomes research outcomes.","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141924854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Gondode, Vaishali Mahor, Deepa Rani, Rupavath Ramkumar, Pooja Yadav
Palliative care plays a crucial role in comprehensive healthcare, yet misconceptions among patients and caregivers hinder access to services. Artificial Intelligence (AI) chatbots offer potential solutions for debunking myths and providing accurate information. This study aims to evaluate the effectiveness of AI chatbots, ChatGPT and Google Gemini, in debunking palliative care myths. Thirty statements reflecting common palliative care misconceptions were compiled. ChatGPT and Google Gemini generated responses to each statement, which were evaluated by a palliative care expert for accuracy. Sensitivity, positive predictive value, accuracy, and precision were calculated to assess chatbot performance. ChatGPT accurately classified 28 out of 30 statements, achieving a true-positive rate of 93.3% and a true-negative rate of 3.3%. Google Gemini achieved perfect accuracy, correctly classifying all 30 statements. Statistical tests showed no significant difference between chatbots’ classifications. Both ChatGPT and Google Gemini demonstrated high accuracy in debunking palliative care myths. These findings suggest that AI chatbots have the potential to effectively dispel misconceptions and improve patient education and awareness in palliative care.
姑息关怀在综合医疗保健中发挥着至关重要的作用，然而患者和护理人员的误解却阻碍了服务的获取。人工智能（AI）聊天机器人为揭穿误解和提供准确信息提供了潜在的解决方案。本研究旨在评估人工智能聊天机器人 ChatGPT 和 Google Gemini 在揭穿姑息治疗误区方面的有效性。研究汇编了 30 个反映姑息治疗常见误解的陈述。ChatGPT 和 Google Gemini 针对每条陈述生成回复，并由姑息关怀专家对回复的准确性进行评估。计算了灵敏度、阳性预测值、准确度和精确度，以评估聊天机器人的性能。ChatGPT 对 30 条语句中的 28 条进行了准确分类，真实阳性率为 93.3%，真实阴性率为 3.3%。谷歌双子座达到了完美的准确率，对所有 30 条语句都进行了正确分类。统计测试表明，聊天机器人的分类没有明显差异。ChatGPT 和 Google Gemini 在揭穿姑息治疗误区方面都表现出很高的准确性。这些研究结果表明，人工智能聊天机器人有可能有效地消除误解，提高病人对姑息治疗的教育和认识。
{"title":"Debunking Palliative Care Myths: Assessing the Performance of Artificial Intelligence Chatbots (ChatGPT vs. Google Gemini)","authors":"P. Gondode, Vaishali Mahor, Deepa Rani, Rupavath Ramkumar, Pooja Yadav","doi":"10.25259/ijpc_44_2024","DOIUrl":"https://doi.org/10.25259/ijpc_44_2024","url":null,"abstract":"Palliative care plays a crucial role in comprehensive healthcare, yet misconceptions among patients and caregivers hinder access to services. Artificial Intelligence (AI) chatbots offer potential solutions for debunking myths and providing accurate information. This study aims to evaluate the effectiveness of AI chatbots, ChatGPT and Google Gemini, in debunking palliative care myths. Thirty statements reflecting common palliative care misconceptions were compiled. ChatGPT and Google Gemini generated responses to each statement, which were evaluated by a palliative care expert for accuracy. Sensitivity, positive predictive value, accuracy, and precision were calculated to assess chatbot performance. ChatGPT accurately classified 28 out of 30 statements, achieving a true-positive rate of 93.3% and a true-negative rate of 3.3%. Google Gemini achieved perfect accuracy, correctly classifying all 30 statements. Statistical tests showed no significant difference between chatbots’ classifications. Both ChatGPT and Google Gemini demonstrated high accuracy in debunking palliative care myths. These findings suggest that AI chatbots have the potential to effectively dispel misconceptions and improve patient education and awareness in palliative care.","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The current global practice is to plan for the end-of-life period of persons already terminally ill with chronic diseases. However, affected persons should not have to wait till the stage of terminal illness to begin making plans for future healthcare preferences. This pilot study explored perceived barriers to and willingness of physicians to initiate discussions on advance care planning (ACP) with young adults living with cardiometabolic diseases. The study was the pilot phase of descriptive cross-sectional research conducted among primary care physicians practising in Kuwait. Pilot data was collected with an electronic version of the modified DECIDE questionnaire (adapted from the “DECIsion-making about goals of care for hospitalized ElDErly patients” study) from February to April 2023. Data were analysed with Google Sheets. Nine out of 22 participants exited the study early on grounds of non-familiarity with the concept of ACP. Thirteen responses were analysed and reported herein. The mean age of the participants was 44.2 (±7.9) years; eight were male and five were female; five were Hindu, 7 Muslim, and 2 Christian. Perceived barriers to initiating ACP discussions included lack of knowledge about ACP and its relationship to ACP and goals of care discussions (8), lack of knowledge about the legal status of ACP documents in Kuwait (11), religious disapproval (12), lack of knowledge about how to elicit values, beliefs, preferences related to end-of-life care (13) and fear that these conversations will diminish hope in patients with serious illness (12), among others. Twelve participants were willing to initiate discussions and exchange information with young adult patients. Twelve participants indicated that they were confident about initiating discussions and exchanging ACP information, had all not taken any extra training or certification in ACP, but, respectively, described their current level of skill in having ACP discussions and supporting patients in the finalisation of their advance care plans as limited (2), fair (3), average (4), very good (3) and expert (1). Despite the low level of awareness and other factors perceived as barriers, the primary care physicians who participated in the study were confident and willing to initiate ACP discussions with young adults living with cardiometabolic diseases. With the generally reported lack of previous training in ACP, there might be a need for coordinated efforts in training or up-skilling on knowledge and practice of ACP among primary care physicians.
{"title":"Physicians’ Perceived Barriers and Willingness to Initiate Advance Care Planning with Young Adults Living with Cardiometabolic Diseases","authors":"R. I. Ekore, J. Ekore, Hany Ramadan Mohammed","doi":"10.25259/ijpc_36_2024","DOIUrl":"https://doi.org/10.25259/ijpc_36_2024","url":null,"abstract":"\u0000\u0000The current global practice is to plan for the end-of-life period of persons already terminally ill with chronic diseases. However, affected persons should not have to wait till the stage of terminal illness to begin making plans for future healthcare preferences. This pilot study explored perceived barriers to and willingness of physicians to initiate discussions on advance care planning (ACP) with young adults living with cardiometabolic diseases.\u0000\u0000\u0000\u0000The study was the pilot phase of descriptive cross-sectional research conducted among primary care physicians practising in Kuwait. Pilot data was collected with an electronic version of the modified DECIDE questionnaire (adapted from the “DECIsion-making about goals of care for hospitalized ElDErly patients” study) from February to April 2023. Data were analysed with Google Sheets.\u0000\u0000\u0000\u0000Nine out of 22 participants exited the study early on grounds of non-familiarity with the concept of ACP. Thirteen responses were analysed and reported herein. The mean age of the participants was 44.2 (±7.9) years; eight were male and five were female; five were Hindu, 7 Muslim, and 2 Christian. Perceived barriers to initiating ACP discussions included lack of knowledge about ACP and its relationship to ACP and goals of care discussions (8), lack of knowledge about the legal status of ACP documents in Kuwait (11), religious disapproval (12), lack of knowledge about how to elicit values, beliefs, preferences related to end-of-life care (13) and fear that these conversations will diminish hope in patients with serious illness (12), among others. Twelve participants were willing to initiate discussions and exchange information with young adult patients. Twelve participants indicated that they were confident about initiating discussions and exchanging ACP information, had all not taken any extra training or certification in ACP, but, respectively, described their current level of skill in having ACP discussions and supporting patients in the finalisation of their advance care plans as limited (2), fair (3), average (4), very good (3) and expert (1).\u0000\u0000\u0000\u0000Despite the low level of awareness and other factors perceived as barriers, the primary care physicians who participated in the study were confident and willing to initiate ACP discussions with young adults living with cardiometabolic diseases. With the generally reported lack of previous training in ACP, there might be a need for coordinated efforts in training or up-skilling on knowledge and practice of ACP among primary care physicians.\u0000","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141673561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Breast cancer affects millions of women worldwide, including Indonesia and brings a burden on many aspects, especially quality of life. This study investigated the influence of demographic characteristics, psychological distress and physical activity levels on quality of life among breast cancer women undergoing therapy in Indonesia. This cross-sectional study was conducted among 200 breast cancer women. We used the Indonesian version of depression, anxiety, stress scales, international physical activity questionnaires and World Health Organization Quality of Life-BREF to evaluate psychological distress, physical activity levels and quality of life. Descriptive, bivariate and multiple linear regressions were applied. Study participants had moderate quality of life scores. Approximately 22% of the variance in physical health was explained by family history, depression and physical activity. Having a family history is associated with better psychological health (ß = 5.32, P = 0.04). In contrast, experienced moderate to severe depressive symptoms contributed to lower environment domains (ß = −6.30, P = 0.02). Furthermore, having a low level of physical activity was the only significant factor influencing all domain scores, including physical health (β = −24.82, P < 0.001), psychological health (β = −19.72, P < 0.001), social relation (β= −16.91, P < 0.001) and environment (β = −13.91, P < 0.001). Physical activity levels are the strongest determinant of quality of life among breast cancer women in Indonesia. Nurses should not only widen information access regarding breast cancer, especially for patients with genetic risk, but also should early screen for depressive symptoms and develop strategies to motivate patients to increase their physical activity to escalate breast cancer patient’s quality of life.
{"title":"Quality of Life Determinants among Breast Cancer Women Undergoing Treatment in Indonesia: A Cross-Sectional Study","authors":"Anita Sukarno, Ratna Dewi, Melati Putri Kurnia, Sherlly Kalalo","doi":"10.25259/ijpc_344_2023","DOIUrl":"https://doi.org/10.25259/ijpc_344_2023","url":null,"abstract":"\u0000\u0000Breast cancer affects millions of women worldwide, including Indonesia and brings a burden on many aspects, especially quality of life. This study investigated the influence of demographic characteristics, psychological distress and physical activity levels on quality of life among breast cancer women undergoing therapy in Indonesia.\u0000\u0000\u0000\u0000This cross-sectional study was conducted among 200 breast cancer women. We used the Indonesian version of depression, anxiety, stress scales, international physical activity questionnaires and World Health Organization Quality of Life-BREF to evaluate psychological distress, physical activity levels and quality of life. Descriptive, bivariate and multiple linear regressions were applied.\u0000\u0000\u0000\u0000Study participants had moderate quality of life scores. Approximately 22% of the variance in physical health was explained by family history, depression and physical activity. Having a family history is associated with better psychological health (ß = 5.32, P = 0.04). In contrast, experienced moderate to severe depressive symptoms contributed to lower environment domains (ß = −6.30, P = 0.02). Furthermore, having a low level of physical activity was the only significant factor influencing all domain scores, including physical health (β = −24.82, P < 0.001), psychological health (β = −19.72, P < 0.001), social relation (β= −16.91, P < 0.001) and environment (β = −13.91, P < 0.001).\u0000\u0000\u0000\u0000Physical activity levels are the strongest determinant of quality of life among breast cancer women in Indonesia. Nurses should not only widen information access regarding breast cancer, especially for patients with genetic risk, but also should early screen for depressive symptoms and develop strategies to motivate patients to increase their physical activity to escalate breast cancer patient’s quality of life.\u0000","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141673560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of physical restraints (PR) in healthcare settings, especially in psychiatric units, is a controversial topic. The attitude, knowledge, and practices of nurses towards PR can influence its application, which raises concerns about the balance between patient safety and individual rights. With mental disorders being a leading cause of disability globally, understanding the complexities surrounding PR use becomes paramount. A comprehensive literature review was conducted using multiple databases, including PubMed, Medline, CINAHL, PsycINFO, ProQuest, The Cochrane Library, the Saudi Digital Library, and Google Scholar. The search spanned literature published up to December 2022, focusing on studies that explored the relationship between nurses’ knowledge, attitudes, and practices regarding PR in psychiatric settings. Inclusion and exclusion criteria were applied to filter out relevant studies. From 220 records initially retrieved, 12 articles were identified for the final review. The reviewed studies highlighted a moderate knowledge and attitude among nurses concerning PR. Many nurses were found to be uncertain about the reasons for PR application and its alternatives. Educational interventions were emphasized in several studies as beneficial in improving nurses’ knowledge, attitudes, and practices. However, inconsistencies were observed regarding the impact of these interventions on nurses’ attitudes. Experience, higher education, and continuous training sessions were found to be correlated with better knowledge and more favourable attitudes towards PR. This review emphasizes the critical need for consistent training and education for nurses regarding PR, given the profound implications for patient care and safety. While educational interventions show promise in enhancing knowledge and practice, their impact on attitudes remains contested. Future research should consider the gaps identified in this review, including the exploration of alternatives to PR, larger sample sizes and longitudinal studies to understand the long-term effects of interventions.
{"title":"Assessment of Nurses’ Knowledge, Attitude and Practice Regarding Physical Restraint: A Scoping Review","authors":"Zahra Alsomali, H. Elsayes, L. Sharif","doi":"10.25259/ijpc_227_2023","DOIUrl":"https://doi.org/10.25259/ijpc_227_2023","url":null,"abstract":"The use of physical restraints (PR) in healthcare settings, especially in psychiatric units, is a controversial topic. The attitude, knowledge, and practices of nurses towards PR can influence its application, which raises concerns about the balance between patient safety and individual rights. With mental disorders being a leading cause of disability globally, understanding the complexities surrounding PR use becomes paramount. A comprehensive literature review was conducted using multiple databases, including PubMed, Medline, CINAHL, PsycINFO, ProQuest, The Cochrane Library, the Saudi Digital Library, and Google Scholar. The search spanned literature published up to December 2022, focusing on studies that explored the relationship between nurses’ knowledge, attitudes, and practices regarding PR in psychiatric settings. Inclusion and exclusion criteria were applied to filter out relevant studies. From 220 records initially retrieved, 12 articles were identified for the final review. The reviewed studies highlighted a moderate knowledge and attitude among nurses concerning PR. Many nurses were found to be uncertain about the reasons for PR application and its alternatives. Educational interventions were emphasized in several studies as beneficial in improving nurses’ knowledge, attitudes, and practices. However, inconsistencies were observed regarding the impact of these interventions on nurses’ attitudes. Experience, higher education, and continuous training sessions were found to be correlated with better knowledge and more favourable attitudes towards PR. This review emphasizes the critical need for consistent training and education for nurses regarding PR, given the profound implications for patient care and safety. While educational interventions show promise in enhancing knowledge and practice, their impact on attitudes remains contested. Future research should consider the gaps identified in this review, including the exploration of alternatives to PR, larger sample sizes and longitudinal studies to understand the long-term effects of interventions.","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141109823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Nair, Priyakumari Thankamony, B. Rajeswari, C. Guruprasad, V. R. Prasanth, C. V. Prasanth, Kusumakumary Parukkutty
The burden of advanced and metastatic cancer is high among children in developing countries, and palliative care (PC) services for children are sparsely available and poorly accessed. To estimate the burden of PC requirements in children with metastatic neuroblastoma (NB), and to evaluate the PC services offered. Retrospective analysis of case records of children 1–14 years diagnosed with metastatic NB from 1 January 2008 to 31 December 2017. One hundred and nineteen patients with metastatic NB were included, of which 87 patients received PC consultation. Early PC referral occurred only in 13 patients (14.9%), and pain was the most prominent symptom. Shifting of care from oncology to PC occurred at disease relapse in 58 patients (66.6%) and at end-of-life in 16 patients (18.3%). Nausea/vomiting, constipation and abdominal distension were the most common symptoms during end-of-life. Seventy-one patients (85%) died of disease, median time to death being 9 months from diagnosis and 4 months from relapse. The mean time from initiation of PC to death was 4.2 months. Timely integration of PC and shared care incorporating the oncology team, PC team and local paediatricians can ease out transition in care, ensure a continuum of care and improve the quality of treatment delivered to children with metastatic cancer.
{"title":"Optimising Palliative Care for Children with Metastatic Neuroblastoma and the Paediatrician’s Role in a Shared Care Model – Proposal from a Regional Cancer Centre in India","authors":"M. Nair, Priyakumari Thankamony, B. Rajeswari, C. Guruprasad, V. R. Prasanth, C. V. Prasanth, Kusumakumary Parukkutty","doi":"10.25259/ijpc_254_2022","DOIUrl":"https://doi.org/10.25259/ijpc_254_2022","url":null,"abstract":"\u0000\u0000The burden of advanced and metastatic cancer is high among children in developing countries, and palliative care (PC) services for children are sparsely available and poorly accessed. To estimate the burden of PC requirements in children with metastatic neuroblastoma (NB), and to evaluate the PC services offered.\u0000\u0000\u0000\u0000Retrospective analysis of case records of children 1–14 years diagnosed with metastatic NB from 1 January 2008 to 31 December 2017.\u0000\u0000\u0000\u0000One hundred and nineteen patients with metastatic NB were included, of which 87 patients received PC consultation. Early PC referral occurred only in 13 patients (14.9%), and pain was the most prominent symptom. Shifting of care from oncology to PC occurred at disease relapse in 58 patients (66.6%) and at end-of-life in 16 patients (18.3%). Nausea/vomiting, constipation and abdominal distension were the most common symptoms during end-of-life. Seventy-one patients (85%) died of disease, median time to death being 9 months from diagnosis and 4 months from relapse. The mean time from initiation of PC to death was 4.2 months.\u0000\u0000\u0000\u0000Timely integration of PC and shared care incorporating the oncology team, PC team and local paediatricians can ease out transition in care, ensure a continuum of care and improve the quality of treatment delivered to children with metastatic cancer.\u0000","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141111489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study addresses the growing demand for palliative care (PC) by exploring the role of advanced nursing practice (ANP) within the multidisciplinary team. The purpose is to outline the background of ANP in PC, its interest, training needs, and some recommendations for its establishment in the Moroccan healthcare system. A rapid review of relevant studies was carried out through databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards, edition (2020). The inclusion criteria focussed on studies published within the nursing domain between 2012 and 2022, with a preference for the English language. Study selection allowed to obtain eight relevant studies. The studies agreed that ANP improves the quality of care provided. It has a major role to play in the multidisciplinary team by mobilising all the knowledge required to offer a complete range of care for patients with needs. Nevertheless, its implementation is fraught with challenges. ANP will be able to address the complexity of patient and family needs and serve as cost-effective medical care coordinators for patients and families with both chronic and life-limiting illnesses, to reduce suffering and improve the quality of living and dying across the lifespan. Advanced practice nurses execute assigned authorisations by mobilising the knowledge acquired through university training. The establishment of this cadre in the healthcare system is subject to many challenges that Morocco must anticipate.
{"title":"Advancing Palliative Care through Advanced Nursing Practice: A Rapid Review","authors":"Khaoula Jounaidi, Meryem Hamdoune, Khadija Daoudi, Najwa Barka, Abdellah Gantare","doi":"10.25259/ijpc_308_2023","DOIUrl":"https://doi.org/10.25259/ijpc_308_2023","url":null,"abstract":"\u0000\u0000This study addresses the growing demand for palliative care (PC) by exploring the role of advanced nursing practice (ANP) within the multidisciplinary team. The purpose is to outline the background of ANP in PC, its interest, training needs, and some recommendations for its establishment in the Moroccan healthcare system.\u0000\u0000\u0000\u0000A rapid review of relevant studies was carried out through databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards, edition (2020). The inclusion criteria focussed on studies published within the nursing domain between 2012 and 2022, with a preference for the English language.\u0000\u0000\u0000\u0000Study selection allowed to obtain eight relevant studies. The studies agreed that ANP improves the quality of care provided. It has a major role to play in the multidisciplinary team by mobilising all the knowledge required to offer a complete range of care for patients with needs. Nevertheless, its implementation is fraught with challenges.\u0000\u0000\u0000\u0000ANP will be able to address the complexity of patient and family needs and serve as cost-effective medical care coordinators for patients and families with both chronic and life-limiting illnesses, to reduce suffering and improve the quality of living and dying across the lifespan. Advanced practice nurses execute assigned authorisations by mobilising the knowledge acquired through university training. The establishment of this cadre in the healthcare system is subject to many challenges that Morocco must anticipate.\u0000","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141112571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mena K. Agbodjavou, P. C. Mêliho, E. A. Akpi, W. M. Gandaho, A. Kpatchavi
For patients with diabetes and cancer at the end-of-life and their families, the safety sought in end-of-life care leads them to opt for home care. In developing countries where palliative care is not yet effectively integrated into public health policies, factors such as long distances to hospital referrals, lack of adequate infrastructure and shortage of specialised health professionals create a sense of insecurity for people seeking end-of-life care. The present study explored the factors that reinforce the feeling of security and insecurity of family members who have opted to accompany their relatives with diabetes and/or advanced cancer at the end-of-life at home in Togo. This was an ethnographic approach based on observations and in-depth semi-structured interviews with people with the following characteristics: family members (bereaved or not) with experience of caring for a patient with diabetes and cancer at home at the end-of-life. The data were analysed using content and thematic analysis. This was done to identify categories and subcategories using the qualitative analysis software Nvivo12. The results show that of the ten relatives interviewed, eight had lived with the patient. Factors contributing to the feeling of security in the accompaniment of end-of-life care at home by the family members were, among others: ‘Informal support from health-care professionals,’ ‘social support’ from relatives and finally, attitudes and predispositions of the family members (presence and availability to the patient, predisposition to respect the patient’s wishes at the place of end-of-life care and predisposition to talk about death with the dying person). The ‘informal support of health-care professionals’, the ‘perception of the home as a safe space for end-of-life care’ and the ‘social support’ of family members contributed most to the feeling of safety among family members accompanying their diabetic and cancer patient family members at the end-of-life at home in Togo. Therefore, palliative and end-of-life care must be rethought in public health policies in Togo to orientate this care toward the home while providing families/caregivers with the knowledge and tools necessary to strengthen care.
{"title":"‘We had to be there, Present to Help Him’: Local Evidence on the Feeling of Safety in End-of-Life Care in Togo","authors":"Mena K. Agbodjavou, P. C. Mêliho, E. A. Akpi, W. M. Gandaho, A. Kpatchavi","doi":"10.25259/ijpc_66_2023","DOIUrl":"https://doi.org/10.25259/ijpc_66_2023","url":null,"abstract":"\u0000\u0000For patients with diabetes and cancer at the end-of-life and their families, the safety sought in end-of-life care leads them to opt for home care. In developing countries where palliative care is not yet effectively integrated into public health policies, factors such as long distances to hospital referrals, lack of adequate infrastructure and shortage of specialised health professionals create a sense of insecurity for people seeking end-of-life care. The present study explored the factors that reinforce the feeling of security and insecurity of family members who have opted to accompany their relatives with diabetes and/or advanced cancer at the end-of-life at home in Togo.\u0000\u0000\u0000\u0000This was an ethnographic approach based on observations and in-depth semi-structured interviews with people with the following characteristics: family members (bereaved or not) with experience of caring for a patient with diabetes and cancer at home at the end-of-life. The data were analysed using content and thematic analysis. This was done to identify categories and subcategories using the qualitative analysis software Nvivo12.\u0000\u0000\u0000\u0000The results show that of the ten relatives interviewed, eight had lived with the patient. Factors contributing to the feeling of security in the accompaniment of end-of-life care at home by the family members were, among others: ‘Informal support from health-care professionals,’ ‘social support’ from relatives and finally, attitudes and predispositions of the family members (presence and availability to the patient, predisposition to respect the patient’s wishes at the place of end-of-life care and predisposition to talk about death with the dying person).\u0000\u0000\u0000\u0000The ‘informal support of health-care professionals’, the ‘perception of the home as a safe space for end-of-life care’ and the ‘social support’ of family members contributed most to the feeling of safety among family members accompanying their diabetic and cancer patient family members at the end-of-life at home in Togo. Therefore, palliative and end-of-life care must be rethought in public health policies in Togo to orientate this care toward the home while providing families/caregivers with the knowledge and tools necessary to strengthen care.\u0000","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Madhuri S. Kurdi, Athira As, D. Ladhad, M. Mitragotri, Amritha Baiju
The primary objective was to compare the hypnotic efficacy of oral melatonin, oral L-theanine, and placebo in improving sleep in cancer patients with insomnia by the Athens Insomnia Scale (AIS). The secondary objective was to know the prevalence of insomnia in patients with cancer. A prospective, double-blinded, placebo-controlled study was conducted after obtaining Institutional Ethics Committee approval. One hundred and twenty patients were randomly assigned to either Group A (melatonin), Group B (L-theanine), or Group C (placebo). They were instructed to take the tablets for 14 consecutive days, two h (hours) before bedtime, and evaluated with AIS on the 1st day, 7th day, and 14th day. There were seven dropouts: Two in Group A, two in Group B, and three in Group C. Significant differences in favour of melatonin treatment were found. There were statistically significant improvements in insomnia in cancer patients on melatonin intake compared to L-theanine. L-theanine had statistically significant improvements in insomnia in comparison to placebo. The mean ± standard deviation AIS on day one in Group A was 14.82 ± 1.29; on day seven was 10.92 ± 1.12; and on day 14 was 5.00 ± 0.70. Similarly, in Group B, the mean ± standard deviation AIS was 15.39 ± 1.03, 13.05 ± 1.06, and 9.55 ± 1.01, and in Group C, the mean AIS was 14.92 ± 1.40, 14.54 ± 1.35 and 13.05 ± 1.61 on the 1st, 7th and 10th day, respectively. There was an improvement in sleep from 1 to 7 days, 7 days to 14 days, and 1 day to 14 days in all the groups (P < 0.005). The hypnotic efficacy of oral melatonin 3 mg was better than oral L-theanine 200 mg in cancer patients having insomnia. Furthermore, L-theanine had a better hypnotic efficacy when compared to a placebo.
{"title":"Comparison Between Efficacy of Oral Melatonin and Oral L-theanine in Improving Sleep in Cancer Patients Suffering From Insomnia: A Randomised Double-blinded Placebo-controlled Study","authors":"Madhuri S. Kurdi, Athira As, D. Ladhad, M. Mitragotri, Amritha Baiju","doi":"10.25259/ijpc_89_2023","DOIUrl":"https://doi.org/10.25259/ijpc_89_2023","url":null,"abstract":"\u0000\u0000The primary objective was to compare the hypnotic efficacy of oral melatonin, oral L-theanine, and placebo in improving sleep in cancer patients with insomnia by the Athens Insomnia Scale (AIS). The secondary objective was to know the prevalence of insomnia in patients with cancer.\u0000\u0000\u0000\u0000A prospective, double-blinded, placebo-controlled study was conducted after obtaining Institutional Ethics Committee approval. One hundred and twenty patients were randomly assigned to either Group A (melatonin), Group B (L-theanine), or Group C (placebo). They were instructed to take the tablets for 14 consecutive days, two h (hours) before bedtime, and evaluated with AIS on the 1st day, 7th day, and 14th day.\u0000\u0000\u0000\u0000There were seven dropouts: Two in Group A, two in Group B, and three in Group C. Significant differences in favour of melatonin treatment were found. There were statistically significant improvements in insomnia in cancer patients on melatonin intake compared to L-theanine. L-theanine had statistically significant improvements in insomnia in comparison to placebo. The mean ± standard deviation AIS on day one in Group A was 14.82 ± 1.29; on day seven was 10.92 ± 1.12; and on day 14 was 5.00 ± 0.70. Similarly, in Group B, the mean ± standard deviation AIS was 15.39 ± 1.03, 13.05 ± 1.06, and 9.55 ± 1.01, and in Group C, the mean AIS was 14.92 ± 1.40, 14.54 ± 1.35 and 13.05 ± 1.61 on the 1st, 7th and 10th day, respectively. There was an improvement in sleep from 1 to 7 days, 7 days to 14 days, and 1 day to 14 days in all the groups (P < 0.005).\u0000\u0000\u0000\u0000The hypnotic efficacy of oral melatonin 3 mg was better than oral L-theanine 200 mg in cancer patients having insomnia. Furthermore, L-theanine had a better hypnotic efficacy when compared to a placebo.\u0000","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141016927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：