This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. Wojciech Leppert 2 Chair of Palliative Medicine, Institute of Medical Sciences, Collegium Medicum University of Zielona Góra, Poland University Clinical Hospital in Poznań, Poland
{"title":"Palliative and supportive care: progress needed in clinical care, research and education","authors":"Wojciech Leppert","doi":"10.5603/pmp.97571","DOIUrl":"https://doi.org/10.5603/pmp.97571","url":null,"abstract":"This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. Wojciech Leppert 2 Chair of Palliative Medicine, Institute of Medical Sciences, Collegium Medicum University of Zielona Góra, Poland University Clinical Hospital in Poznań, Poland","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135199541","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}
Leszek Pawłowski, Iga Pawłowska, Sofiya Shunkina, Wojciech Leppert, Natalia Krzyżaniak, Monika Lichodziejewska-Niemierko
The Russian invasion of Ukraine has caused a serious humanitarian crisis. The Ukrainian healthcare system has collapsed and many healthcare institutions, including palliative care facilities, have been destroyed. In Poland, hospices and palliative care centres, non-governmental and public organizations, local authorities as well as individual citizens have been involved in the provision of care and other forms of support for palliative care patients who fled Ukraine. Due to the implementation of new regulations, 1.5 million refugees have been granted access to Polish public services. The rapid aid response for Ukrainian refugees has provided these patients with dignity, by meeting their basic needs, and allowed them to experience some level of peace in a deeply troubling time. Palliat Med Pract 2023; 17, 3: 164
{"title":"The Polish palliative care response to the war in Ukraine and the subsequent humanitarian crisis","authors":"Leszek Pawłowski, Iga Pawłowska, Sofiya Shunkina, Wojciech Leppert, Natalia Krzyżaniak, Monika Lichodziejewska-Niemierko","doi":"10.5603/pmpi.a2023.0018","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0018","url":null,"abstract":"The Russian invasion of Ukraine has caused a serious humanitarian crisis. The Ukrainian healthcare system has collapsed and many healthcare institutions, including palliative care facilities, have been destroyed. In Poland, hospices and palliative care centres, non-governmental and public organizations, local authorities as well as individual citizens have been involved in the provision of care and other forms of support for palliative care patients who fled Ukraine. Due to the implementation of new regulations, 1.5 million refugees have been granted access to Polish public services. The rapid aid response for Ukrainian refugees has provided these patients with dignity, by meeting their basic needs, and allowed them to experience some level of peace in a deeply troubling time. Palliat Med Pract 2023; 17, 3: 164","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135244455","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}
Justyna Sraga, Katarzyna Zmarlak, Weronika Szajnowska, Ilona Kuźmicz, Ewa Kawalec-Kajstura
Penile cancer is a rare malignant neoplasm, occurring mainly in men in their sixties and seventies. The consequences of treatment often include a severely disturbed perception of one’s body image, lowered self-esteem and difficulties in daily functioning, which can result in reduced satisfaction with further life. This study aimed to assess the life satisfaction and level of acceptance of illness of a 42-year-old patient after penectomy in the course of cancer. The following tools were applied in the study: the authors’ own questionnaire, the Acceptance of Illness Scale (AIS) and the Satisfaction With Life Scale (SWLS). The patient surveyed scored 38 out of 40 on the AIS scale, indicating that he accepted his illness, while on the SWLS scale, he scored the maximum number of points indicating a high overall sense of satisfaction with life. The patient did not report any difficulties in terms of daily functioning resulting from the diagnosed disease and the treatment administered.
{"title":"Acceptance of illness and satisfaction with the life of the patient after penectomy","authors":"Justyna Sraga, Katarzyna Zmarlak, Weronika Szajnowska, Ilona Kuźmicz, Ewa Kawalec-Kajstura","doi":"10.5603/pmpi.a2023.0020","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0020","url":null,"abstract":"Penile cancer is a rare malignant neoplasm, occurring mainly in men in their sixties and seventies. The consequences of treatment often include a severely disturbed perception of one’s body image, lowered self-esteem and difficulties in daily functioning, which can result in reduced satisfaction with further life. This study aimed to assess the life satisfaction and level of acceptance of illness of a 42-year-old patient after penectomy in the course of cancer. The following tools were applied in the study: the authors’ own questionnaire, the Acceptance of Illness Scale (AIS) and the Satisfaction With Life Scale (SWLS). The patient surveyed scored 38 out of 40 on the AIS scale, indicating that he accepted his illness, while on the SWLS scale, he scored the maximum number of points indicating a high overall sense of satisfaction with life. The patient did not report any difficulties in terms of daily functioning resulting from the diagnosed disease and the treatment administered.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135244229","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}
Filip Lebiedziński, Bartosz Kaniowski, Grzegorz Loroch
{"title":"Report from the 16th International Conference of the Journal “Palliative Medicine in Practice”","authors":"Filip Lebiedziński, Bartosz Kaniowski, Grzegorz Loroch","doi":"10.5603/pmpi.a2023.0028","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0028","url":null,"abstract":"","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135296079","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}
Background: This article aims to conduct a systematic review of the present literature and assess the use of intra-discal steroids injection (IDSI) for patients suffering from chronic discogenic back pain irresponsive to conservative treatment. Methods: The search was conducted in PubMed, PubMed Central, Cochrane, Scopus, Embase, and Google Scholar databases between 1990 and 2021. Included were studies assessing the administration of IDSI to adults suffering from chronic discogenic back pain. Studies evaluating combination interventions were excluded. The quality of evidence was determined by the GRADE assessment. The PROSPERO registration number for the review is CRD42022307690. Results: Eight studies enrolling a total of 548 patients were finally included in the systematic review. A significant reduction in pain scores after IDSI was calculated one month after intervention [standardized mean difference (SMD) −1.32 (−2.32, −0.31), p = 0.01, I2 = 89%]. This effect was not sustained at three- six- and twelve-month assessments. The analysis revealed no therapeutic benefit of intra-discal steroids for disability and activity limitation at one month, [SMD −0.76 (−1.88, 0.36), p = 0.18, I2 = 92%], three-, six- or twelve-months intervals. Overall, the quality of effect estimates was found to be moderate. Conclusions: The authors believe that Intradiscal steroid therapy can only be used as a bridge therapy for short-term pain relief while the patient with chronic discogenic pain awaits another intervention or surgery.
{"title":"Intradiscal steroid therapy in chronic discogenic pain: a systematic review of literature","authors":"Priyanka Mishra, Sonal Goyal, Robina Makker","doi":"10.5603/pmpi.a2023.0014","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0014","url":null,"abstract":"Background: This article aims to conduct a systematic review of the present literature and assess the use of intra-discal steroids injection (IDSI) for patients suffering from chronic discogenic back pain irresponsive to conservative treatment. Methods: The search was conducted in PubMed, PubMed Central, Cochrane, Scopus, Embase, and Google Scholar databases between 1990 and 2021. Included were studies assessing the administration of IDSI to adults suffering from chronic discogenic back pain. Studies evaluating combination interventions were excluded. The quality of evidence was determined by the GRADE assessment. The PROSPERO registration number for the review is CRD42022307690. Results: Eight studies enrolling a total of 548 patients were finally included in the systematic review. A significant reduction in pain scores after IDSI was calculated one month after intervention [standardized mean difference (SMD) −1.32 (−2.32, −0.31), p = 0.01, I2 = 89%]. This effect was not sustained at three- six- and twelve-month assessments. The analysis revealed no therapeutic benefit of intra-discal steroids for disability and activity limitation at one month, [SMD −0.76 (−1.88, 0.36), p = 0.18, I2 = 92%], three-, six- or twelve-months intervals. Overall, the quality of effect estimates was found to be moderate. Conclusions: The authors believe that Intradiscal steroid therapy can only be used as a bridge therapy for short-term pain relief while the patient with chronic discogenic pain awaits another intervention or surgery.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135199237","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}
{"title":"Student exams during the COVID-19 pandemic","authors":"Zbigniew Żylicz","doi":"10.5603/pmp.96471","DOIUrl":"https://doi.org/10.5603/pmp.96471","url":null,"abstract":"","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"313 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135199231","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}
Muhammad Luthfi Adnan, Widyo Nugroho Utomo, Miranti Dewi Pramaningtyas
Introduction: Long-term treatment and associated side effects can affect a patient's quality of life, one of which is the patient's regret during the treatment program of prostate cancer. The Decision Aid (DA) program can help patients with chronic diseases to face disease treatment, but the effect on the treatment of prostate cancer patients has not been evaluated further. This study aims to assess the effect of a decision aid program on treatment regret in prostate cancer patients. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines with the search engines PubMed and Google Scholar from January–March 2023. The inclusion criteria used were randomized controlled-trial studies with full text in English, published for the last ten years, the decision regret during or after treatment program was reported and the type of regret measurement was described. Results: Based on a literature search, 5 studies met the inclusion criteria. The relationship between decision aid and regret was not significantly lower, but has significant effect for long-term (12 months) and in minority ethnic. Studies on a wider and heterogeneous population are needed to assess the effect of decision aids on the perspective of patients with prostate cancer programs. Conclusions: Decision aid may affect the level of regret of prostate cancer patients in the treatment program.
{"title":"Decision aid program affect regret in patients with prostate cancer treatment: a systematic review of randomized controlled trials","authors":"Muhammad Luthfi Adnan, Widyo Nugroho Utomo, Miranti Dewi Pramaningtyas","doi":"10.5603/pmp.96856","DOIUrl":"https://doi.org/10.5603/pmp.96856","url":null,"abstract":"Introduction: Long-term treatment and associated side effects can affect a patient's quality of life, one of which is the patient's regret during the treatment program of prostate cancer. The Decision Aid (DA) program can help patients with chronic diseases to face disease treatment, but the effect on the treatment of prostate cancer patients has not been evaluated further. This study aims to assess the effect of a decision aid program on treatment regret in prostate cancer patients. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines with the search engines PubMed and Google Scholar from January–March 2023. The inclusion criteria used were randomized controlled-trial studies with full text in English, published for the last ten years, the decision regret during or after treatment program was reported and the type of regret measurement was described. Results: Based on a literature search, 5 studies met the inclusion criteria. The relationship between decision aid and regret was not significantly lower, but has significant effect for long-term (12 months) and in minority ethnic. Studies on a wider and heterogeneous population are needed to assess the effect of decision aids on the perspective of patients with prostate cancer programs. Conclusions: Decision aid may affect the level of regret of prostate cancer patients in the treatment program.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135491242","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 discontinuation of life-sustaining therapy has been the subject of dispute for many years. Despite the guidelines, which were created to facilitate the resolution of disputes between the doctor (hospital) and the patient (family, surrogate), new cases of seriously ill patients continue to emerge and stir up controversy. One such case was the RS case. A Polish citizen living in the UK suffered severe brain damage as a result of cardiac arrest. The hospital applied to the court to withdraw ventilation, hydration, and nutrition for RS. The judge ultimately ruled that it was in RS’s best interest to withdraw ventilation and nutrition, but he left the decision on hydration to RS’s wife and the hospital. The court’s ruling has stirred up controversy among the Polish public. Some Polish doctors assessed the UK court’s decision as “legal murder” and “euthanasia”. I believe that it is worth examining the RS case for at least two reasons. Firstly, it provides a better understanding of the difference in approaches to therapy cessation in the UK and Poland. Secondly, many Poles live in the UK, and therefore similar disputes may arise in the future. In this paper, I point out several differences between the British and Polish approaches to discontinuing life-sustaining therapy. These differences are focused on the definitions of medical futility and persistent therapy, best interest and dignity, and quality of life and sanctity of life.
{"title":"Why is the approach to discontinuing life-sustaining treatment different in the UK and Poland? Based on the case of RS","authors":"Marcin Paweł Ferdynus","doi":"10.5603/pmp.96886","DOIUrl":"https://doi.org/10.5603/pmp.96886","url":null,"abstract":"The discontinuation of life-sustaining therapy has been the subject of dispute for many years. Despite the guidelines, which were created to facilitate the resolution of disputes between the doctor (hospital) and the patient (family, surrogate), new cases of seriously ill patients continue to emerge and stir up controversy. One such case was the RS case. A Polish citizen living in the UK suffered severe brain damage as a result of cardiac arrest. The hospital applied to the court to withdraw ventilation, hydration, and nutrition for RS. The judge ultimately ruled that it was in RS’s best interest to withdraw ventilation and nutrition, but he left the decision on hydration to RS’s wife and the hospital. The court’s ruling has stirred up controversy among the Polish public. Some Polish doctors assessed the UK court’s decision as “legal murder” and “euthanasia”. I believe that it is worth examining the RS case for at least two reasons. Firstly, it provides a better understanding of the difference in approaches to therapy cessation in the UK and Poland. Secondly, many Poles live in the UK, and therefore similar disputes may arise in the future. In this paper, I point out several differences between the British and Polish approaches to discontinuing life-sustaining therapy. These differences are focused on the definitions of medical futility and persistent therapy, best interest and dignity, and quality of life and sanctity of life.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136035600","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 case report highlights the possibility of discharging terminally ill and intubated patients from the emergency department (ED) for home extubation. Many barriers exist in the ED that hinders home extubation for elderly palliative patients. Patients intubated in the ED are typically admitted to an intensive care unit or hospice. However, we present the case of a 93-year-old female patient brought to the ED due to altered consciousness, who experienced a sudden cardiac arrest, and subsequently received resuscitation and intubation. The patient's family expressed their desire to have her discharged for end-of-life care at home. By establishing effective communication and cooperation between a palliative care team, the ED staff, and the family members, a discharge care plan was developed to facilitate home extubation. The patient passed away peacefully within 40 hours of extubation, surrounded by her loved ones. This case exemplifies the feasibility of discharging terminally ill and intubated patients discharging from the ED for home extubation.
{"title":"Home extubation in a terminally ill older patient visiting emergency department","authors":"Pasitpon Vatcharavongvan","doi":"10.5603/pmp.96125","DOIUrl":"https://doi.org/10.5603/pmp.96125","url":null,"abstract":"This case report highlights the possibility of discharging terminally ill and intubated patients from the emergency department (ED) for home extubation. Many barriers exist in the ED that hinders home extubation for elderly palliative patients. Patients intubated in the ED are typically admitted to an intensive care unit or hospice. However, we present the case of a 93-year-old female patient brought to the ED due to altered consciousness, who experienced a sudden cardiac arrest, and subsequently received resuscitation and intubation. The patient's family expressed their desire to have her discharged for end-of-life care at home. By establishing effective communication and cooperation between a palliative care team, the ED staff, and the family members, a discharge care plan was developed to facilitate home extubation. The patient passed away peacefully within 40 hours of extubation, surrounded by her loved ones. This case exemplifies the feasibility of discharging terminally ill and intubated patients discharging from the ED for home extubation.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136214992","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}
Parkinson's disease is the most common neurodegenerative disease. Until recently, the treatment was focused on dopamine deficiency and enabling patient activity. Much less attention was paid to the cognitive impairment and non-motor symptoms of the disease. Dementia, hallucinations and delusions are the most common cognitive disorder influencing a patient's quality of life. Hallucinations are probably the most common and bothersome non-motoric symptom. This paper discusses the diagnosis and treatment of hallucinations with atypical antipsychotics and possible alternatives. We also suggest a sensible approach for patients with hallucinations and delusions.
{"title":"Diagnosis and treatment of hallucinations in elderly palliative care patients with Parkinson’s disease","authors":"Karolina Ochyra, Zbigniew Żylicz","doi":"10.5603/pmpi.a2023.0029","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0029","url":null,"abstract":"Parkinson's disease is the most common neurodegenerative disease. Until recently, the treatment was focused on dopamine deficiency and enabling patient activity. Much less attention was paid to the cognitive impairment and non-motor symptoms of the disease. Dementia, hallucinations and delusions are the most common cognitive disorder influencing a patient's quality of life. Hallucinations are probably the most common and bothersome non-motoric symptom. This paper discusses the diagnosis and treatment of hallucinations with atypical antipsychotics and possible alternatives. We also suggest a sensible approach for patients with hallucinations and delusions.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135841307","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}
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