PROGRESS IN PALLIATIVE CARE最新文献_第2页

Integrating palliative care into primary health care: Indian perspectives 将姑息治疗纳入初级卫生保健:印度人的观点

IF 1.7 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

PROGRESS IN PALLIATIVE CARE

Pub Date : 2023-08-27 DOI: 10.1080/09699260.2023.2241799

Radhika R. Pai, Malathi G. Nayak, Anita Jesline Serrao, N. Salins

Access to palliative care is essential in primary healthcare as most patients and families prefer end-of-life care at home. However, integrating palliative care into the community is often lacking, disrupting the continuity of care. In a low-middle-income country like India, palliative care is usually provided in tertiary and secondary hospitals. Primary palliative care is sporadically offered in some parts of India, like Kerala, through a neighbourhood network of palliative care (NNPC) programmes. The availability of trained providers, funding, and awareness, limits the capacity to provide primary palliative care. It leads to people accessing care at their end of life in acute hospitals, receiving unnecessary medical interventions, and diminishing their quality of dying. The need for developing palliative care in the community in a low-middle-income country like India is explicated here.

获得姑息治疗在初级卫生保健中至关重要，因为大多数患者和家属更喜欢在家中进行临终关怀。然而，往往缺乏将姑息治疗纳入社区，从而破坏了护理的连续性。在印度这样的中低收入国家，姑息治疗通常由三级和二级医院提供。在印度的一些地区，如喀拉拉邦，通过社区姑息治疗规划网络偶尔提供初级姑息治疗。缺乏训练有素的医务人员、资金和认识限制了提供初级姑息治疗的能力。它导致人们在生命的最后阶段在急症医院接受治疗，接受不必要的医疗干预，并降低了他们的死亡质量。在像印度这样的中低收入国家，需要在社区发展姑息治疗。

引用次数: 0

Volunteer experiences at a hospice for homeless individuals during the COVID-19 pandemic 新冠肺炎大流行期间无家可归者收容所的志愿者体验

IF 1.7 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

PROGRESS IN PALLIATIVE CARE

Pub Date : 2023-08-27 DOI: 10.1080/09699260.2023.2241791

A. Kamimura, S. Panahi, Ashley Kang, K. C. Whitesitt, Jeanie Ashby, Jill Olmsted

Context Volunteers provide important social support for homeless people. While motivations of the volunteer population for homeless people have been studied, little is known about volunteers for a hospice targeting the homeless population. Objectives The purpose of this study is to describe volunteer experiences and motivation at a hospice for homeless people during the COVID-19 pandemic. Methods This study was conducted at a hospice for homeless individuals in Fall 2021. Data were collected by six virtual focus groups in November and December 2021. There were 21 participants. The recordings of the focus groups were automatically transcribed via ZOOM. The data were analyzed based on themes. Results This study has highlighted three main findings. First, honoring a loved one and being engaged in the community were two main reasons individuals began volunteering at the hospice center. Second, volunteers faced many challenges during the COVID-19 pandemic, including a slow start, increased use of technology, and constant change in volunteers’ responsibilities due to safety reasons. During this time however, volunteers felt much support from the program staff. Third, interactions with staff, other volunteers and residents were the main reasons driving volunteer motivation. Conclusions This project examined the under-studied subject of volunteers’ experiences at a hospice for homeless people and provided insight in this topic. While the COVID-19 pandemic affected volunteering at a hospice for homeless people, support from the program staff and leadership helped sustain volunteer motivation.

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引用次数: 0

Exploring the awareness, knowledge and perceptions of palliative care at end-of-life in a Canadian population 探索意识，知识和看法的临终关怀在加拿大人口

IF 1.7 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

PROGRESS IN PALLIATIVE CARE

Pub Date : 2023-08-08 DOI: 10.1080/09699260.2023.2241789

Priya Patel, S. Koppikar, Lily Spoozak, L. Lyons

Background The role of palliative care (PC) in chronic disease and end-of-life (EOL) management is rapidly evolving. However, studies globally have demonstrated limited public knowledge and awareness of PC with several misconceptions. Objective The purpose was to expand upon previous Canadian studies by providing more current and detailed information about the awareness, knowledge and perceptions of PC in EOL management. Additionally, the reliability of self-reported PC knowledge was explored. Methods A cross-sectional study using an 8-item questionnaire was conducted at an urban medical centre with 100 adults. Descriptive statistics and Chi-square tests were used for analyses. Results Ninety-one participants had heard of PC, while 58 reported being knowledgeable of PC services. Females were significantly more knowledgeable than males (p < 0.05). Most participants knew that PC improves a patient’s quality of life (n = 71), would not shorten life in a dying individual (n = 71) and can be provided in locations outside of the hospital (n = 72). Many indicated that involving PC services would not make them feel like they were giving up hope. There was less awareness around when to involve PC services, as there were mixed answers to whether PC is only needed if someone is dying from an illness. Two-thirds of participants who reported being knowledgeable of PC answered at least 75% of questions correctly. Conclusion Participants were quite aware and knowledgeable of PC but would benefit from education about the PC role in both chronic disease and EOL management. Self-reported knowledge was a fairly reliable indicator of true knowledge in this study.

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引用次数: 0

A comparison of symptom management and utilization of specialist palliative care in the early COVID-19 pandemic: A multi-site retrospective chart review COVID-19大流行早期症状管理和专科姑息治疗应用的比较:一项多地点回顾性图表综述

IF 1.7 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

PROGRESS IN PALLIATIVE CARE

Pub Date : 2023-08-08 DOI: 10.1080/09699260.2023.2241784

Madelaine Baetz-Dougan, J. Guan, B. Henry, K. Stilos, Desmond D. Leung, Niren Shetty, Shruti Gupta, A. Chakraborty

Background: COVID-19 is associated with high rates of morbidity and mortality. Previous work has described symptom management provided by specialists in palliative care for COVID-19 patients. However, there is a paucity of literature describing primary level palliative care provided by general internal medicine teams or reasons for referral to specialists. Objective: Our aim was to describe and compare the following outcomes for patients dying of COVID-19: (1) symptom management by acute care providers and palliative care specialists, and (2) utilization of palliative care consultation across two acute care hospitals in Toronto, Ontario during the onset of the COVID-19 pandemic. Methods: We undertook a retrospective chart review of 45 adult inpatients diagnosed with COVID-19 between 23 January 2020 to 19 May 2020 who died, and/or those who had a palliative care consultation. Findings: Forty-one of the 45 patients died. Common symptoms were shortness of breath and agitation. For these symptoms, pharmacologic management was not significantly different for patients seen by palliative care compared to those without consultation. Most consultations were for end-of-life care. There were significantly more palliative care consults for COVID-19 patients at one hospital (P=.001). Conclusion: The findings highlight the significant discrepancy in involvement of specialist palliative care between settings. More research is needed to validate the initial findings from this small sample size, understand the needs of palliative care providers in this setting, and appreciate the factors influencing consultation.

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引用次数: 0

Differences in patients accessing inpatient versus outpatient palliative care at time of referral at a cancer centre 患者在癌症中心转诊时获得住院与门诊姑息治疗的差异

IF 1.7 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

PROGRESS IN PALLIATIVE CARE

Pub Date : 2023-08-08 DOI: 10.1080/09699260.2023.2241798

David Marco, A. Collins, B. Le, J. Philip

Outpatient palliative care clinics are a new and developing area of service delivery that can respond to increasing demand and facilitate earlier contact in the illness trajectory. Work is needed to standardise the criteria for referral to outpatient palliative care services and clarify which patients are likely to benefit the most from this mode of support. This study aimed to describe the demographic, clinical and symptom profile, and survival of patients referred to a newly established hospital-based integrated palliative care program. Comparisons were made between patients initially seen as outpatients versus those seen as inpatients. A retrospective population was identified from routinely collected hospital admitted inpatient and ambulatory databases comprising adult cancer patients receiving a new referral to the service during a 6-month period. Patients were grouped into two cohorts according to the setting of their first palliative care assessment and followed to death or study censor date. During the study period, 473 new referrals were made comprising 229 (48%) patients initially seen as outpatients and 244 (52%) initially seen as inpatients. The outpatient cohort had higher performance status, experienced higher symptom burden, lived longer, had fewer inpatient admissions, and received earlier referral to palliative care resulting in greater palliative care involvement up to their death (all p < .05). Early palliative care can be effectively delivered by an outpatient palliative care service for cancer patients who are experiencing symptom burden but are otherwise functional. These cases lived longer and had fewer subsequent inpatient visits, demonstrating the preliminary effectiveness of this integrated service.

门诊姑息治疗诊所是一个新的、不断发展的服务提供领域，可以应对日益增长的需求，并促进疾病轨迹中的早期接触。需要努力标准化转诊到门诊姑息治疗服务的标准，并澄清哪些患者可能从这种支持模式中受益最大。本研究旨在描述新建立的以医院为基础的综合姑息治疗项目患者的人口统计学、临床和症状特征以及生存率。将最初被视为门诊患者的患者与被视为住院患者的患者进行比较。从常规收集的住院患者和流动数据库中确定了一个回顾性人群，包括在6个月内接受新转诊的成年癌症患者。根据首次姑息治疗评估的设置，患者被分为两组，并随访至死亡或研究审查日期。在研究期间，473名新的转诊患者被转诊，其中229名（48%）患者最初被视为门诊患者，244名（52%）患者最初为住院患者。门诊队列的表现状态更高，症状负担更高，寿命更长，住院人数更少，并且更早地接受姑息治疗转诊，导致更多的姑息治疗参与，直到死亡（所有p < .05）。早期姑息治疗可以通过门诊姑息治疗服务有效地为癌症患者提供，这些患者正在经历症状负担，但在其他方面功能正常。这些病例的寿命更长，随后的住院就诊次数更少，这表明了这种综合服务的初步有效性。

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引用次数: 0

Nurses’ challenges in the end-of-life care of patients with COVID-19: A qualitative study 护士在COVID-19患者临终关怀中的挑战:一项定性研究

IF 1.7 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

PROGRESS IN PALLIATIVE CARE

Pub Date : 2023-08-03 DOI: 10.1080/09699260.2023.2241785

Hadiseh Monadi Ziarat, M. Mardani-Hamooleh, N. Seyedfatemi, Akram Salamat

The coronavirus disease 2019 (COVID-19) pandemic has brought rapid changes in end-of-life care for nurses and patients. The aim of this study was to explain the Iranian nurses’ perception of challenges in providing end-of-life care for patients with COVID-19. The present study is a qualitative research with content analysis approach. A total of 32 nurses participated in this study. Semi-structural and individual interviews were conducted. Nurses’ narratives indicated that, the challenges of end-of-life care of patients with COVID-19 can be classified in two categories of undesirable care and problems with family support. The category of undesirable care had two subcategories of low quality care and futile care. The category of problems with family support also had two subcategories of lack of family support at the time of hospitalization and lack of a support system for family after the patient's death. The health system, and in particular nursing managers, should strive to formulate clear rules and regulations and design the necessary protocols that are effective in addressing the nurses’ challenges in end-of-life care of COVID-19 patient.

2019年冠状病毒病(COVID-19)大流行给护士和患者的临终关怀带来了快速变化。本研究的目的是解释伊朗护士对为COVID-19患者提供临终关怀的挑战的看法。本研究采用内容分析法进行定性研究。共有32名护士参与了本研究。进行了半结构访谈和个别访谈。护士的叙述表明，COVID-19患者临终关怀的挑战可分为两类:不受欢迎的护理和家庭支持问题。不良护理类别分为低质量护理和无效护理两类。家庭支持方面的问题类别还有两个子类别，即住院时缺乏家庭支持和患者死后缺乏家庭支持系统。卫生系统，特别是护理管理者应努力制定明确的规章制度，设计必要的方案，有效应对护士在COVID-19患者临终关怀中的挑战。

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引用次数: 0

Thyroid Dysfunction after Atezolizumab and Bevacizumab Is Associated with Favorable Outcomes in Hepatocellular Carcinoma. 肝细胞癌患者使用阿特珠单抗和贝伐珠单抗后出现甲状腺功能障碍与预后有关

IF 13.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

PROGRESS IN PALLIATIVE CARE

Pub Date : 2023-05-25 eCollection Date: 2024-02-01 DOI: 10.1159/000531182

Young Shin Song, Hannah Yang, Beodeul Kang, Jaekyung Cheon, Ilhwan Kim, Hyeyeong Kim, Won Suk Lee, Yun Beom Sang, Sanghoon Jung, Ho Yeong Lim, Vincent E Gaillard, Chan Kim, Hong Jae Chon

Introduction: Atezolizumab and bevacizumab (Ate/Bev) combination has become the new first-line systemic therapy for unresectable hepatocellular carcinoma (HCC). Although several studies reported thyroid dysfunction after treatment with immune checkpoint inhibitors, the clinical and immunological significance of thyroid dysfunction in patients treated with Ate/Bev has not been comprehensively addressed. We aimed to comprehensively evaluate the clinical and immunological implications of thyroid dysfunction in unresectable HCC patients treated with Ate/Bev.

Methods: We enrolled 208 patients with unresectable HCC treated with Ate/Bev from three Korean cancer centers. Thyroid adverse events (AEs) were reviewed, and cytokines and T cells in the blood samples were analyzed at baseline. For external validation, we analyzed clinical outcomes according to thyroid AEs in patients treated with Ate/Bev in the IMbrave150 study.

Results: Forty-one (19.7%) out of 208 patients experienced thyroid dysfunction (hypothyroidism [17.3%] and thyrotoxicosis [5.8%]) after Ate/Bev treatment. Median time to onset of hypothyroidism and thyrotoxicosis after Ate/Bev treatment was 3.5 and 1.3 months, respectively. Patients with thyroid AEs demonstrated significantly better progression-free survival, overall survival, and objective response rate than those without thyroid AEs. These findings were still consistent even after adjusting for confounding factors. Furthermore, favorable survival outcomes in patients with thyroid AEs were also validated in a cohort of IMbrave150 patients. While patients with thyrotoxicosis showed a significantly lower level of baseline IL-6, those with hypothyroidism did not show significant differences in circulating cytokine levels and CD8⁺ T-cell fractions.

Conclusions: A fraction of patients with HCC treated with Ate/Bev experienced thyroid dysfunction, and the development of thyroid AEs was associated with favorable clinical outcomes.

简介阿特珠单抗和贝伐单抗（Ate/Bev）联合疗法已成为治疗不可切除肝细胞癌（HCC）的新一线系统疗法。尽管有多项研究报道了免疫检查点抑制剂治疗后的甲状腺功能障碍，但Ate/Bev治疗患者甲状腺功能障碍的临床和免疫学意义尚未得到全面探讨。我们旨在全面评估接受Ate/Bev治疗的不可切除HCC患者甲状腺功能障碍的临床和免疫学意义：我们从韩国三家癌症中心招募了208名接受Ate/Bev治疗的不可切除HCC患者。我们对甲状腺不良事件（AEs）进行了审查，并对基线血液样本中的细胞因子和 T 细胞进行了分析。为了进行外部验证，我们根据IMbrave150研究中接受Ate/Bev治疗的患者的甲状腺AEs分析了临床结果：结果：208 例患者中有 41 例（19.7%）在接受 Ate/Bev 治疗后出现甲状腺功能障碍（甲状腺功能减退 [17.3%] 和甲状腺毒症 [5.8%]）。Ate/Bev 治疗后出现甲减和甲亢的中位时间分别为 3.5 个月和 1.3 个月。与未出现甲状腺AEs的患者相比，出现甲状腺AEs的患者的无进展生存期、总生存期和客观反应率明显更佳。即使在调整了混杂因素后，这些结果仍然是一致的。此外，甲状腺 AEs 患者的良好生存结果也在 IMbrave150 患者队列中得到了验证。虽然甲亢患者的基线IL-6水平明显较低，但甲状腺功能减退患者的循环细胞因子水平和CD8+ T细胞比例并无明显差异：结论：一部分接受Ate/Bev治疗的HCC患者会出现甲状腺功能障碍，甲状腺AE的发生与良好的临床预后有关。

{"title":"Thyroid Dysfunction after Atezolizumab and Bevacizumab Is Associated with Favorable Outcomes in Hepatocellular Carcinoma.","authors":"Young Shin Song, Hannah Yang, Beodeul Kang, Jaekyung Cheon, Ilhwan Kim, Hyeyeong Kim, Won Suk Lee, Yun Beom Sang, Sanghoon Jung, Ho Yeong Lim, Vincent E Gaillard, Chan Kim, Hong Jae Chon","doi":"10.1159/000531182","DOIUrl":"10.1159/000531182","url":null,"abstract":"Introduction: Atezolizumab and bevacizumab (Ate/Bev) combination has become the new first-line systemic therapy for unresectable hepatocellular carcinoma (HCC). Although several studies reported thyroid dysfunction after treatment with immune checkpoint inhibitors, the clinical and immunological significance of thyroid dysfunction in patients treated with Ate/Bev has not been comprehensively addressed. We aimed to comprehensively evaluate the clinical and immunological implications of thyroid dysfunction in unresectable HCC patients treated with Ate/Bev.Methods: We enrolled 208 patients with unresectable HCC treated with Ate/Bev from three Korean cancer centers. Thyroid adverse events (AEs) were reviewed, and cytokines and T cells in the blood samples were analyzed at baseline. For external validation, we analyzed clinical outcomes according to thyroid AEs in patients treated with Ate/Bev in the IMbrave150 study.Results: Forty-one (19.7%) out of 208 patients experienced thyroid dysfunction (hypothyroidism [17.3%] and thyrotoxicosis [5.8%]) after Ate/Bev treatment. Median time to onset of hypothyroidism and thyrotoxicosis after Ate/Bev treatment was 3.5 and 1.3 months, respectively. Patients with thyroid AEs demonstrated significantly better progression-free survival, overall survival, and objective response rate than those without thyroid AEs. These findings were still consistent even after adjusting for confounding factors. Furthermore, favorable survival outcomes in patients with thyroid AEs were also validated in a cohort of IMbrave150 patients. While patients with thyrotoxicosis showed a significantly lower level of baseline IL-6, those with hypothyroidism did not show significant differences in circulating cytokine levels and CD8+ T-cell fractions.Conclusions: A fraction of patients with HCC treated with Ate/Bev experienced thyroid dysfunction, and the development of thyroid AEs was associated with favorable clinical outcomes.","PeriodicalId":45106,"journal":{"name":"PROGRESS IN PALLIATIVE CARE","volume":"15 1","pages":"89-98"},"PeriodicalIF":13.8,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10857827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87550304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Auriculotherapy to manage chemotherapy-induced nausea and vomiting in patients with cancer: a systematic review 听觉疗法治疗癌症患者化疗引起的恶心和呕吐：一项系统综述

IF 1.7 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

PROGRESS IN PALLIATIVE CARE

Pub Date : 2023-01-20 DOI: 10.1080/09699260.2022.2152168

E. Paiva, Si-jia Zhu, Yuan Chi, Ramon A. Oliveira, C. Moura, Ana Cláudia M. Garcia

Objective To assess the effects of auriculotherapy for the management of CINV in cancer patients. Methods This is a systematic review of randomized controlled trials (RCTs). We searched MEDLINE via PubMed, AMED, Biblio Auriculo, Embase, CINAHL, CENTRAL, BVS, MTCI Américas, Web of Science, Scopus, PEDro, CNKI, CBMdisc, and CSJD-VIP databases up to September 2021 with no language restrictions. Results We included 25 studies with a total of 2,167 randomized participants. The results of the included studies suggest positive effects of auriculotherapy for the control of CINV, however 92% studies presented a high risk of bias overall. In the included studies, the most used auricular acupoints in the studies were the stomach (CO4) (n = 24, 96%), shenmen (TF4) (n = 23, 92%), sympathetic nerve (AH6a) (n = 15, 60%), spleen (CO13) (n = 14, 56%), liver (CO12) (n = 11, 44%), subcortex (AT4) (n = 10, 40%), and cardia (CO3) (n = 9, 36%). Conclusions It was not possible to assess the effectiveness of auriculotherapy for the management of CINV due to the great heterogeneity of the studies regarding the form of evaluating the outcome, the application of auriculotherapy, and the high risk of bias. It is suggested that robust clinical trials be conducted and reported according to the STRICTA guidelines.

目的探讨耳穴疗法对肿瘤患者CINV的治疗效果。方法对随机对照试验(rct)进行系统综述。截止到2021年9月，我们通过PubMed、AMED、Biblio Auriculo、Embase、CINAHL、CENTRAL、BVS、MTCI、am ricas、Web of Science、Scopus、PEDro、CNKI、cbdisc和CSJD-VIP数据库检索MEDLINE，无语言限制。我们纳入了25项研究，共2167名随机受试者。纳入的研究结果表明耳穴疗法对控制CINV有积极作用，但92%的研究总体上存在高偏倚风险。在纳入的研究中，研究中使用最多的耳穴为胃(CO4) (n = 24, 96%)、肾门(TF4) (n = 23, 92%)、交感神经(AH6a) (n = 15, 60%)、脾(CO13) (n = 14, 56%)、肝(CO12) (n = 11, 44%)、皮层下(AT4) (n = 10, 40%)、心(CO3) (n = 9, 36%)。结论:由于评估结果的形式、耳廓疗法的应用以及高偏倚风险等方面的研究存在很大的异质性，因此无法评估耳廓疗法治疗CINV的有效性。建议根据STRICTA指南进行可靠的临床试验并进行报告。

{"title":"Auriculotherapy to manage chemotherapy-induced nausea and vomiting in patients with cancer: a systematic review","authors":"E. Paiva, Si-jia Zhu, Yuan Chi, Ramon A. Oliveira, C. Moura, Ana Cláudia M. Garcia","doi":"10.1080/09699260.2022.2152168","DOIUrl":"https://doi.org/10.1080/09699260.2022.2152168","url":null,"abstract":"Objective To assess the effects of auriculotherapy for the management of CINV in cancer patients. Methods This is a systematic review of randomized controlled trials (RCTs). We searched MEDLINE via PubMed, AMED, Biblio Auriculo, Embase, CINAHL, CENTRAL, BVS, MTCI Américas, Web of Science, Scopus, PEDro, CNKI, CBMdisc, and CSJD-VIP databases up to September 2021 with no language restrictions. Results We included 25 studies with a total of 2,167 randomized participants. The results of the included studies suggest positive effects of auriculotherapy for the control of CINV, however 92% studies presented a high risk of bias overall. In the included studies, the most used auricular acupoints in the studies were the stomach (CO4) (n = 24, 96%), shenmen (TF4) (n = 23, 92%), sympathetic nerve (AH6a) (n = 15, 60%), spleen (CO13) (n = 14, 56%), liver (CO12) (n = 11, 44%), subcortex (AT4) (n = 10, 40%), and cardia (CO3) (n = 9, 36%). Conclusions It was not possible to assess the effectiveness of auriculotherapy for the management of CINV due to the great heterogeneity of the studies regarding the form of evaluating the outcome, the application of auriculotherapy, and the high risk of bias. It is suggested that robust clinical trials be conducted and reported according to the STRICTA guidelines.","PeriodicalId":45106,"journal":{"name":"PROGRESS IN PALLIATIVE CARE","volume":"31 1","pages":"100 - 110"},"PeriodicalIF":1.7,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46931329","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}

引用次数: 0

Referral patterns and consultation locations for a novel palliative care telehealth service 新型姑息治疗远程医疗服务的转诊模式和咨询地点

IF 1.7 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

PROGRESS IN PALLIATIVE CARE

Pub Date : 2023-01-07 DOI: 10.1080/09699260.2022.2160084

Taylan Gurgenci, Luke Nicholls, Sangitha Mensingh, A. Broadbent, Graham Grove

Background The optimal location to conduct telehealth consultations for rural Australian palliative patients was unclear prior to starting a novel palliative telehealth service in Queensland. The present study sought to collect data which may suggest the best location for such consultations so that future service provision can be planned accordingly. Methods A retrospective review of the referral patterns and demographic data between March 2020 and November 2020 was undertaken with a focus on the number of referrals, location of consultations, and the source of referrals. Results 153 referrals resulted in 526 unique consultations. All referrals in the first month came from the local public hospital. After 4 months, public hospital referrals and private family doctor referrals accounted for 30% and 50% respectively. The proportion of telehealth consultations delivered in the patient’s home increased throughout the eight-month period. There was no obvious relationship between referral source and consultation location. Conclusion The patient’s home was the preferred location for all specialist telehealth care and patient preference was the main determinant of consult location. Further research should involve qualitative analysis of these factors to optimize the delivery of this service and the design of other similar services.

背景在昆士兰开始一项新的姑息性远程医疗服务之前，为澳大利亚农村姑息性患者进行远程医疗咨询的最佳地点尚不清楚。本研究试图收集数据，这些数据可能表明进行此类咨询的最佳地点，以便对未来的服务提供进行相应规划。方法对2020年3月至2020年11月期间的转诊模式和人口统计数据进行回顾性审查，重点关注转诊数量、会诊地点和转诊来源。结果153例转诊导致526例独特会诊。第一个月的所有转诊都来自当地的公立医院。4个月后，公立医院转诊和私人家庭医生转诊分别占30%和50%。在八个月的时间里，在患者家中进行远程医疗咨询的比例有所增加。转诊来源和会诊地点之间没有明显的关系。结论患者的家是所有专家远程医疗的首选地点，患者的偏好是咨询地点的主要决定因素。进一步的研究应包括对这些因素的定性分析，以优化这项服务的提供和其他类似服务的设计。

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引用次数: 0

Palliative care roles and responsibilities of mesothelioma clinical nurse specialists in the UK 英国间皮瘤临床护理专家的姑息治疗角色和责任

IF 1.7 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

PROGRESS IN PALLIATIVE CARE

Pub Date : 2022-12-30 DOI: 10.1080/09699260.2022.2158286

C. Gardiner, Madeleine Harrison, Sarah Hargreaves, B. Taylor

Mesothelioma is a rare incurable cancer caused by exposure to asbestos. Patients with mesothelioma have palliative care needs throughout the course of their illness, from diagnosis to the end of life. Mesothelioma clinical nurse specialists (CNSs) are central to providing care for patients with mesothelioma, but little is known about their role in providing palliative care. The aim of this study was to explore the views of mesothelioma patients and CNSs on the role of palliative care in mesothelioma, and explore which aspects of palliative care are provided by CNS’s. The cross-sectional study included: (1) Secondary analysis of existing data from 510 mesothelioma patients who completed a 2019 survey of patient experiences and; (2) A survey of 23 Mesothelioma UK CNS’s exploring their role in delivering palliative care. Data were analysed using descriptive statistics. Results indicated that 63% of mesothelioma patients did not feel that palliative care was needed at the time of survey completion. Data from the CNS survey showed that over 95% of CNS’s felt they had a role in providing palliative care, and all CNSs had received some prior training or education in palliative care. Confidence in delivering palliative care was generally high with the mean score of 26.52 (SD = 2.68) out of a maximum of 30. CNS’s are highly skilled at providing palliative care in mesothelioma, providing both specialist and generalist palliative care. However, work is required to encourage patients and their families to engage with palliative care earlier in the disease trajectory.

间皮瘤是一种罕见的无法治愈的癌症，由接触石棉引起。间皮瘤患者在从诊断到生命终结的整个病程中都需要姑息治疗。间皮瘤临床护理专家(CNSs)是为间皮瘤患者提供护理的核心，但很少有人知道他们在提供姑息治疗中的作用。本研究旨在探讨间皮瘤患者和中枢神经系统医生对姑息治疗在间皮瘤中的作用的看法，并探讨中枢神经系统医生提供哪些方面的姑息治疗。横断面研究包括:(1)对510名间皮瘤患者的现有数据进行二次分析，这些患者完成了2019年的患者经历调查;(2)对23名间皮瘤英国中枢神经系统医生的调查，探讨他们在提供姑息治疗中的作用。数据分析采用描述性统计。结果表明，63%的间皮瘤患者在调查完成时不认为需要姑息治疗。来自CNS调查的数据显示，超过95%的CNS认为他们在提供姑息治疗方面发挥了作用，所有的CNS都接受过姑息治疗方面的培训或教育。提供姑息治疗的信心普遍较高，平均得分为26.52 (SD = 2.68)，满分为30分。中枢神经系统在提供间皮瘤姑息治疗方面非常熟练，既提供专科姑息治疗，也提供全科姑息治疗。然而，还需要开展工作，鼓励患者及其家属在疾病发展早期接受姑息治疗。

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引用次数: 0