Pub Date : 2023-08-08DOI: 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.
{"title":"A comparison of symptom management and utilization of specialist palliative care in the early COVID-19 pandemic: A multi-site retrospective chart review","authors":"Madelaine Baetz-Dougan, J. Guan, B. Henry, K. Stilos, Desmond D. Leung, Niren Shetty, Shruti Gupta, A. Chakraborty","doi":"10.1080/09699260.2023.2241784","DOIUrl":"https://doi.org/10.1080/09699260.2023.2241784","url":null,"abstract":"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.","PeriodicalId":45106,"journal":{"name":"PROGRESS IN PALLIATIVE CARE","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46674142","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}
Pub Date : 2023-08-08DOI: 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.
{"title":"Differences in patients accessing inpatient versus outpatient palliative care at time of referral at a cancer centre","authors":"David Marco, A. Collins, B. Le, J. Philip","doi":"10.1080/09699260.2023.2241798","DOIUrl":"https://doi.org/10.1080/09699260.2023.2241798","url":null,"abstract":"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.","PeriodicalId":45106,"journal":{"name":"PROGRESS IN PALLIATIVE CARE","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43978192","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}
Pub Date : 2023-08-03DOI: 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.
{"title":"Nurses’ challenges in the end-of-life care of patients with COVID-19: A qualitative study","authors":"Hadiseh Monadi Ziarat, M. Mardani-Hamooleh, N. Seyedfatemi, Akram Salamat","doi":"10.1080/09699260.2023.2241785","DOIUrl":"https://doi.org/10.1080/09699260.2023.2241785","url":null,"abstract":"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.","PeriodicalId":45106,"journal":{"name":"PROGRESS IN PALLIATIVE CARE","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47671976","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}
Pub Date : 2023-01-20DOI: 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.
{"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":null,"pages":null},"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}
Pub Date : 2023-01-07DOI: 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.
{"title":"Referral patterns and consultation locations for a novel palliative care telehealth service","authors":"Taylan Gurgenci, Luke Nicholls, Sangitha Mensingh, A. Broadbent, Graham Grove","doi":"10.1080/09699260.2022.2160084","DOIUrl":"https://doi.org/10.1080/09699260.2022.2160084","url":null,"abstract":"Background\u0000 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. \u0000 Methods\u0000 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. \u0000 Results\u0000 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. \u0000 Conclusion\u0000 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.","PeriodicalId":45106,"journal":{"name":"PROGRESS IN PALLIATIVE CARE","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47480543","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}
Pub Date : 2022-12-30DOI: 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.
{"title":"Palliative care roles and responsibilities of mesothelioma clinical nurse specialists in the UK","authors":"C. Gardiner, Madeleine Harrison, Sarah Hargreaves, B. Taylor","doi":"10.1080/09699260.2022.2158286","DOIUrl":"https://doi.org/10.1080/09699260.2022.2158286","url":null,"abstract":"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.","PeriodicalId":45106,"journal":{"name":"PROGRESS IN PALLIATIVE CARE","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47252232","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}
Pub Date : 2022-12-30DOI: 10.1080/09699260.2022.2158287
Prarthna Jayaseelan, J. Deodhar, A. Ashok, S. Jiwnani, Jyothsna Kuriakose, Shamali Poojary
Background Palliative care plays an important role in improving symptom burden and quality of life for patients with incurable oesophageal cancers. There is a dearth of studies regarding palliative care needs in advanced oesophageal cancer patients. Aim To understand the unmet palliative care needs and the associated factors in advanced oesophageal cancer patients. Design We conducted a cross-sectional observational study. Study/Participants We recruited 50 patients in the Thoracic Oncology OPD in a tertiary cancer centre in Mumbai, India, who were newly diagnosed with locally advanced, unresectable, or metastatic Oesophageal Cancer. The recruited patients’ concerns were assessed using Needs Assessment Tool-Progressive Disease Cancer (NAT-PDC) and symptom burden was assessed using Edmonton Symptom Assessment Score (ESAS). A Chi-square test was performed for correlating different factors with some or significant concerns, considering p ≤ 0.05 as statistically significant. Results Oesophageal cancer patients had concerns in physical (94%), financial (94%), psychological (82%), sociocultural (76%), activities of daily living (70%) and spiritual (58%) domains. They had a high symptom burden, most common symptoms being dysphagia, pain and tiredness. Anxiety and depression were associated with higher psychological and spiritual concerns. Older age, female gender and low financial income were associated with higher levels of concerns. Caregivers were most concerned about their patients’ physical symptoms (94%) and financial issues (92%). Conclusion Patients with advanced oesophageal cancer have significant burden of unmet palliative care needs. This should trigger referrals to specialist palliative care for comprehensive care of patients and their caregivers.
{"title":"Palliative care needs assessment in patients with metastatic and locally advanced oesophageal cancer","authors":"Prarthna Jayaseelan, J. Deodhar, A. Ashok, S. Jiwnani, Jyothsna Kuriakose, Shamali Poojary","doi":"10.1080/09699260.2022.2158287","DOIUrl":"https://doi.org/10.1080/09699260.2022.2158287","url":null,"abstract":"Background Palliative care plays an important role in improving symptom burden and quality of life for patients with incurable oesophageal cancers. There is a dearth of studies regarding palliative care needs in advanced oesophageal cancer patients. Aim To understand the unmet palliative care needs and the associated factors in advanced oesophageal cancer patients. Design We conducted a cross-sectional observational study. Study/Participants We recruited 50 patients in the Thoracic Oncology OPD in a tertiary cancer centre in Mumbai, India, who were newly diagnosed with locally advanced, unresectable, or metastatic Oesophageal Cancer. The recruited patients’ concerns were assessed using Needs Assessment Tool-Progressive Disease Cancer (NAT-PDC) and symptom burden was assessed using Edmonton Symptom Assessment Score (ESAS). A Chi-square test was performed for correlating different factors with some or significant concerns, considering p ≤ 0.05 as statistically significant. Results Oesophageal cancer patients had concerns in physical (94%), financial (94%), psychological (82%), sociocultural (76%), activities of daily living (70%) and spiritual (58%) domains. They had a high symptom burden, most common symptoms being dysphagia, pain and tiredness. Anxiety and depression were associated with higher psychological and spiritual concerns. Older age, female gender and low financial income were associated with higher levels of concerns. Caregivers were most concerned about their patients’ physical symptoms (94%) and financial issues (92%). Conclusion Patients with advanced oesophageal cancer have significant burden of unmet palliative care needs. This should trigger referrals to specialist palliative care for comprehensive care of patients and their caregivers.","PeriodicalId":45106,"journal":{"name":"PROGRESS IN PALLIATIVE CARE","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42117390","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}
Pub Date : 2022-12-30DOI: 10.1080/09699260.2022.2152987
Matthew Bzura, H. Kubba, Steve West, Lori Schramm, A. Clay, Solveig Nilson
Advance care plans (ACPs) increase patient-centered care, reduce caregiver burden and healthcare costs. However, only about 25% of Canadians over 50 years of age have completed an ACP. An anonymous, cross-sectional survey was distributed to those ≥70 years attending a primary care clinic-based COVID-19 vaccination event in Regina, SK in April 2021. The survey included questions about demographics, attitudes, engagement in ACPs according to the Stage of Change model, and patient-reported influence of COVID-19 on ACP thoughts or actions. One hundred thirty-four surveys were completed (96% response rate). Twenty-seven percent of respondents were at the precontemplation stage, 21% at contemplation stage, 16% at planning stage, 26% at action stage, and 10% at maintenance stage. Thirty-three percent of respondents had thought more about ACPs during the pandemic, but few updated or created plans. Most respondents felt comfortable talking with their physician and partners. There is a need for physicians to initiate ACP conversations with patients.
{"title":"Engagement and attitudes towards advanced care planning in primary care during COVID-19: A cross-sectional survey of older adults","authors":"Matthew Bzura, H. Kubba, Steve West, Lori Schramm, A. Clay, Solveig Nilson","doi":"10.1080/09699260.2022.2152987","DOIUrl":"https://doi.org/10.1080/09699260.2022.2152987","url":null,"abstract":"Advance care plans (ACPs) increase patient-centered care, reduce caregiver burden and healthcare costs. However, only about 25% of Canadians over 50 years of age have completed an ACP. An anonymous, cross-sectional survey was distributed to those ≥70 years attending a primary care clinic-based COVID-19 vaccination event in Regina, SK in April 2021. The survey included questions about demographics, attitudes, engagement in ACPs according to the Stage of Change model, and patient-reported influence of COVID-19 on ACP thoughts or actions. One hundred thirty-four surveys were completed (96% response rate). Twenty-seven percent of respondents were at the precontemplation stage, 21% at contemplation stage, 16% at planning stage, 26% at action stage, and 10% at maintenance stage. Thirty-three percent of respondents had thought more about ACPs during the pandemic, but few updated or created plans. Most respondents felt comfortable talking with their physician and partners. There is a need for physicians to initiate ACP conversations with patients.","PeriodicalId":45106,"journal":{"name":"PROGRESS IN PALLIATIVE CARE","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47087279","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}
Pub Date : 2022-12-28DOI: 10.1080/09699260.2022.2152169
A. Ghoshal, M. Muckaden, C. Garg, J. Iyengar, K. Ganpathy, A. Damani, J. Deodhar, T. Vora, G. Chinnaswamy
Prognostic information in advanced cancers is distressing. We surveyed 30 parents of children with advanced cancer from a tertiary cancer center in India to understand parental preferences for prognostic information. We found that 17/20 (85%) parents desired as much information about prognosis as possible and wanted it expressed numerically. All parents found information about the prognosis to be upsetting but still wanted additional information about the prognosis, except, 2/20 (10%). Parents who found information ‘somewhat’ or ‘extremely’ upsetting 8/20 (40%) were no less likely to say that knowing prognosis was important, or that it helped in decision-making. Thus, although many parents find prognostic information about their children with cancer upsetting, parents who are upset by prognostic information are no less likely to want it. The upsetting nature of prognostic information does not diminish parents’ desire for such information or their sense of hope.
{"title":"Parents’ experiences with prognosis communication in advanced pediatric cancers","authors":"A. Ghoshal, M. Muckaden, C. Garg, J. Iyengar, K. Ganpathy, A. Damani, J. Deodhar, T. Vora, G. Chinnaswamy","doi":"10.1080/09699260.2022.2152169","DOIUrl":"https://doi.org/10.1080/09699260.2022.2152169","url":null,"abstract":"Prognostic information in advanced cancers is distressing. We surveyed 30 parents of children with advanced cancer from a tertiary cancer center in India to understand parental preferences for prognostic information. We found that 17/20 (85%) parents desired as much information about prognosis as possible and wanted it expressed numerically. All parents found information about the prognosis to be upsetting but still wanted additional information about the prognosis, except, 2/20 (10%). Parents who found information ‘somewhat’ or ‘extremely’ upsetting 8/20 (40%) were no less likely to say that knowing prognosis was important, or that it helped in decision-making. Thus, although many parents find prognostic information about their children with cancer upsetting, parents who are upset by prognostic information are no less likely to want it. The upsetting nature of prognostic information does not diminish parents’ desire for such information or their sense of hope.","PeriodicalId":45106,"journal":{"name":"PROGRESS IN PALLIATIVE CARE","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44293345","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}
Pub Date : 2022-12-05DOI: 10.1080/09699260.2022.2148196
C. Effendy, M. S. Kristanti
Purpose Although the concept of ‘cancer-related problems’ is complex, few studies compare nurses’ and caregivers’ perspectives on cancer-related problems, particularly in eastern cultures. The study aimed to identify the perceptions of patients and nurses concerning to what extent the problems of patients with cancer were assessed and addressed during hospitalization in Indonesia. Method A descriptive correlational study with cross-sectional comparisons was conducted in three major cities in Indonesia. With a convenience sample of 119 patients (response rate = 79.3%) with cancer and 147 nurses (response rate = 71%). The domains of validated Problems and Needs of Palliative Care – short version were used to measure the perceptions of the patients and nurses regarding the assessing and addressing of patients’ problems. Results The patients stated that their physical and psychological problems were very often assessed (>84%) and addressed (>90%). Patients who reported difficulties spontaneously had a lower prevalence of problems than patients who reported problems to a professional, except for the psychological subscale (P-value 0.05). The open assessment reported that the problems exhibited lower frequency than structure assessment, while nurses addressed all sub-scale problems (P-value < 0.005). Patients’ educational status, age, gender, and time of diagnosis had positive correlations with their perceptions of cancer-related problems, which they voluntarily stated. Conclusion These findings indicate essential similarities and incongruities between patients with cancer and nurses perceive cancer-related problems. The results highlight the complex technical directions of cancer nursing care in Indonesia.
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