Pub Date : 2023-09-29DOI: 10.29011/2689-9825.000019
Background: Recurrent pleural effusions and abdominal ascites are seen in both malignant and non-malignant diseases, and can cause significant disease burden. Indwelling catheters for malignant pleural effusions are part of current accepted practice. Indwelling peritoneal catheters for malignant ascites have yet to be recommended by any society guideline. We aimed to evaluate outcomes in our patients who have had indwelling pleural and peritoneal catheters placed for malignant and non-malignant pleural effusions and abdominal ascites. Method: A retrospective cohort study of patients who had indwelling pleural and peritoneal catheters inserted over a 10 year period from 2011 to 2020 was carried out. Inclusion criteria consisted of all patients who had either a pleural or peritoneal indwelling catheter placed for any indication. We evaluated catheter-related complications. Results: There were 193 discrete indwelling pleural catheters for malignant pleural effusions, with a median dwell time of 41 days. The infection rate in these were 6.2%, and 12.4% of catheters had complications of blockage or dislodgement. There were 2 catheters inserted for parapneumonic effusions, further analysis was limited given the low number. There were 121 discrete indwelling peritoneal catheters for malignant abdominal ascites, with a median dwell time of 31 days. The rate of infection was 5.8%, and another 5.8% of catheters became blocked or dislodged. An additional 6 peritoneal catheters were inserted for non-malignant abdominal ascites, with a median dwell time of 28 days. Two cases of infection were found in this group. Conclusion: This is to our knowledge one of the larger patient cohorts in studies relating to indwelling peritoneal catheters for malignant abdominal ascites. Our data shows that indwelling peritoneal catheters have low complication rates on par with pleural catheters which are current accepted practice. The usage of indwelling pleural and peritoneal catheters may be considered for the management of refractory pleural effusions and abdominal ascites.
{"title":"Indwelling Pleural and Abdominal Catheters (PleurX) for Management of Pleural Effusions and Ascites: A Single Centre’s 10 Year Experience","authors":"","doi":"10.29011/2689-9825.000019","DOIUrl":"https://doi.org/10.29011/2689-9825.000019","url":null,"abstract":"Background: Recurrent pleural effusions and abdominal ascites are seen in both malignant and non-malignant diseases, and can cause significant disease burden. Indwelling catheters for malignant pleural effusions are part of current accepted practice. Indwelling peritoneal catheters for malignant ascites have yet to be recommended by any society guideline. We aimed to evaluate outcomes in our patients who have had indwelling pleural and peritoneal catheters placed for malignant and non-malignant pleural effusions and abdominal ascites. Method: A retrospective cohort study of patients who had indwelling pleural and peritoneal catheters inserted over a 10 year period from 2011 to 2020 was carried out. Inclusion criteria consisted of all patients who had either a pleural or peritoneal indwelling catheter placed for any indication. We evaluated catheter-related complications. Results: There were 193 discrete indwelling pleural catheters for malignant pleural effusions, with a median dwell time of 41 days. The infection rate in these were 6.2%, and 12.4% of catheters had complications of blockage or dislodgement. There were 2 catheters inserted for parapneumonic effusions, further analysis was limited given the low number. There were 121 discrete indwelling peritoneal catheters for malignant abdominal ascites, with a median dwell time of 31 days. The rate of infection was 5.8%, and another 5.8% of catheters became blocked or dislodged. An additional 6 peritoneal catheters were inserted for non-malignant abdominal ascites, with a median dwell time of 28 days. Two cases of infection were found in this group. Conclusion: This is to our knowledge one of the larger patient cohorts in studies relating to indwelling peritoneal catheters for malignant abdominal ascites. Our data shows that indwelling peritoneal catheters have low complication rates on par with pleural catheters which are current accepted practice. The usage of indwelling pleural and peritoneal catheters may be considered for the management of refractory pleural effusions and abdominal ascites.","PeriodicalId":72289,"journal":{"name":"Archives of palliative care and medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135295673","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 : 2020-01-01DOI: 10.29011/2689-9825.000015
{"title":"Virtual Family Meetings: A Novel Pediatric Palliative Care Teaching and Communication Tool","authors":"","doi":"10.29011/2689-9825.000015","DOIUrl":"https://doi.org/10.29011/2689-9825.000015","url":null,"abstract":"","PeriodicalId":72289,"journal":{"name":"Archives of palliative care and medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76369701","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 : 2019-01-01DOI: 10.29011/2689-9825.000012
J. Cole, Joy N Macdonald, Huma Qamar
The study aims to understand how men cope with the anticipated loss of their child when a life-limiting fetal diagnosis is confirmed in pregnancy. Twenty-five fathers responded to an online qualitative survey exploring their perinatal loss experiences. Data provide the reader with a glimpse of fathers’ thoughts and feelings between the time of the confirmed fetal diagnosis and the baby’s birth. Study participants chose to either engage with their pregnant partners through showing protection, emotional strength or by being productive in the areas in which they felt they could control; while others chose to avoid by not expressing their feelings with their partners, socially isolating, and turning to their work as a source of refuge. Therapeutic birth planning was shown to be a beneficial method to prepare fathers for their pending loss, involve fathers and their partners in the prenatal decision making and allow fathers to express their feelings throughout the process leading up to the loss. Study results hope to enhance the dearth of research on men’s bereavement experiences in the context of perinatal palliative care and encourage providers to acknowledge fathers’ grief in anticipation of a perinatal loss.
{"title":"Leading up to Loss: Understanding the Perinatal Grief Experience for Expectant Fathers when a Life-Limiting Fetal Diagnosis is Confirmed","authors":"J. Cole, Joy N Macdonald, Huma Qamar","doi":"10.29011/2689-9825.000012","DOIUrl":"https://doi.org/10.29011/2689-9825.000012","url":null,"abstract":"The study aims to understand how men cope with the anticipated loss of their child when a life-limiting fetal diagnosis is confirmed in pregnancy. Twenty-five fathers responded to an online qualitative survey exploring their perinatal loss experiences. Data provide the reader with a glimpse of fathers’ thoughts and feelings between the time of the confirmed fetal diagnosis and the baby’s birth. Study participants chose to either engage with their pregnant partners through showing protection, emotional strength or by being productive in the areas in which they felt they could control; while others chose to avoid by not expressing their feelings with their partners, socially isolating, and turning to their work as a source of refuge. Therapeutic birth planning was shown to be a beneficial method to prepare fathers for their pending loss, involve fathers and their partners in the prenatal decision making and allow fathers to express their feelings throughout the process leading up to the loss. Study results hope to enhance the dearth of research on men’s bereavement experiences in the context of perinatal palliative care and encourage providers to acknowledge fathers’ grief in anticipation of a perinatal loss.","PeriodicalId":72289,"journal":{"name":"Archives of palliative care and medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86640563","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 : 2018-11-23DOI: 10.29011/2689-9825.000011
A. Ladha, W. Nevala, Sarah Lee, R. Vierkant, J. Kaur
In 2016, more than 1.43 million patients received hospice care in the United States and nearly half of the hospice days of care were provided at private residences [1]. Home-based hospice care increases the likelihood of death at home by 7 to 8 fold [2]. Although spousal caregivers experiencing strain were shown to be 63% more likely to die within 4 years than non-caregivers, these findings were not replicated in population based studies involving different caregivers [3-6]. Caregivers of terminal cancer and hospice patients often face increased psychosocial stressors and a perception of crisis specially when a loved one’s symptoms continue to intensify near the end of life [7]. In a study involving caregivers of Alzheimer and other dementia patients, 72% acknowledged they felt a sense of relief after the patient’s death [8].
{"title":"What is the Personal Immune Price for Hospice Caregivers? A Case-Control Study.","authors":"A. Ladha, W. Nevala, Sarah Lee, R. Vierkant, J. Kaur","doi":"10.29011/2689-9825.000011","DOIUrl":"https://doi.org/10.29011/2689-9825.000011","url":null,"abstract":"In 2016, more than 1.43 million patients received hospice care in the United States and nearly half of the hospice days of care were provided at private residences [1]. Home-based hospice care increases the likelihood of death at home by 7 to 8 fold [2]. Although spousal caregivers experiencing strain were shown to be 63% more likely to die within 4 years than non-caregivers, these findings were not replicated in population based studies involving different caregivers [3-6]. Caregivers of terminal cancer and hospice patients often face increased psychosocial stressors and a perception of crisis specially when a loved one’s symptoms continue to intensify near the end of life [7]. In a study involving caregivers of Alzheimer and other dementia patients, 72% acknowledged they felt a sense of relief after the patient’s death [8].","PeriodicalId":72289,"journal":{"name":"Archives of palliative care and medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89604148","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 : 2018-11-21DOI: 10.29011/2689-9825.000010
{"title":"Palliative Care and Oncology: A Review","authors":"","doi":"10.29011/2689-9825.000010","DOIUrl":"https://doi.org/10.29011/2689-9825.000010","url":null,"abstract":"","PeriodicalId":72289,"journal":{"name":"Archives of palliative care and medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84455647","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 : 2018-09-24DOI: 10.29011/2689-9825.000008
Roseline Susan Njuguna, Sylvia Tuikong, P. Ngure
Awareness of HIV and AIDS in Kenya is high but stigma is still experienced among women living with HIV. The supportive environment in support groups is correlated with reducing apprehension and depression among people living with HIV although psychological issues are not adequately addressed. A randomized control study with the intervention of narrative approach was carried out for Women living with HIV. Eligibility included a score of above 21 on the Impact of Event (IESR) Scale, severe depression (CES-D) and scored high on the Internal Stigma Scale (HIV ISS). A structured group therapy session using narrative approach was conducted weekly for twelve (12) weeks for five groups of ten (10) members each. The finding was a reduction in the impact of event for all intervention groups on the Impact of Event Scale (IES-R). On the depressive scale, all members in the intervention groups moved from severe depression to moderate 37(75%) and mild 13(25%). The stigma scale indicated that 30(60 %) of the participants improved to moderate and mild while 20(40%) remained with severe stigma. Group therapy should be structured and adopt the narrative approach for women living with HIV. This will complement measures to reduce trauma from the impact of event, depression and internal stigma. Daystar University Repository
{"title":"A Storytelling Program for Women Living with HIV in an Informal Settlement in Kenya: Addressing Psychological Trauma, Depression and Stigma","authors":"Roseline Susan Njuguna, Sylvia Tuikong, P. Ngure","doi":"10.29011/2689-9825.000008","DOIUrl":"https://doi.org/10.29011/2689-9825.000008","url":null,"abstract":"Awareness of HIV and AIDS in Kenya is high but stigma is still experienced among women living with HIV. The supportive environment in support groups is correlated with reducing apprehension and depression among people living with HIV although psychological issues are not adequately addressed. A randomized control study with the intervention of narrative approach was carried out for Women living with HIV. Eligibility included a score of above 21 on the Impact of Event (IESR) Scale, severe depression (CES-D) and scored high on the Internal Stigma Scale (HIV ISS). A structured group therapy session using narrative approach was conducted weekly for twelve (12) weeks for five groups of ten (10) members each. The finding was a reduction in the impact of event for all intervention groups on the Impact of Event Scale (IES-R). On the depressive scale, all members in the intervention groups moved from severe depression to moderate 37(75%) and mild 13(25%). The stigma scale indicated that 30(60 %) of the participants improved to moderate and mild while 20(40%) remained with severe stigma. Group therapy should be structured and adopt the narrative approach for women living with HIV. This will complement measures to reduce trauma from the impact of event, depression and internal stigma. Daystar University Repository","PeriodicalId":72289,"journal":{"name":"Archives of palliative care and medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89913355","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 : 2018-08-09DOI: 10.29011/2689-9825.000007
R. Alluin, Benoît F Leheup, Elise Piot, C. Goetz
Introduction: Palliative care practice confronts us with the dilemma of «equitable care», namely: when to treat, by what means and, above all, when to stop. The issue of artificial nutrition is the perfect example. The present study was conducted to identify the arguments used by the Mobile Palliative Care Team to discuss the introduction or withdrawal of artificial nutrition and compare these arguments according to the advice given. Methods: A descriptive, historical cohort-type epidemiological study was carried out on all medical files of patients followed by the mobile team of the Metz-Thionville Regional Hospital in 2013 and for whom a discussion had taken place regarding artificial nutrition. Results: The most commonly mentioned arguments were general patient condition (68.4% of cases), estimated life expectancy (67.3%) and the palliative nature of care management (55.1%). Advice for the withdrawal or withholding of artificial nutrition formulated by the mobile team was followed in 75.9% of cases while the advice for the introduction or continuation of artificial nutrition was followed in 93.3%. Conclusion: The decision to withdraw or pursue artificial nutrition is based on a body of arguments and a multidisciplinary evaluation with discussion encompassing an ethical dimension involving the patient and his/her relatives. DOI: 10.29011/APCM-107.000007
{"title":"Argumentation for the Withdrawing or Withholding of Artificial Nutrition by the Mobile Palliative Care Team","authors":"R. Alluin, Benoît F Leheup, Elise Piot, C. Goetz","doi":"10.29011/2689-9825.000007","DOIUrl":"https://doi.org/10.29011/2689-9825.000007","url":null,"abstract":"Introduction: Palliative care practice confronts us with the dilemma of «equitable care», namely: when to treat, by what means and, above all, when to stop. The issue of artificial nutrition is the perfect example. The present study was conducted to identify the arguments used by the Mobile Palliative Care Team to discuss the introduction or withdrawal of artificial nutrition and compare these arguments according to the advice given. Methods: A descriptive, historical cohort-type epidemiological study was carried out on all medical files of patients followed by the mobile team of the Metz-Thionville Regional Hospital in 2013 and for whom a discussion had taken place regarding artificial nutrition. Results: The most commonly mentioned arguments were general patient condition (68.4% of cases), estimated life expectancy (67.3%) and the palliative nature of care management (55.1%). Advice for the withdrawal or withholding of artificial nutrition formulated by the mobile team was followed in 75.9% of cases while the advice for the introduction or continuation of artificial nutrition was followed in 93.3%. Conclusion: The decision to withdraw or pursue artificial nutrition is based on a body of arguments and a multidisciplinary evaluation with discussion encompassing an ethical dimension involving the patient and his/her relatives. DOI: 10.29011/APCM-107.000007","PeriodicalId":72289,"journal":{"name":"Archives of palliative care and medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73561613","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}
Abdullah Ladha, Wendy Kay Nevala, Sarah Lee, Robert A Vierkant, Judith Salmon Kaur
{"title":"What is the Personal Immune Price for Hospice Caregivers? A Case-Control Study.","authors":"Abdullah Ladha, Wendy Kay Nevala, Sarah Lee, Robert A Vierkant, Judith Salmon Kaur","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":72289,"journal":{"name":"Archives of palliative care and medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237147/pdf/nihms-1007813.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9576352","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}
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