Pub Date : 2017-09-11DOI: 10.4172/2165-7386.1000318
M. Ikbal, Jingting Wu, M. T. Wahab, R. Kanesvaran, L. Krishna
Background: Mentoring in Palliative Medicine is critical to training, career satisfaction and professional development. Yet, there are no accounts of effective mentoring programs in Palliative Medicine. This gap is attributed to a failure to define mentoring practice and a lack of acknowledgment of mentoring’s context-specific, goal-sensitive, mentee-, mentor- and organizational-dependent nature that has hindered effective review of mentoring programs. Objective: Drawing upon similarities between training in Palliative Medicine and Internal Medicine, this thematic analysis seeks to identify common themes in prevailing mentoring programs in Internal Medicine that can guide the design of mentoring programs in Palliative Medicine. Design: A thematic review of literature reviews, systematic reviews and meta-analyses featured in PubMed, ERIC, Cochrane Database of Systematic Reviews, OVID and Science Direct databases and published in English between 1st January 2000 and 31st December 2015 involving mentoring in Internal Medicine was carried out. Results: 466 abstracts were retrieved, 17 full-text reviews evaluated and 7 reviews included. Thematic analysis revealed 9 themes: common features within definitions of mentoring, characteristics of mentoring relationships, the mentoring approach, facets of the mentoring process, desired characteristics/actions of a mentor and mentee, benefits and drawbacks of mentoring and differences between undergraduate and postgraduate mentoring. Conclusions: Common themes highlight the importance of nurturing personalized mentoring relationships and addressing the different goals of mentoring in undergraduate and postgraduate settings. Supportive mentoring environments can be provided through host organizations that help in selecting, training and supporting mentees and mentors to meet clearly defined goals.
背景：姑息医学指导对培训、职业满意度和职业发展至关重要。然而，在姑息医学中，并没有有效的指导计划。这一差距归因于未能定义辅导实践，以及缺乏对辅导的特定背景、目标敏感、受试者、导师和组织依赖性的认识，阻碍了对辅导计划的有效审查。目的：利用姑息医学培训和内科学培训之间的相似性，本主题分析旨在确定内科学主流辅导项目中的共同主题，以指导姑息医学辅导项目的设计。设计：对PubMed、ERIC、Cochrane System reviews数据库、OVID和Science Direct数据库中的文献综述、系统综述和荟萃分析进行了主题综述，这些文献在2000年1月1日至2015年12月31日期间以英文发表，涉及内科学指导。结果：检索到466篇摘要，评价了17篇全文综述，收录了7篇综述。专题分析揭示了9个主题：辅导定义中的共同特征、辅导关系的特征、辅导方法、辅导过程的各个方面、导师和被学员的期望特征/行动、辅导的好处和缺点以及本科生和研究生辅导之间的差异。结论：共同的主题突出了培养个性化辅导关系的重要性，并解决了本科生和研究生环境中辅导的不同目标。可以通过主办组织提供支持性辅导环境，帮助选择、培训和支持学员和导师，以实现明确的目标。
{"title":"Mentoring in Palliative Medicine: Guiding Program Design through Thematic Analysis of Mentoring in Internal Medicine between 2000 and 2015","authors":"M. Ikbal, Jingting Wu, M. T. Wahab, R. Kanesvaran, L. Krishna","doi":"10.4172/2165-7386.1000318","DOIUrl":"https://doi.org/10.4172/2165-7386.1000318","url":null,"abstract":"Background: Mentoring in Palliative Medicine is critical to training, career satisfaction and professional \u0000 development. Yet, there are no accounts of effective mentoring programs in Palliative Medicine. This gap is \u0000 attributed to a failure to define mentoring practice and a lack of acknowledgment of mentoring’s context-specific, \u0000 goal-sensitive, mentee-, mentor- and organizational-dependent nature that has hindered effective review of \u0000 mentoring programs. \u0000Objective: Drawing upon similarities between training in Palliative Medicine and Internal Medicine, this thematic \u0000 analysis seeks to identify common themes in prevailing mentoring programs in Internal Medicine that can guide the \u0000 design of mentoring programs in Palliative Medicine. \u0000Design: A thematic review of literature reviews, systematic reviews and meta-analyses featured in PubMed, \u0000 ERIC, Cochrane Database of Systematic Reviews, OVID and Science Direct databases and published in English \u0000 between 1st January 2000 and 31st December 2015 involving mentoring in Internal Medicine was carried out. \u0000Results: 466 abstracts were retrieved, 17 full-text reviews evaluated and 7 reviews included. Thematic analysis \u0000 revealed 9 themes: common features within definitions of mentoring, characteristics of mentoring relationships, the \u0000 mentoring approach, facets of the mentoring process, desired characteristics/actions of a mentor and mentee, \u0000 benefits and drawbacks of mentoring and differences between undergraduate and postgraduate mentoring. \u0000Conclusions: Common themes highlight the importance of nurturing personalized mentoring relationships and \u0000 addressing the different goals of mentoring in undergraduate and postgraduate settings. Supportive mentoring \u0000 environments can be provided through host organizations that help in selecting, training and supporting mentees \u0000 and mentors to meet clearly defined goals.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42671314","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 : 2017-09-05DOI: 10.4172/2165-7386.1000317
A. Rêgo, Larissa Daniele Machado Góes, C. Almeida, A. Ribeiro, Camila Alves Corrêa Neiva, L. S. Rêgo
Introduction: Malignant neoplasms are considered a public health problem due to the high rates of morbidity and mortality presented worldwide, particularly those associated with breast cancer. Methods: This is a qualitative exploratory study that included 32 volunteers affected by breast cancer who were followed up at a public brazilian hospital in Macapa city. The volunteers were divided into two groups: group 1 (n=16) consisting of mastectomized volunteers and group 2 (n=16) by mastectomized volunteers with breast reconstruction; both groups were evaluated using the SF-36 (Medical Outcomes Study 36). Results: The results showed that mastectomized women without breast reconstruction presented a very low level of quality of life and those who did breast reconstruction presented better mean scores in all aspects evaluated when compared to the group without reconstruction (except in the social aspect, p>0.05). However, even those with breast reconstruction had an important impact in all areas of the quality of life questionnaire. Conclusions: The domains analysis made it possible to understand the negative impact that mastectomy and breast reconstruction have on the woman's life, besides noting that the maintenance of an esthetic state closer to normality is determinant for the quality of life of these women. However, new studies must be carried out to obtain statistically more relevant values.
{"title":"Quality of Life Outcomes in Patients with Breast Cancer in an Amazon City: The Impact of Breast Reconstruction","authors":"A. Rêgo, Larissa Daniele Machado Góes, C. Almeida, A. Ribeiro, Camila Alves Corrêa Neiva, L. S. Rêgo","doi":"10.4172/2165-7386.1000317","DOIUrl":"https://doi.org/10.4172/2165-7386.1000317","url":null,"abstract":"Introduction: Malignant neoplasms are considered a public health problem due to the high rates of morbidity and mortality presented worldwide, particularly those associated with breast cancer. \u0000Methods: This is a qualitative exploratory study that included 32 volunteers affected by breast cancer who were followed up at a public brazilian hospital in Macapa city. The volunteers were divided into two groups: group 1 (n=16) consisting of mastectomized volunteers and group 2 (n=16) by mastectomized volunteers with breast reconstruction; both groups were evaluated using the SF-36 (Medical Outcomes Study 36). \u0000Results: The results showed that mastectomized women without breast reconstruction presented a very low level of quality of life and those who did breast reconstruction presented better mean scores in all aspects evaluated when compared to the group without reconstruction (except in the social aspect, p>0.05). However, even those with breast reconstruction had an important impact in all areas of the quality of life questionnaire. \u0000Conclusions: The domains analysis made it possible to understand the negative impact that mastectomy and breast reconstruction have on the woman's life, besides noting that the maintenance of an esthetic state closer to normality is determinant for the quality of life of these women. However, new studies must be carried out to obtain statistically more relevant values.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" 1024","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41251689","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 : 2017-09-01DOI: 10.4172/2165-7386.1000316
H. Ettahri, N. Berrada, A. Tahir, Mustapha Elkabous, H. Mrabti, H. Errihani
The essence of palliative care is to provide health services for managing patient’s symptoms, reduce their pain, and improve their quality of life. In Morocco, the incidence of cancer is increasing; around 50% of patients are diagnosed at advanced stage. For the majority of them, only palliative treatment and pain relief can be considered. This article is interested on the current situation and challenges of palliative care in Morocco. Currently only three centers devoted to palliative care are functional in Morocco, in Rabat and Casablanca with very restricted bed capacity. The area of coverage is very restricted and palliative care services can be provided by medical or radian oncologists affected in different region of the country, which still insufficient. National Cancer Prevention and Control Plan (NCPCP) make the promotion of palliative care as an important and strategic element of healthcare system, the objective is to be aligned on the WHO recommendations to ensure palliative care and pain treatment for all Moroccans whose need it.
{"title":"Palliative Care, A Reel Challenge in Income and Middle Countries. Example of Morocco","authors":"H. Ettahri, N. Berrada, A. Tahir, Mustapha Elkabous, H. Mrabti, H. Errihani","doi":"10.4172/2165-7386.1000316","DOIUrl":"https://doi.org/10.4172/2165-7386.1000316","url":null,"abstract":"The essence of palliative care is to provide health services for managing patient’s symptoms, reduce their pain, and improve their quality of life. In Morocco, the incidence of cancer is increasing; around 50% of patients are diagnosed at advanced stage. For the majority of them, only palliative treatment and pain relief can be considered. \u0000This article is interested on the current situation and challenges of palliative care in Morocco. Currently only three centers devoted to palliative care are functional in Morocco, in Rabat and Casablanca with very restricted bed capacity. The area of coverage is very restricted and palliative care services can be provided by medical or radian oncologists affected in different region of the country, which still insufficient. \u0000National Cancer Prevention and Control Plan (NCPCP) make the promotion of palliative care as an important and strategic element of healthcare system, the objective is to be aligned on the WHO recommendations to ensure palliative care and pain treatment for all Moroccans whose need it.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47905146","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 : 2017-07-31DOI: 10.4172/2165-7386.1000315
Fatma Uslu-Şahan, Fusun Terzioğlu
Objectives: Gynecologic cancers are the second main reasons for morbidity in women following breast cancer in Turkey and globally. The majority of patients with gynecologic cancer experience recurrence and die despite aggressive treatment. Because of this, patients with gynecologic cancers remain an ideal population for palliative care. Nurses are an essential part of the palliative care team in providing high standards of care since they spend the longest time with patients. The aim of the study to assess knowledge, practice and opinions about barriers toward palliative care among nurses working in gynecologic oncology units. Methods: The cross-sectional survey-based study was conducted nurses (N=65) working in six tertiary care hospitals’ gynecologic oncology units in Ankara Province in Turkey. For data collection a survey was used. The descriptive statistics were used in data analysis. Results: It was determined that 52.3% of the nurses did not receive any knowledge regarding palliative care. The knowledge nurses received was mostly about communication skills (96.8%), pain management (96.8%) and symptom control (96.8%). It was found that 73.8% of the nurses did not talk about death with patients and their families. One of the most common barriers faced by nurses was opioid phobia experienced by patients (66.2%) and healthcare professionals (41.5%). Conclusions The current study indicates the need for wider coverage of palliative care in the education of preservice and in-service nurses to increase their knowledge and therefore practice. This education needs to be comprehensive in covering the basic principles of palliative care and symptom management and it should be distributed throughout the different courses to discuss palliative care within different contexts, such as gynecologic oncology setting.
{"title":"Nurses' Knowledge and Practice toward Gynecologic Oncology Palliative Care","authors":"Fatma Uslu-Şahan, Fusun Terzioğlu","doi":"10.4172/2165-7386.1000315","DOIUrl":"https://doi.org/10.4172/2165-7386.1000315","url":null,"abstract":"Objectives: Gynecologic cancers are the second main reasons for morbidity in women following breast cancer in \u0000 Turkey and globally. The majority of patients with gynecologic cancer experience recurrence and die despite \u0000 aggressive treatment. Because of this, patients with gynecologic cancers remain an ideal population for palliative \u0000 care. Nurses are an essential part of the palliative care team in providing high standards of care since they spend \u0000 the longest time with patients. The aim of the study to assess knowledge, practice and opinions about barriers \u0000 toward palliative care among nurses working in gynecologic oncology units. \u0000Methods: The cross-sectional survey-based study was conducted nurses (N=65) working in six tertiary care \u0000 hospitals’ gynecologic oncology units in Ankara Province in Turkey. For data collection a survey was used. The \u0000 descriptive statistics were used in data analysis. \u0000Results: It was determined that 52.3% of the nurses did not receive any knowledge regarding palliative care. The \u0000 knowledge nurses received was mostly about communication skills (96.8%), pain management (96.8%) and \u0000 symptom control (96.8%). It was found that 73.8% of the nurses did not talk about death with patients and their \u0000 families. One of the most common barriers faced by nurses was opioid phobia experienced by patients (66.2%) and \u0000 healthcare professionals (41.5%). \u0000Conclusions The current study indicates the need for wider coverage of palliative care in the education of preservice \u0000 and in-service nurses to increase their knowledge and therefore practice. This education needs to be \u0000 comprehensive in covering the basic principles of palliative care and symptom management and it should be \u0000 distributed throughout the different courses to discuss palliative care within different contexts, such as gynecologic \u0000 oncology setting.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44279697","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 : 2017-07-25DOI: 10.4172/2165-7386.1000311
H. Homler, Earl L. Smith
Howard Homler1* and Earl L Smith2 1Medical Director, Interim Healthcare Hospice, Associate Volunteer Clinical Faculty, UC Davis Medical Center, University of California at Davis Medical School, USA 2Visiting Nurse Services Hospice, New York, USA *Corresponding author: Howard Homler, Medical Director, Interim Healthcare Hospice, Associate Volunteer Clinical Faculty, UC Davis Medical Center, University of California at Davis Medical School, USA; Tel: (916) 962-2035; E-mail: hhomler@ix.netcom.com
Howard Homler1*和Earl L Smith2美国加州大学戴维斯医学院加州大学戴维斯分校医学中心临时医疗保健临终关怀中心副志愿者临床系医学主任2访问护士服务临终关怀中心，美国纽约*通讯作者：Howard Hohler，加州大学戴维斯医疗中心临时医疗护理临终关怀中心医学主任，美国加州大学戴维斯医学院；电话：（916）962-2035；电子邮件：hhomler@ix.netcom.com
{"title":"Unrecognized Familial Cancer Syndromes in Hospice Patients - A Precious, butFleeting Opportunity for Recognition and Testing","authors":"H. Homler, Earl L. Smith","doi":"10.4172/2165-7386.1000311","DOIUrl":"https://doi.org/10.4172/2165-7386.1000311","url":null,"abstract":"Howard Homler1* and Earl L Smith2 1Medical Director, Interim Healthcare Hospice, Associate Volunteer Clinical Faculty, UC Davis Medical Center, University of California at Davis Medical School, USA 2Visiting Nurse Services Hospice, New York, USA *Corresponding author: Howard Homler, Medical Director, Interim Healthcare Hospice, Associate Volunteer Clinical Faculty, UC Davis Medical Center, University of California at Davis Medical School, USA; Tel: (916) 962-2035; E-mail: hhomler@ix.netcom.com","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47273902","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 : 2017-07-25DOI: 10.4172/2165-7386.1000312
Prachi P. Chavan, Satish K. Kedia, Xinhua Yu
Objective: The ability to independently perform daily activities is a crucial component of quality of life among older cancer survivors. However, many cancer survivors face difficulties performing their daily activities for living an independent life. The purpose of this study was to evaluate whether physical and functional status significantly decreased in cancer survivors compared to people without cancer. Methods: The Medicare Current Beneficiary Survey (MCBS) is a nationally representative longitudinal study for the entire aged Medicare beneficiaries. Data from 2006 to 2010 were used for analysis of this study. Design-based descriptive analysis and logistic models with adjusted survey weights were performed. To ensure comparability between cancer and non-cancer older adults, propensity score weighting was developed using logistic regressions. Results: The final sample consisted of 11,533 participants. Cancer survivors had more limitations compared to non-cancer individuals: physical limitations (23.3% vs. 19.7%, p=0.006), activity daily living limitations (ADL) (7.7% vs. 5.8%, p=0.02), and instrumental activity of daily living limitations (IADL) (13.5% vs. 11.0%, p=0.02. The odds ratio (OR) for cancer survivors compared to non-cancer individuals was 1.62 (95% CI: 1.28-2.06) for physical limitations, 1.08 (95% CI: 0.72-1.62) for ADL, and 1.30 (95% CI: 0.97-1.73) for IADL. There was a one year lag in functional limitations resulting in one year loss of physical capabilities among cancer survivors. However, these differences between cancer and non-cancer participants decreased over the follow-up year (p=0.01). Conclusion: Cancer survivors have higher prevalence of physical and functional limitations compared to noncancer individuals. Such disparities in functional limitations impact the independent functioning of these survivors. Healthcare professionals need to recognize potential for debilitating functional abilities among cancer survivors and address their needs. Our findings extend our understanding of the burden of physical and functional limitations in cancer survivors and call for action from health care providers.
{"title":"Physical and Functional Limitations in US Older Cancer Survivors","authors":"Prachi P. Chavan, Satish K. Kedia, Xinhua Yu","doi":"10.4172/2165-7386.1000312","DOIUrl":"https://doi.org/10.4172/2165-7386.1000312","url":null,"abstract":"Objective: The ability to independently perform daily activities is a crucial component of quality of life among \u0000 older cancer survivors. However, many cancer survivors face difficulties performing their daily activities for living an \u0000 independent life. The purpose of this study was to evaluate whether physical and functional status significantly \u0000 decreased in cancer survivors compared to people without cancer. \u0000Methods: The Medicare Current Beneficiary Survey (MCBS) is a nationally representative longitudinal study for \u0000 the entire aged Medicare beneficiaries. Data from 2006 to 2010 were used for analysis of this study. Design-based \u0000 descriptive analysis and logistic models with adjusted survey weights were performed. To ensure comparability \u0000 between cancer and non-cancer older adults, propensity score weighting was developed using logistic regressions. \u0000Results: The final sample consisted of 11,533 participants. Cancer survivors had more limitations compared to \u0000 non-cancer individuals: physical limitations (23.3% vs. 19.7%, p=0.006), activity daily living limitations (ADL) (7.7% \u0000 vs. 5.8%, p=0.02), and instrumental activity of daily living limitations (IADL) (13.5% vs. 11.0%, p=0.02. The odds \u0000 ratio (OR) for cancer survivors compared to non-cancer individuals was 1.62 (95% CI: 1.28-2.06) for physical \u0000 limitations, 1.08 (95% CI: 0.72-1.62) for ADL, and 1.30 (95% CI: 0.97-1.73) for IADL. There was a one year lag in \u0000 functional limitations resulting in one year loss of physical capabilities among cancer survivors. However, these \u0000 differences between cancer and non-cancer participants decreased over the follow-up year (p=0.01). \u0000Conclusion: Cancer survivors have higher prevalence of physical and functional limitations compared to noncancer \u0000 individuals. Such disparities in functional limitations impact the independent functioning of these survivors. \u0000 Healthcare professionals need to recognize potential for debilitating functional abilities among cancer survivors and \u0000 address their needs. Our findings extend our understanding of the burden of physical and functional limitations in \u0000 cancer survivors and call for action from health care providers.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000312","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46322932","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 : 2017-07-24DOI: 10.4172/2165-7386.1000313
Orapan Fumaneeshoat
Introduction: Code Z515, which indicates palliative care, is a part of the International Classification of Diseases and Related Health Problems (ICD). At present, this diagnostic code is still rarely used although the number of patients requiring palliative care is increasing. So many patients forfeit their right to access the best palliative care and all that it entails. Objectives: To determine the prevalence of the code Z515 diagnostis according to ICD-10 in patients diagnosed with cancer as well as the relationship between treatment and costs in Songklanagarind Hospital. Methods: A retrospective descriptive study on patients diagnosed with code Z515 in Songklanagarind Hospital between 2012 and 2016 was conducted. We collected data from our hospital information system (HIS) and divided into 2 groups, In and outpatients department. Then we recorded data using extraction forms. We analyzed the data using percentages, 95% CI and odds ratios. Results: Prevalence of diagnosis with code Z515 in cancer patients was 1.7 × 10-3 for both in- and outpatients. For outpatients, patients who received radiation and combined treatment were 9.4 and 26.5 times, respectively, to incur medical costs in the range of 4,001 to 6,000 THB (118-177 USD) compared with patients who received supportive treatment or had no cost. The results shows no relationship between the number of medications taken and cost among inpatients, there was no observable difference in statistical significance The same was true for the relationship between treatment and costs as well. Conclusion: Study found a very low prevalence of coding Z515 use. Although we know that all cancer patients should receive the best palliative care, the greater their benefit from this type of treatment, the Z515 diagnosis remains less pervasive than it should be.
{"title":"Prevalence of Coding Z515 Diagnosis in Cancer Patients and Relationship between Treatment and Cost in Songklanagarind Hospital, Hat Yai, Songkhla","authors":"Orapan Fumaneeshoat","doi":"10.4172/2165-7386.1000313","DOIUrl":"https://doi.org/10.4172/2165-7386.1000313","url":null,"abstract":"Introduction: Code Z515, which indicates palliative care, is a part of the International Classification of Diseases and Related Health Problems (ICD). At present, this diagnostic code is still rarely used although the number of patients requiring palliative care is increasing. So many patients forfeit their right to access the best palliative care and all that it entails. \u0000Objectives: To determine the prevalence of the code Z515 diagnostis according to ICD-10 in patients diagnosed with cancer as well as the relationship between treatment and costs in Songklanagarind Hospital. \u0000Methods: A retrospective descriptive study on patients diagnosed with code Z515 in Songklanagarind Hospital between 2012 and 2016 was conducted. We collected data from our hospital information system (HIS) and divided into 2 groups, In and outpatients department. Then we recorded data using extraction forms. We analyzed the data using percentages, 95% CI and odds ratios. \u0000Results: Prevalence of diagnosis with code Z515 in cancer patients was 1.7 × 10-3 for both in- and outpatients. For outpatients, patients who received radiation and combined treatment were 9.4 and 26.5 times, respectively, to incur medical costs in the range of 4,001 to 6,000 THB (118-177 USD) compared with patients who received supportive treatment or had no cost. The results shows no relationship between the number of medications taken and cost among inpatients, there was no observable difference in statistical significance The same was true for the relationship between treatment and costs as well. \u0000Conclusion: Study found a very low prevalence of coding Z515 use. Although we know that all cancer patients should receive the best palliative care, the greater their benefit from this type of treatment, the Z515 diagnosis remains less pervasive than it should be.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47546481","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 : 2017-07-17DOI: 10.4172/2165-7386.1000310
W. Younes, L. Tawalbeh
Constipation has a negative effect on patients with cancer and their families. It negatively affects the quality of life terms of physical, social, psychological, and spiritual dimensions. The aim of this paper was to review the studies that addressed constipation among patients with cancer and to explore its influence on the quality of life and wellbeing for patients and their families. Completed studies were identified through systematic search using Cumulative index for Nursing and Applied Health Literature, EBSCO Host, Ovid Journal and PubMed. This search located the studies that were published between 1989 and 2015 about constipation effect, pathophysiology, assessment and management. The review identified 44 studies and indicated that constipation has negative effect on QOL among patient with cancer and their families. Various assessment and management constipation tools and strategies were used according to patient’s health condition. Pharmacological and non-pharmacological methodologies were used to manage constipation. Appropriate assessment has a positive impact on effective management of constipation among patients with cancer; that may help improve the quality of life. Nurses play a significant role in performing comprehensive assessment strategies to detect the risk factor for constipation and applying the prevention precaution to reduce opportunity of its occurrence. Nurses should perform constipation management strategies that include both pharmacological and non-pharmacological approaches.
{"title":"Bowel Management: Constipation among Patients with Cancer","authors":"W. Younes, L. Tawalbeh","doi":"10.4172/2165-7386.1000310","DOIUrl":"https://doi.org/10.4172/2165-7386.1000310","url":null,"abstract":"Constipation has a negative effect on patients with cancer and their families. It negatively affects the quality of life \u0000 terms of physical, social, psychological, and spiritual dimensions. The aim of this paper was to review the studies \u0000 that addressed constipation among patients with cancer and to explore its influence on the quality of life and wellbeing \u0000 for patients and their families. Completed studies were identified through systematic search using Cumulative \u0000 index for Nursing and Applied Health Literature, EBSCO Host, Ovid Journal and PubMed. This search located the \u0000 studies that were published between 1989 and 2015 about constipation effect, pathophysiology, assessment and \u0000 management. The review identified 44 studies and indicated that constipation has negative effect on QOL among \u0000 patient with cancer and their families. Various assessment and management constipation tools and strategies were \u0000 used according to patient’s health condition. Pharmacological and non-pharmacological methodologies were used to \u0000 manage constipation. Appropriate assessment has a positive impact on effective management of constipation \u0000 among patients with cancer; that may help improve the quality of life. Nurses play a significant role in performing \u0000 comprehensive assessment strategies to detect the risk factor for constipation and applying the prevention \u0000 precaution to reduce opportunity of its occurrence. Nurses should perform constipation management strategies that \u0000 include both pharmacological and non-pharmacological approaches.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46363379","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 : 2017-07-03DOI: 10.4172/2165-7386.1000308
L. B. Bateman
Objective: By exploring perspectives of pediatric specialists on end-of-life (EOL) communication and care through narrative interviews, we aim to examine the extent to which interactions about death lead to feelings of moral distress. Methods: 17 pediatric emergency medicine and pediatric critical care physicians practicing in a 380-bed academic children’s medical center in the southeast went through 2 rounds of narrative interviews. The overarching interview question in Phase I was: “How has your background influenced the way you communicate with and care for dying children and their families?” The data generated from the interviews in Phase I led to additional questions and topics for exploration in Phase II. Grounded theory informed the design of this study and analysis of the data. Results: Although most participants felt that EOL decisions were the families’ jurisdiction, the physicians described experiencing moral distress in some cases, especially when they felt they were forced to put the parents’ prerogatives over the child-patients’ best interests. Moral distress ensued from observing other physicians withdrawing life-sustaining care too soon, from parents prolonging care contrary to what these physicians thought were the child best interests, and issues surrounding resuscitation and organ donation. Conclusion: Research indicates that physician burnout is more prevalent among those physicians in palliative care who feel inadequately trained in communication skills. In addition to promoting better patient care, more education and training in communication and EOL issues may prevent physician moral distress which can decrease physician burnout and ensure more efficacious humane patient care.
{"title":"Physician Moral Distress and End-of-Life Physician-Parent Communication and Care","authors":"L. B. Bateman","doi":"10.4172/2165-7386.1000308","DOIUrl":"https://doi.org/10.4172/2165-7386.1000308","url":null,"abstract":"Objective: By exploring perspectives of pediatric specialists on end-of-life (EOL) communication and care through narrative interviews, we aim to examine the extent to which interactions about death lead to feelings of moral distress. \u0000Methods: 17 pediatric emergency medicine and pediatric critical care physicians practicing in a 380-bed academic children’s medical center in the southeast went through 2 rounds of narrative interviews. The overarching interview question in Phase I was: “How has your background influenced the way you communicate with and care for dying children and their families?” The data generated from the interviews in Phase I led to additional questions and topics for exploration in Phase II. Grounded theory informed the design of this study and analysis of the data. \u0000Results: Although most participants felt that EOL decisions were the families’ jurisdiction, the physicians described experiencing moral distress in some cases, especially when they felt they were forced to put the parents’ prerogatives over the child-patients’ best interests. Moral distress ensued from observing other physicians withdrawing life-sustaining care too soon, from parents prolonging care contrary to what these physicians thought were the child best interests, and issues surrounding resuscitation and organ donation. \u0000Conclusion: Research indicates that physician burnout is more prevalent among those physicians in palliative care who feel inadequately trained in communication skills. In addition to promoting better patient care, more education and training in communication and EOL issues may prevent physician moral distress which can decrease physician burnout and ensure more efficacious humane patient care.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"2017 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49135178","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 : 2017-06-27DOI: 10.4172/2165-7386-C1-008
E. Wekesa
{"title":"PATIENTS ATTITUDES TOWARDS ADVANCE CARE PLANNING: COMPARISON OF HIGH INCOME ECONOMIES VERSUS LOW INCOME ECONOMIES","authors":"E. Wekesa","doi":"10.4172/2165-7386-C1-008","DOIUrl":"https://doi.org/10.4172/2165-7386-C1-008","url":null,"abstract":"","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70691131","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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