Early integration of palliative/supportive cancer care—healthcare professionals’ perspectives on the support needs of cancer patients and their caregivers across the cancer treatment trajectory

BackgroundDementia and cancer are both diseases associated with older age. The National Cancer Data Audit in England found that 4.4% of people diagnosed with cancer also had cognitive impairment. Decisions about cancer treatment can be very complex when someone already has dementia. Often someone’s closest relative may be asked to make decisions on their behalf. Little is known about the psychosocial impact that this has on carers, or what their support needs are during this time.AimTo explore the experiences of family carers who have been involved in making cancer treatment decisions on behalf of a relative with dementia, in particular identifying challenges and support needs.MethodThe authors are conducting semi-structured interviews with carers of people with dementia who have been involved in making decisions about cancer treatment on their behalf. Data is being thematically analysed using an inductive approach. Two researchers will independently verify themes.ResultsThe authors expect to have completed 14–18 interviews and will report their preliminary findings. Family carers experience many difficulties in the context of cancer and dementia, including lack of support when coping with the aftereffects of cancer treatment, lack of awareness among healthcare professionals regarding the authority granted by a lasting power of attorney and the anxiety created by feeling responsible for identifying cancer recurrence.ConclusionThis study will highlight that supporting someone with dementia through cancer treatment, and having to make decisions about it on their behalf, creates unique challenges for carers. Currently there is a significant lack of support for those facing this distressing experience.

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Pastoral care of cancer patients: Defining utilization of services at a comprehensive cancer center.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24171 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24171-e24171

Author(s):

Elizabeth Palmer ◽

Anghela Paredes ◽

Madison Hyer ◽

Timothy M. Pawlik

Keyword(s):

Pastoral Care ◽

Cancer Treatment ◽

Cancer Patients ◽

Spiritual Care ◽

Cancer Care ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Spiritual Needs ◽

Active Listening ◽

Patients With Cancer

e24171 Background: Addressing the religious/spiritual needs of patients is an important component of comprehensive cancer care. Patients often report that providers infrequently engage them about their needs during treatment. In addition, providers cite inadequate training as a significant barrier to providing spiritual care. While patients may benefit from the presence of a spiritual care specialist during cancer treatment, the utilization and content of these services are not well defined. We sought to characterize utilization of pastoral care (PC) services, as well as delineate differences in PC utilization among patients with cancer. Methods: Data on patients being treated for cancer at a Comprehensive Cancer Center between 2015-2018 were obtained from the electronic medical record. Overall utilization, type of PC services utilized, as well as factors associated with use of PC were assessed. Analyses included descriptive statistics and logistic regression. Results: Among 14,322 cancer patients, roughly one-third (n = 5166, 36.1%) had at least one PC encounter during their cancer treatment. Interventions most frequently provided by PC included supportive presence (93.5%) and active listening (86.6%), while the most frequently explored topics were treatment expectations (59.8%), issues with faith/beliefs (42.9%), and available coping mechanisms (35.4%). Patients diagnosed with colorectal (OR:1.42, 95%CI:1.07-1.89), liver (OR:2.41, 95%CI:1.80-3.24), or pancreatic cancer (OR:1.43, 95%CI:1.02-2.00) were more likely to utilize PC services compared with other cancers. Patients that identified as Catholic (OR:1.47, 95%CI:1.17-1.84) or Christian (OR:1.73, 95%CI:1.39-2.15) were more likely to request PC services (both p < 0.001) than individuals who had no religious preference/affiliation. Among surgical patients (n = 1,174), the majority of encounters with PC services were in the postoperative setting (n = 801, 70.6%). Patients most often reported that PC helped with verbalization of their feelings (93.6%) and helped reduce stress (76.9%). Conclusions: Over one-third of patients with cancer interacted with PC and received services that often addressed both psychosocial and spiritual concerns. Overall PC utilization and types of PC services rendered varied relative to demographic and religious factors. Providers should be aware of varying patient religious/spiritual needs so as to optimize the entire cancer care experience for patients.

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Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care

10.21203/rs.2.16088/v2 ◽

2020 ◽

Author(s):

Ellinor Christin Haukland ◽

Christian von Plessen ◽

Carsten Nieder ◽

Barthold Vonen

Keyword(s):

Palliative Care ◽

Adverse Events ◽

End Of Life ◽

Cancer Patients ◽

Cancer Care ◽

Quality And Safety ◽

Negative Consequences ◽

Specialist Palliative Care ◽

Early Integration ◽

Anticancer Treatment

Abstract Background: Anticancer treatment exposes patients to negative consequences such as increased toxicity and decreased quality of life, and there are clear guidelines recommending limiting use of aggressive anticancer treatments for patients near end of life. The aim of this study is to investigate the association between anticancer treatment given during the last 30 days of life and adverse events contributing to death and elucidate how adverse events can be used as a measure of quality and safety in end-of-life cancer care Methods: Retrospective cohort study of 247 deceased hospitalised cancer patients at three hospitals in Norway. The Global Trigger Tool method were used to identify adverse events. We used Poisson regression and binary logistic regression to compare adverse events and association with use of anticancer treatment given during the last 30 days of life. Results: 30 % of deceased hospitalised cancer patients received some kind of anticancer treatment during the last 30 days of life, mainly systemic anticancer treatment. These patients had 62 % more adverse events compared to patients not being treated last 30 days, 39 vs. 24 adverse events per 1 000 patient days (p<0.001, OR 1.62 (1.23 – 2.15). They also had twice the odds of an adverse event contributing to death compared to patients without such treatment, 33 vs. 18 % (p=0.045, OR 1.85 (1.01 – 3.36)). Receiving follow up by specialist palliative care reduced the rate of AEs per 1 000 patient days in both groups by 29 % (p= 0.02, IRR 0.71, CI 95% 0.53 – 0.96). Conclusions: Anticancer treatment given during the last 30 days of life is associated with a significantly increased rate of adverse events and related mortality. Patients receiving specialist palliative care had significantly fewer adverse events, supporting recommendations of early integration of palliative care in a patient safety perspective.

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Special aspects of medical care for cancer patients during COVID-19 pandemic

Archive of oncology ◽

10.2298/aoo210205002p ◽

2021 ◽

pp. 2-2

Author(s):

Mariia Pavlushenko ◽

Roman Liubota ◽

Roman Vereshchako ◽

Nikolay Anikusko ◽

Irina Liubota

Keyword(s):

Cancer Treatment ◽

Medical Care ◽

World Health Organization ◽

Cancer Patients ◽

Cancer Care ◽

World Health ◽

Cancer Therapies ◽

Risk Of Infection ◽

The World ◽

Health Organization

The biggest challenge for the World Health Organization today is the fight against the COVID-19 pandemic. The current situation prompted major adjustments in the system of cancer care. In this review, we investigate the aspects of cancer treatment and care during the pandemic, since in this setting oncological services face challenges in determining the feasibility of anticancer treatments while minimizing the risk of infection. Cancer patients are at a higher risk from COVID-19 disease. Therefore, oncological community is discussing on the priorities for providing cancer therapies and care and at the same time minimizing the risk of infection.

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Acupuncture as a complementary therapy for cancer care: acceptability and preferences of patients and informal caregivers

10.21203/rs.3.rs-38589/v1 ◽

2020 ◽

Author(s):

Tessa Lefebvre ◽

Laura Tack ◽

Virginie Blieck ◽

Lieselot Cool ◽

Hans Pottel ◽

...

Keyword(s):

Side Effects ◽

Cancer Patients ◽

Cancer Care ◽

Informal Caregivers ◽

Participation Rate ◽

Complementary Therapy ◽

Care Clinic ◽

Supportive Cancer Care ◽

Number Of Patients ◽

To Receive

Abstract Background: Acupuncture provides a possible complementary therapy which can be used alongside or following cancer treatment to relieve side-effects for cancer patients and survivors, such as pain and depression. Equally, it can provide relief from symptoms such as anxiety and sleep disturbance, which are recognised as significant issues among caregivers of those with cancer. The aim of this study was to explore the acceptability and preferences of cancer patients, disease survivors and their informal caregivers in relation to acupuncture.Methods: A questionnaire was developed to explore acceptability and preferences of cancer patients, disease survivors and their caregivers in relation to acupuncture, including motivations to use acupuncture, preferred symptoms to be addressed, and practical issues (location; cost).Results: A participation rate of 94.5% was obtained, with 116 participating patients and survivors, and 54 caregivers. Acceptability of acupuncture was around 1/3 for patients (34.5%; 40/116) and almost half for informal caregivers (48.0%; 26/54). In terms of preferences, the day care clinic was the favoured location for patients (52.5%; 21/40) to undergo acupuncture, while there was no specific preference on location observed for caregivers. A large number of patients indicated they would be willing to pay to receive the complementary therapy (60%; 24/40). Symptoms of fatigue, feeling listless, and pain were most often identified as complaints patients and survivors would use acupuncture for (60.0%, 57.5%, and 47.5% respectively). For informal caregivers, 48.0% (26/54) expressed an interest in using acupuncture for their pain, stress and sleeping difficulties.Conclusions: This study indicates that many cancer patients, disease survivors and informal caregivers would accept acupuncture as a complementary therapy. They could further identify many symptoms they felt this therapy could relieve. This openness to acupuncture, and expressed preferences provide the foundations for this complementary therapy to be incorporated into holistic and supportive cancer care, both for patients and those supporting them.

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Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care

10.21203/rs.2.16088/v3 ◽

2020 ◽

Author(s):

Ellinor Christin Haukland ◽

Christian von Plessen ◽

Carsten Nieder ◽

Barthold Vonen

Keyword(s):

Palliative Care ◽

Adverse Events ◽

End Of Life ◽

Cancer Patients ◽

Cancer Care ◽

Quality And Safety ◽

Negative Consequences ◽

Specialist Palliative Care ◽

Early Integration ◽

Anticancer Treatment

Abstract Background: Anticancer treatment exposes patients to negative consequences such as increased toxicity and decreased quality of life, and there are clear guidelines recommending limiting use of aggressive anticancer treatments for patients near end of life. The aim of this study is to investigate the association between anticancer treatment given during the last 30 days of life and adverse events contributing to death and elucidate how adverse events can be used as a measure of quality and safety in end-of-life cancer careMethods: Retrospective cohort study of 247 deceased hospitalised cancer patients at three hospitals in Norway in 2012 and 2013. The Global Trigger Tool method were used to identify adverse events. We used Poisson regression and binary logistic regression to compare adverse events and association with use of anticancer treatment given during the last 30 days of life.Results: 30 % of deceased hospitalised cancer patients received some kind of anticancer treatment during the last 30 days of life, mainly systemic anticancer treatment. These patients had 62 % more adverse events compared to patients not being treated last 30 days, 39 vs. 24 adverse events per 1 000 patient days (p<0.001, OR 1.62 (1.23 – 2.15). They also had twice the odds of an adverse event contributing to death compared to patients without such treatment, 33 vs. 18 % (p=0.045, OR 1.85 (1.01 – 3.36)). Receiving follow up by specialist palliative care reduced the rate of AEs per 1 000 patient days in both groups by 29 % (p= 0.02, IRR 0.71, CI 95% 0.53 – 0.96).Conclusions: Anticancer treatment given during the last 30 days of life is associated with a significantly increased rate of adverse events and related mortality. Patients receiving specialist palliative care had significantly fewer adverse events, supporting recommendations of early integration of palliative care in a patient safety perspective.

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Accrual and retention trends among diverse patients in a supportive cancer care trial.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.31_suppl.40 ◽

2019 ◽

Vol 37 (31_suppl) ◽

pp. 40-40

Author(s):

Grace A. Hanvey ◽

Adaixa Padron ◽

Elizabeth L. Kacel ◽

Chantel Ulfig ◽

Deidre B. Pereira

Keyword(s):

Clinical Trial ◽

Cancer Patients ◽

Race And Ethnicity ◽

Cancer Care ◽

Minority Groups ◽

Gynecologic Oncology ◽

Ethnic Disparities ◽

Willingness To Participate ◽

Supportive Cancer Care ◽

Interest Level

40 Background: Despite reporting similar levels of willingness to participate in clinical trials, minority cancer patients remain underrepresented in research interventions. The purpose of this analysis was to examine participant age, race, and ethnicity as predictors of study interest, eligibility, enrollment decision, and attrition in an intervention providing supportive care for women with cancer. Methods: Patients from the UF&Shands Gynecologic Oncology Service (N = 568) were approached for recruitment to either a six-week cognitive-behavioral intervention for insomnia and pain or a psychoeducational control condition. These women were queried about their willingness to participate in the study, interest level, and reasons for declining participation if they did not wish to enroll in the trial. Among enrolled patients (N = 64), predictors of attrition were explored. Results: Of approached patients, 57.2% were older than age 60, 14.7% were non-White, and 3.2% were Hispanic. Chi-square analyses indicated that there were no significant differences in interest level by age [χ2(2,441) = 2.732, p = .255], race [χ2(2,439) = 2.019, p = .364], or ethnicity [χ2(2,431) = 3.242, p = .198]. Eligible minority patients were significantly more likely to enroll than were non-Hispanic Whites [χ2(1,364) = 4.125, p = .042], with Hispanic recruitment driving this difference (p = .011). Survival analyses demonstrated no differences in attrition hazard based on age (B = -.088, p = .825), race (B = .583, p = .275), or ethnicity (B = -19.518, p = .999) among enrolled patients. Conclusions: In our supportive cancer clinical trial (CCT), there were no significant differences in trial interest across racial and ethnic minority groups. In fact, Hispanics were more likely to enroll than non-Hispanics. Furthermore, neither race nor ethnicity was a significant predictor of trial attrition. Future investigation is needed to better understand racial and ethnic disparities in cancer research enrollment, motivators and barriers to participation in supportive cancer care trials, potential inconsistencies in accrual patterns among minority cancer patients, and best practices for enrolling and retaining diverse participants for supportive CCTs. Clinical trial information: NCT02609880.

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Experience of Cancer Patients on their Visit to Cancer Outpatient Department: A Qualitative Study from a Regional Hospital in Mauritius

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45059.14058 ◽

2020 ◽

Author(s):

Abhishek Kashyap ◽

Indrajit Banerjee ◽

Akash Thakur ◽

Vaishali Notwani ◽

Mitanshi Raghuvanshi

Keyword(s):

Qualitative Study ◽

Cancer Treatment ◽

Cancer Patients ◽

Cancer Care ◽

Treatment Compliance ◽

Sampling Technique ◽

Emotional Reactions ◽

Care Needs ◽

Female Ratio ◽

State Of Mind

Introduction: Cancer care studies suggest that being diagnosed with cancer, the patients and their families face various hardships such as financial crisis, increased mental stress, difficulty in managing their relationships and routine lifestyle activities. Moreover, psycho-oncological studies also describe the intense distress and disbelief experienced by patients on their initial diagnosis. The role of cancer care needs to be understood as well as implemented in cancer treatment, thus further enriching the insights of the treating oncologist about their patient’s state of mind. This ultimately allows for the betterment of treatment compliance. Aim: To study the experience of cancer patients on their visit to the cancer clinic and the emotional turmoil after diagnosis and throughout treatment. Materials and Methods: A descriptive phenomenological qualitative study was designed and conducted from August to September 2019 at the Oncology Department of Victoria Hospital, Mauritius. Participation in the study was voluntary, and written consent was taken from each of the study participants. The data was collected on an in-depth one on one interview basis and was recorded, and the purposive sampling technique was used for collecting the data. Results: Out of 12 patients, the male/female ratio equated to 5:7, these patients were from the ages of 23 to 70 years and the mean age of the participants was 48.2 years. A total of 25 different codes were generated in the study, seven main themes were established there from (Motivational factors, Psychological factors, Society, Message for others, Awareness about the disease, Economic factors and Perception towards the healthcare environment). Conclusion: The main implication that emerged from this study is the notion of the lateral views of informal caregivers, family members and medical professionals, towards the patient’s feelings and emotional reactions in respect to their experience of cancer. It has been noted that the positivity of the caregiver corresponds directly to positive outcomes in the cancer treatment whilst simultaneously decreasing the psychological ramifications of the process.

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The COVID-19 Pandemic: Role of Supportive Care in Cancer Patients

Asian Pacific Journal of Cancer Care ◽

10.31557/apjcc.2020.5.s1.259-261 ◽

2021 ◽

Vol 5 (S1) ◽

pp. 259-261

Author(s):

Wasimul Hoda ◽

Sachidanand Jee Bharati ◽

Abvinav Kumar ◽

Sanjay Kumar ◽

Chandrashekhar Choudhari ◽

...

Keyword(s):

Supportive Care ◽

Cancer Treatment ◽

Cancer Patients ◽

Cancer Care ◽

Virus Disease ◽

Healthcare Resources ◽

Corona Virus ◽

Difficult Time ◽

Basic Minimum

Cancer care is adversely affected by the corona virus disease 2019 (COVID-19). Due to increasing number of COVID-19 cases, all healthcare resources are diverted to take care of COIVD-19 patients. This is the most difficult time for cancer patients because cancer treatment is getting delayed or interrupted due to COVID-19. In this tough time, the supportive care can be continued with basic minimum resources and can provide a big relief to cancer patients.

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Oncology healthcare professionals’ perspectives on the psychosocial support needs of cancer patients during oncology treatment

Journal of Health Psychology ◽

10.1177/1359105315626999 ◽

2016 ◽

Vol 22 (10) ◽

pp. 1332-1344 ◽

Cited By ~ 7

Author(s):

Bruno E Aldaz ◽

Gareth J Treharne ◽

Robert G Knight ◽

Tamlin S Conner ◽

David Perez

Keyword(s):

Cancer Patients ◽

Thematic Analysis ◽

Healthcare Professionals ◽

Psychosocial Support ◽

Support Needs ◽

Supportive Services ◽

Oncology Treatment ◽

Building Rapport ◽

Practical Implications ◽

Patients Acceptance

This study explored oncology healthcare professionals’ perspectives on the psychosocial support needs of diverse cancer patients during oncology treatment. Six themes were identified using thematic analysis. Healthcare professionals highlighted the importance of their sensitivity, respect and emotional tact during appointments in order to effectively identify and meet the needs of oncology patients. Participants also emphasised the importance of building rapport that recognises patients as people. Patients’ acceptance of treatment-related distress and uncertainty was described as required for uptake of available psychosocial supportive services. We offer some practical implications that may help improve cancer patients’ experiences during oncology treatment.

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