scholarly journals The quality of palliative sedation in end-stage disease: audit from a department of oncology and haematology

2022 ◽  
Author(s):  
Saviola Alessia ◽  
Schipilliti Francesca Matilde ◽  
Isca Chrystel ◽  
Salati Massimiliano ◽  
Dini Daniele ◽  
...  
Keyword(s):  
Palliative Sedation ◽  
Stage Disease ◽  
End Stage

scholarly journals The Quality of Palliative Sedation in End-Stage Disease: Audit From a Department of Oncology and Haematology

2021 ◽  
Author(s):  
Saviola Alessia ◽  
Schipilliti Francesca Matilde ◽  
Isca Chrystel ◽  
Massimiliano Salati ◽  
Daniele Dini ◽  
...  
Keyword(s):  
Karnofsky Performance Status ◽  
Performance Status ◽  
Critical Role ◽  
Palliative Sedation ◽  
University Hospital ◽  
Refractory Symptoms ◽  
Stage Disease ◽  
End Stage ◽  
The Impact

Abstract PurposePalliative sedation (PS) plays a critical role to give suffering relief from refractory symptoms at the end of life. Our audit aimed to assess and improve quality of PS at the Department of Oncology and Hematology of University Hospital of Modena, to verify the adherence to international guidelines, the cooperation among members of care team, focusing with attention on family’s perception of this delicate situation. MethodsFrom December 2016 to June 2019, data of patients undergoing PS in the Department were collected by an electronic folder tool, “Sedation Tool” (ST), that recorded clinical and PS informations, D-PaP, Rudkin Score and family’s perception. Results245 patients were enrolled. 82% had a Karnofsky Performance Status 10-20%. The most common cancer types were lung and gastro-intestinal carcinomas (27% and 21% respectively). Refractory symptoms observed were confusion and agitation (76%), dyspnea (39%), pain (15%), delirium (10%), psychological distress (5%). Midazolam was the drug of choice for PS. Most of patients had Rudkin score 5 after 24 hours and 33% had terminal event within a period of 24 hours from the beginning of PS. During PS most of Patient’s relatives reported peacefulness (65%), agitation/impatience in 6% of cases, concern for suffering (16%). ConclusionPS is used in case of worsening general conditions at the end-stage disease to relieve refractory symptoms with dignity. The ST can become a simple instrument to evaluate and improve PS quality, providing more attention on the impact of PS on relatives to then possibly develop new supportive procedures for patients and their families.

Predictors of Change in Quality of Life in Patients With End-Stage Disease During Hospitalization

2017 ◽  
Vol 32 (2) ◽  
pp. 69-76
Author(s):  
Radka Bužgová ◽  
Lucie Sikorová ◽  
Radka Kozáková ◽  
Darja Jarošová
Keyword(s):  
Quality Of Life ◽  
Functional Status ◽  
Karnofsky Performance Status ◽  
Depression Scale ◽  
Life Questionnaire ◽  
European Organization ◽  
Stage Disease ◽  
End Stage ◽  
Predictors Of Change

Background: Currently, there are no studies aimed at evaluating the quality of life (QoL) of patients with end-stage disease during hospitalization and the factors that influence it. Aim: The aim of the research was to identify predictors of change in the QoL of patients hospitalized due to advanced stage of disease. Methods: The sample consisted of 140 patients with end-stage disease who were hospitalized on this account. For evaluation of QoL, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was used. The Hospital Anxiety and Depression Scale and Karnofsky Performance Status questionnaires were used for the assessment of mental and functional status. For the evaluation of predictors of negative change in QoL, a logistic regression analysis was used. Results: During hospitalization, there was a significant deterioration in the scores given for all domains of the functional QLQ-C30 scale, but not the symptomatic scale. Predictors of change in overall QoL detected were marital status, improved functional status, and depression detected on admission to hospital. Gender and age were found to be protective factors against deterioration in overall QoL. Conclusion: Sociodemographic characteristics and mental and functional status may be associated with change in QoL of patients with end-stage disease during hospitalization.

A Review of Prognostic Tools in Heart Failure

2017 ◽  
Vol 35 (3) ◽  
pp. 514-522 ◽  
Author(s):  
Jennifer Treece ◽  
Hrak Chemchirian ◽  
Neil Hamilton ◽  
Manar Jbara ◽  
Venkataramanan Gangadharan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Palliative Medicine ◽  
Poor Prognosis ◽  
Advanced Heart Failure ◽  
Improve Quality ◽  
Stage Disease ◽  
End Stage ◽  
Patients With Poor Prognosis

A minority of patients with end-stage disease are referred to palliative medicine for consultation in advanced heart failure. Educating stakeholders, including primary care, cardiology, and critical care of the benefits of hospice and palliative medicine for patients with poor prognosis, may increase appropriately timed referrals and improve quality of life for these patients. This article reviews multiple tools useful in prognostication in the setting of advanced heart failure.

Assessment of Quality of Life of Family Members of Inpatients with End-Stage Disease

2015 ◽  
Vol 31 (4) ◽  
pp. 250-257 ◽  
Author(s):  
Radka Bužngová ◽  
Radka Kozáková ◽  
Lucie Sikorová
Keyword(s):  
Quality Of Life ◽  
Family Members ◽  
Stage Disease ◽  
End Stage

The Deteriorating Patient: Therapies Including Lung Transplantation

2021 ◽  
Vol 42 (04) ◽  
pp. 623-638
Author(s):  
Stephanie Detailleur ◽  
Robin Vos ◽  
Pieter Goeminne
Keyword(s):  
Lung Transplantation ◽  
Severity Index ◽  
Forced Expiratory Volume ◽  
Exacerbation Rate ◽  
Stage Disease ◽  
Severity Scores ◽  
Dyspnea Score ◽  
Deteriorating Patient ◽  
End Stage

AbstractIn this review paper, we discuss the characteristics that define severe bronchiectasis and which may lead to deterioration of noncystic fibrosis bronchiectasis. These characteristics were used to establish the current severity scores: bronchiectasis severity index (BSI), FACED, and E-FACED (exacerbation frequency, forced expiratory volume in 1 second, age, colonization, extension and dyspnea score). They can be used to predict mortality, exacerbation rate, hospital admission, and quality of life. Furthermore, there are different treatable traits that contribute to severe bronchiectasis and clinical deterioration. When present, they can be a target of the treatment to stabilize bronchiectasis.One of the first steps in treatment management of bronchiectasis is evaluation of compliance to already prescribed therapy. Several factors can contribute to treatment adherence, but to date no real interventions have been published to ameliorate this phenomenon. In the second step, treatment in deteriorating patients with bronchiectasis should be guided by the predominant symptoms, for example, cough, sputum, difficulty expectoration, exacerbation rate, or physical impairment. In the third step, we evaluate treatable traits that could influence disease severity in the deteriorating patient. Finally, in patients who are difficult to treat despite maximum medical treatment, eligibility for surgery (when disease is localized), should be considered. In case of end-stage disease, the evaluation for lung transplantation should be performed. Noninvasive ventilation can serve as a bridge to lung transplantation in patients with respiratory failure.

scholarly journals MANAGEMENT OF THE PATIENT WITH ADVANCED AMYOTROPHIC LATERAL SCLEROSIS: THE CAREGIVER’S OPINION

2016 ◽  
Vol 15 (1) ◽  
pp. 24-29
Author(s):  
Maria Rivara ◽  
◽  
Cornelius Barlascini ◽  
Paolo Banfi ◽  
Antonello Nicolini ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Amyotrophic Lateral Sclerosis ◽  
Invasive Mechanical Ventilation ◽  
Level Of Care ◽  
Burden Of Care ◽  
Stage Disease ◽  
Heavy Burden ◽  
End Stage ◽  
Lateral Sclerosis

Objectives. The possibility of prolonging and augmenting the quality of life of respiratory patients in end-stage disease and in particular neuromuscular disease patients depends on an increased level of care. Amyotrophic lateral sclerosis (ALS) is a neurological disease characterized by a fast progressive impairment of respiratory function which leads to mechanical ventilation and high burden of care. A specifically designed questionnaire was administered to caregivers to analyze the level of care provided to these patients in our districts. Patients and methods. The study population consisted of 70 patients (44 males and 26 females). Of the 70 patients, 46 were being treated with non-invasive ventilation and 24 with invasive mechanical ventilation. The questionnaire was divided in two parts: questions 1 to 13 investigated life conditions and 14 to 22 the quality of care provided. Results. The patients studied present a heavy burden of care and this is in relation to the quantity of respiratory aids prescribed. The symptom which created statistically significant problems for care was breathlessness, as is often reported in the literature. The presence of homecare tended to create conditions of greater serenity for the caregivers. Conclusions. This study shows that the burden of care in end-stage ALS patients is very onerous, and it can help to point out problems not sufficiently contemplated in healthcare planning.

Skin disorders

2015 ◽  
pp. 325-340 ◽  
Author(s):  
Susie Seaman ◽  
Barbara M. Bates-Jensen
Keyword(s):  
Quality Of Life ◽  
Management Strategies ◽  
Skin Disorders ◽  
Cutaneous Manifestations ◽  
Goals Of Care ◽  
Basic Care ◽  
Stage Disease ◽  
Psychosocial Implications ◽  
End Stage

Skin disorders are both emotionally and physically challenging for patients and caregivers. Cutaneous symptoms may be the result of disease progression, complications associated with end-stage disease or the end of life, or simple changes in function of urinary or fecal diversions. All cutaneous symptoms require attention to basic care issues, creativity in management strategies, and thoughtful attention to the psychosocial implications of cutaneous manifestations. Although the goals of care do not include curing the condition, they always include alleviating the distressing symptomatology and improving quality of life. The most distressing symptoms associated with skin disorders are odor, exudate, and pain.

scholarly journals Mechanism of Macrophage Action in Osteoarthritis

2021 ◽  
Vol 5 (4) ◽  
pp. 209-212
Author(s):  
Yangle Li ◽  
Jie Zheng ◽  
Xiaoqing Wu ◽  
Feng Yang
Keyword(s):  
The Elderly ◽  
Incidence Rates ◽  
Joint Disease ◽  
Disability Rate ◽  
Stage Disease ◽  
Chronic Progressive Disease ◽  
Huge Impact ◽  
End Stage

Osteoarthritis (OA) is the most common chronic joint disease and the main cause of pain and disability in adults (typical clinical OA characteristics), and women are more predisposed to this disease than men. About 400 million people worldwide and more than 100 million in China suffer from arthritis. OA was named the 11th largest contributor of mortality in the world, with a disability rate of as high as 53%, and is among the three major killers threatening the health of the elderly. Colloquially, OA is called the “number one disabling disease of the 21st century.” It is the main reason for the malfunctioned mobility of the elderly. Generally, women and men start to have OA at 40 and 50, respectively. Incidence rates increased dramatically between the ages of 55 and 60. The prevalence rate among older persons over 70 years of age is almost 80–90%. In addition, the disease is a chronic progressive disease, which can not only lead to the decline of life function and the reduction or even loss of quality of life, but also has an important and huge impact on health care and social costs. This disease may also demand higher economic requirements of the affected families. Until now, since the pain mechanism of the disease is not clear, there are no effective treatment methods, and surgical joint replacement is the only choice to treat the end-stage disease. This paper focuses on the role of macrophages in OA development, with particular attention to the occurrence of pain and possible mediators involved.

Health-related quality of life among breast, prostate, and colorectal cancer patients with end-stage disease

2013 ◽  
Vol 23 (4) ◽  
pp. 1387-1394 ◽  
Author(s):  
Niilo Färkkilä ◽  
Saku Torvinen ◽  
Risto P. Roine ◽  
Harri Sintonen ◽  
Juha Hänninen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Cancer Patients ◽  
Health Related Quality ◽  
Stage Disease ◽  
Related Quality ◽  
Health Related ◽  
Colorectal Cancer Patients ◽  
End Stage

scholarly journals Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025692 ◽  
Author(s):  
Corita R Grudzen ◽  
Deborah J Shim ◽  
Abigail M Schmucker ◽  
Jeanne Cho ◽  
Keith S Goldfeld
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Palliative Care ◽  
Randomised Controlled Trial ◽  
Case Management ◽  
Controlled Trial ◽  
Chronic Obstructive ◽  
Randomised Controlled ◽  
End Stage

IntroductionEmergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysisThis is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and disseminationInstitutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03325985; Pre-results.

Sign in / Sign up

Export Citation Format

Share Document