scholarly journals Caring Advanced Cancer Patients at Home During COVID-19 Outbreak: Burnout and Psychological Morbidity Among Palliative Care Professionals in Italy

2020 ◽  
Author(s):  
Silvia Varani ◽  
Rita Ostan ◽  
Luca Franchini ◽  
Giacomo Ercolani ◽  
Raffaella Pannuti ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Psychological Morbidity ◽  
Advanced Cancer Patients ◽  
At Home

Impact of a dedicated supportive care center telephone triaging program (SCCTP) for patients with advanced cancer.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 54-54
Author(s):  
Lindsey E Pimentel ◽  
Sriram Yennurajalingam ◽  
Gary B. Chisholm ◽  
Tonya Edwards ◽  
Maria Guerra-Sanchez ◽  
...  
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Symptom Management ◽  
Care Center ◽  
Assessment Scale ◽  
Cancer Type ◽  
Advanced Cancer Patients ◽  
At Home

54 Background: Due to high symptom burden in advanced cancer patients, ongoing symptom management for outpatient palliative care patients is vital. More patients are receiving outpatient care; Yet, most palliative care patients receive less than 2 follow ups. Nurse telephone care can improve quality of life in these patients. Our aim was to determine frequency and care provided by Supportive Care Center Telephone Program (SCCTP) in advanced cancer patients. Methods: 400 consecutive patients who utilized palliative care service, 200 from outpatient Supportive Care Center (SCC) and 200 from inpatient Palliative Care (IPC), were followed for 6 months starting 3/2012 to examine call frequency and reason and outcomes including pain and other symptoms [Edmonton Symptom Assessment Scale (ESAS) and Memorial Delirium Assessment Scale (MDAS)] associated with utilization of SCCTP. We also examined the effect of SCCTP interventions on pain, ESAS and counseling needs. Results: 375 patients were evaluable. Median age 59 years, 53% female, 70% white. Most frequent cancer type were gastrointestinal (20%, p < 0.0001) for IPC and thoracic (23%, p <0.0001) for SCC. SCC patients had higher prevalence of CAGE positivity (28% SCC vs 11% IPC, p <0.0001), ESAS SDS(p=0.0134), depression(p=0.0009), anxiety(p=0.0097) and sleep(p=0.0015); MDAS scores were significantly higher in IPC (p<0.0001).115/400 patients (29%) utilized SCCTP. 96/115 outpatients (83%) used the SCCTP vs 19/115 IPC (17%). Common reasons for calls were pain (24%), pain medication refills (24%) and counseling (12%). Of 115 phone calls, 340 recommendations were made; 43% (145/340) were regarding care at home; 56% of these recommendations were regarding opioids. Patients who utilized SCCTP had worse pain(p=0.0059), fatigue(p=0.0448), depression(p=0.0410), FWB(p=0.0149) and better MDAS scores(p=0.0138) compared to non-utilizers. Conclusions: There was more frequent SCCTP use by outpatients than inpatients. Most common reason for utilization was pain control. Frequently, recommendations were made to continue symptom management at home. Patients who utilized SCCTP had worse pain, fatigue, depression, well-being scores and better delirium scores.

scholarly journals Late referrals to home palliative care service affecting death at home in advanced cancer patients in Japan: a nationwide survey

2011 ◽  
Vol 22 (9) ◽  
pp. 2113-2120 ◽  
Author(s):  
S. Fukui ◽  
J. Fujita ◽  
M. Tsujimura ◽  
Y. Sumikawa ◽  
Yayoi Hayashi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Care Service ◽  
Palliative Care Service ◽  
Nationwide Survey ◽  
Advanced Cancer Patients ◽  
At Home

Exploring the preferences for place of death among cancer patients and their family caregivers.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 40-40 ◽  
Author(s):  
Marieberta Vidal
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Place Of Death ◽  
Hospital Death ◽  
Advanced Cancer Patients ◽  
Home Death ◽  
Significant Difference ◽  
The Uk ◽  
At Home

40 Background: Understanding the preferred place of death (POD) for advanced cancer patients (Pts) is very important when they are approaching the end of life. Meeting the preferences of Pts is considered an important palliative care (PC) outcome. Prior studies reported that more than 80% of Pts with terminally ill cancer prefer to die at home. In many countries such as the UK, Italy, Greece, South Korea and Japan home deaths have been falling, but in some states of the US and Canada there are indications of a reversal of trends. Dying at home may be more difficult for Pts in severe physical and psychosocial distress, or when there are social or financial difficulties. The purpose of this study was to determine POD preference among PC Pts in the outpatient center (OC) and the palliative care unit (PCU). Methods: A sectional anonymous questionnaire was administered to advanced cancer Pts and caregivers (PCU patients and OC) between August 2012 and September 2014. PCU Pts responded when there was no delirium and the primary caregiver responded when the patient was unable to respond. In the case of outpatients dyads (patient and caregiver) were assessed. Results: Overall 141/216 (65%) preferred home death. PCU patients preferred home death less than outpatients. Patient and caregiver agreement regarding preferred place of death was 86% (p <0.001). The preferred POD was the same as one month ago for 82/99 (83%) PCU Pts and 111/116 (96%) outpatients, with significant difference between groups (p=0.002). Conclusions: Although home is the preferred POD in advanced cancer Pts, a substantial minority prefer hospital death or no difference. Patients admitted to the PCU have a higher preference for hospital death in comparison to the outpatients, likely reflecting more severe distress because they already tried home care. Pts and caregivers agree on POD in most cases. Personalized assessment of POD preference for both patient and caregiver is needed. [Table: see text]

Palliative Referrals in Advanced Cancer Patients: Utilizing the Supportive and Palliative Care Indicators Tool and Rothman Index

2021 ◽  
pp. 104990912110178
Author(s):  
Abigail Sy Chan ◽  
Amit Rout ◽  
Christopher R. D.’Adamo ◽  
Irina Lev ◽  
Amy Yu ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Length Of Hospital Stay ◽  
Inpatient Setting ◽  
Advanced Cancer Patients ◽  
Care Needs ◽  
Early Palliative Care ◽  
Code Status ◽  
Palliative Care Needs

Background: Timely identification of palliative care needs can reduce hospitalizations and improve quality of life. The Supportive & Palliative Care Indicators Tool (SPICT) identifies patients with advanced medical conditions who may need special care planning. The Rothman Index (RI) detects patients at high risk of acutely decompensating in the inpatient setting. SPICT and RI among cancer patients were utilized in this study to evaluate their potential roles in palliative care referrals. Methods: Advanced cancer patients admitted to an institution in Baltimore, Maryland in 2019 were retrospectively reviewed. Patient demographics, length of hospital stay (LOS), palliative care referrals, RI scores, and SPICT scores were obtained. Patients were divided into SPICT positive or negative and RI > 60 or RI < 60.Unpaired t-tests and chi-square tests were utilized to determine the associations between SPICT and RI and early palliative care needs and mortality. Results: 227 patients were included, with a mean age of 68 years, 63% Black, 59% female, with the majority having lung and GI malignancies. Sixty percent were SPICT +, 21% had RI < 60. SPICT + patients were more likely to have RI < 60 (p = 0.001). SPICT + and RI < 60 patients were more likely to have longer LOS, change in code status, more palliative/hospice referrals, and increased mortality (p <0.05). Conclusions: SPICT and RI are valuable tools in predicting mortality and palliative/hospice care referrals. These can also be utilized to initiate early palliative and goals of care discussions in patients with advanced cancer.

Differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units: A multicenter prospective cohort study (EASED)

2021 ◽  
pp. 026921632198956
Author(s):  
Takahiro Higashibata ◽  
Takayuki Hisanaga ◽  
Shingo Hagiwara ◽  
Miho Shimokawa ◽  
Ritsuko Yabuki ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Urinary Catheterization ◽  
Urinary Catheters ◽  
Advanced Cancer Patients ◽  
Appropriate Use ◽  
Palliative Care Units ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort

Background: Studies on the appropriate use of urinary catheters for cancer patients at the end of life are limited. Aim: To clarify the differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units. Design: Pre-planned secondary analysis of a multicenter, prospective cohort study; East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED). Setting/participants: This study enrolled consecutive advanced cancer patients admitted to palliative care units between January and December 2017. The final study group comprised 1212 patients from 21 institutions throughout Japan. Results: Out of the 1212 patients, 380 (31.4%; 95% confidence interval, 28.7%–34.0%) underwent urinary catheterization during their palliative care unit stay, and the prevalence of urinary catheterization in patients who died at palliative care units by institution ranged from 0.0% to 55.4%. When the 21 participating institutions were equally divided into three groups according to the institutional prevalence of catheterization, patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation were more likely to be catheterized in institutions with a high prevalence of catheterization than in those with a low or moderate prevalence ( p < 0.008, p = 0.008, and p < 0.008, respectively). Conclusion: This study revealed that the institutional prevalence of urinary catheterization in advanced cancer patients at palliative care units widely varied. Further studies are needed to establish the appropriate use of urinary catheters, especially in patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation.

scholarly journals Palliative Care and COVID-19 Pandemic: Retrospective Study of Factors Associated With Infection and Death at an Oncological Palliative Care Reference Center

2021 ◽  
pp. 104990912098696
Author(s):  
Livia Costa de Oliveira ◽  
Karla Santos da Costa Rosa ◽  
Ana Luísa Durante ◽  
Luciana de Oliveira Ramadas Rodrigues ◽  
Daianny Arrais de Oliveira da Cunha ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Tumor Type ◽  
Advanced Cancer Patients ◽  
Factors Associated ◽  
Reactive Protein

Background: Advanced cancer patients are part of a group likely to be more susceptible to COVID-19. Aims: To describe the profile of advanced cancer inpatients to an exclusive Palliative Care Unit (PCU) with the diagnosis of COVID-19, and to evaluate the factors associated with death in these cases. Design: Retrospective cohort study with data from advanced cancer inpatients to an exclusive PCU, from March to July 2020, with severe acute respiratory syndrome. Diagnostic of COVID-19 and death were the dependent variables. Logistic regression analyses were performed, with the odds ratio (OR) and 95% confidence interval (CI). Results: One hundred fifty-five patients were selected. The mean age was 60.9 (±13.4) years old and the most prevalent tumor type was breast (30.3%). Eighty-three (53.5%) patients had a diagnostic confirmation of COVID-19. Having diabetes mellitus (OR: 2.2; 95% CI: 1.1-6.6) and having received chemotherapy in less than 30 days before admission (OR: 3.8; 95% CI: 1.2-12.2) were associated factors to diagnosis of COVID-19. Among those infected, 81.9% died and, patients with Karnofsky Performance Status (KPS) < 30% (OR: 14.8; 95% CI 2.7-21.6) and C-reactive protein (CRP) >21.6mg/L (OR: 9.3; 95% CI 1.1-27.8), had a greater chance of achieving this outcome. Conclusion: Advanced cancer patients who underwent chemotherapy in less than 30 days before admission and who had diabetes mellitus were more likely to develop Coronavirus 2019 disease. Among the confirmed cases, those hospitalized with worse KPS and bigger CRP were more likely to die.

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