Increasing Readiness for Early Integrated Palliative Oncology Care: Development and Initial Evaluation of the EMPOWER 2 Intervention

Author(s):  
Laura M. Perry ◽  
Oliver Sartor ◽  
Sonia Malhotra ◽  
Sarah Alonzi ◽  
Seowoo Kim ◽  
...  
2021 ◽  
pp. 1395-1405
Author(s):  
Eve Namisango ◽  
Nickhill Bhakta ◽  
Joanne Wolfe ◽  
Michael J. McNeil ◽  
Richard A. Powell ◽  
...  

PURPOSE The burden of cancer disproportionately affects low- and middle-income countries. Low 5-year survival figures for children with cancer in low-income countries are due to late presentation at diagnosis, treatment abandonment, absence of sophisticated multidisciplinary care, and lack of adequate resources. The reasons for late presentation are partly due to limited awareness of cancer symptoms, high treatment costs, and facility-level barriers to timely access to treatment. Given the systemic challenges, the regional need for palliative oncology care for children care is high. Despite the enormity of the need for palliative oncology for children with cancer in Africa, its level of development remains poor. This paper presents the evidence on the status of palliative oncology care for children in sub-Saharan Africa. METHODS This review provides an overview of the current status of palliative oncology care for children in sub-Saharan Africa, using the WHO building blocks for health systems strengthening as reference points, before proposing a forward-looking prioritized agenda for its development. RESULTS We noted that survival rates for children with cancer remain much poorer in Africa compared with developed countries and palliative oncology care resources are scant. Our results also show low coverage for palliative oncology care services for children, lack of a critical mass of health workers with the skills to deliver the care, a lack of robust documentation of the burden of cancer, widespread lack of access to essential controlled medicines, limited funding from government and limited coverage for palliative oncology care in most cancer control plans. CONCLUSION This review highlights priority areas for action that align to the WHO health system building blocks for strengthening health systems.


2013 ◽  
Vol 21 (3) ◽  
pp. 773-779 ◽  
Author(s):  
Marcelle Miranda da Silva ◽  
Marleá Chagas Moreira ◽  
Joséte Luzia Leite ◽  
Alacoque Lorenzini Erdmann

OBJECTIVE: to understand the meaning baccalaureate nurses and nursing technicians attribute to night work in the context of clinical palliative oncology nursing care services, as well as how nursing works to attend to clients and caregivers' needs in this period. METHOD: in this exploratory and qualitative study, grounded theory was used. Seven nurses and four nursing technicians were interviewed, who composed two sample groups. Nine categories were produced and, in their comparative content analysis, a knowledge emphasis was evidenced with implications for nighttime nursing work. In this study, these aspects were discussed in two of the categories, which are: to describe care practice in order to understand nursing care management and to point out the difficulties in care practice and nursing care management. RESULTS: The results evidence the complexity in the nighttime care context, considering the clients' clinical conditions and clients and caregivers' psychological demands, mainly because of the threat of death. CONCLUSION: The team attempts to respond to these needs through communication, but reveals a lack of assistential services and an overload. Interdisciplinarity is a palliative care premise, favoring holistic care delivery, and cannot be neglected at, which requires attention and investment to develop better practices.


2020 ◽  
Vol 38 (2) ◽  
pp. 199-203
Author(s):  
Simone Garruth dos Santos Machado Sampaio ◽  
Andréa Marins Dias ◽  
Renata de Freitas ◽  
Alessandra Zanei Borsatto ◽  
Elisa Maffioletti Furtunato Leocádio Esteves ◽  
...  

Context: Due to the need for isolation of inpatients with suspected COVID-19, accuracy in identifying these cases in Emergency Department (ED) has great relevance, especially in Palliative Oncology Care Unit (PCU). Objective: To evaluate the efficiency of clinical criteria adopted to identify suspected cases of COVID-19 by the ED in PCU. Methods: All patients admitted to PCU between April and June 2020 from ED were included. The clinical criteria adopted to identify suspected COVID-19 cases were: being in contact with a suspected or confirmed case less than 14 days ago and / or presenting fever with no defined focus and / or respiratory symptoms not explained by oncological disease and / or suggestive image in radiological examination (if necessary). All suspected cases were submitted to deep nasal and throat swab for SARS COV-2 investigation by Reverse Transcription Polymerase Chain Reaction Test, adopted as gold standard. Inpatients hospitalized by ED, without suspicion, and then diagnosed with COVID-19 within 10 days of hospitalization were considered as false-negative cases. Results: During the period, 327 patients were admitted from ED. Of these, 69 (21%) were considered suspects, of whom 34 (49%) tested positive for COVID-19. The sensitivity of the clinical criterion to identify suspected cases was 87%, specificity was 88%, positive predictive value was 49%, negative was 98% and accuracy was 88%. Conclusion: The clinical criteria adopted to identify suspected cases of COVID-19 at ED proved to be efficient, with low risk of spreading in-hospital infection, avoiding unnecessary isolation of patients.


2021 ◽  
Vol 74 (5) ◽  
Author(s):  
Carolina Fraga Paiva ◽  
Tânia Cristina Franco Santos ◽  
Pacita Geovana Gama de Sousa Aperibense ◽  
Gizele da Conceição Soares Martins ◽  
Lilian Dias Ennes ◽  
...  

ABSTRACT Objective: Describe the actions implemented for pain management in palliative care oncology and analyze the contribution of Hospital do Câncer IV, as a reference unit at the National Cancer Institute. Methods: Study of the history of the present time, whose sources were written documents and interviews with five participants. The collection took place from February to June 2018. The analysis of the written sources took place through internal and external criticism of the documents, considering their chronology and theme. Results: Professionals contributed with actions for pain management in palliative oncology care: in discussions and final drafting of ordinances, as rapporteurs at national and international events, in the elaboration of humanization conducts and systematization of assistance in addressing pain. Final considerations: These actions favored assistance in palliative oncology care at various levels of health care for patients and families, with greater technical and scientific recognition for all.


2020 ◽  
Vol 14 ◽  
pp. 117955492091572 ◽  
Author(s):  
James L Rogers ◽  
Laura M Perry ◽  
Michael Hoerger

Background: Palliative care is a specialized approach to symptom management that focuses on supporting patients’ physical and psychological quality of life throughout the disease course. In oncology, palliative care has been increasing in utilization. The evidence base for such care is also growing through the use of randomized controlled trials (RCTs). In this review, we aim to integrate the findings from 4 meta-analyses of palliative oncology care RCTs to examine the impact of palliative care on physical and psychological quality of life and survival. Method: We considered 4 meta-analyses of palliative oncology care RCTs, which each used slightly different methodologies and analyses. Two of the meta-analyses included both outpatient and inpatient populations, whereas the remaining meta-analyses focused specifically on outpatient palliative oncology care. Results: All 4 meta-analyses reported a robust quality of life advantage for patients randomized to receive palliative care. Two meta-analyses identified a survival advantage, whereas the other 2 detected no survival differences. In 1 meta-analysis that examined high-quality RCTs of outpatient palliative oncology care, it was found that an increased survival probability for palliative care, compared with standard of care, was confined to 6- to 18-month follow-up. Conclusions: There is a growing evidence base for palliative oncology care, as highlighted by the 4 meta-analyses considered. Such care successfully improves both physical and psychological quality of life for patients with serious illnesses, especially cancer. Clinicians should educate patients and their caregivers about the findings of these meta-analyses. Finally, governmental policies should focus on increasing palliative care access.


2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 9512-9512 ◽  
Author(s):  
Marie Bakitas ◽  
Tor Tosteson ◽  
Zhigang Li ◽  
Kathleen Lyons ◽  
Jay Hull ◽  
...  

2019 ◽  
Vol 22 ◽  
pp. S95
Author(s):  
A. Kee ◽  
V. Csik ◽  
A. Leader ◽  
J. Minetola ◽  
K. Walsh ◽  
...  

2020 ◽  
Vol 38 (9) ◽  
pp. 954-962 ◽  
Author(s):  
Jennifer Snaman ◽  
Sarah McCarthy ◽  
Lori Wiener ◽  
Joanne Wolfe

Pediatric palliative care aims to alleviate suffering and improve the quality of life of children with serious disease and increase support for their parents and other family members. Integration of palliative care into the routine care of children, adolescents, and young adults with cancer has resulted in improved outcomes in patients and their families. The field of pediatric palliative oncology—encompassing primary palliative care provided by the multidisciplinary oncology team as well as subspecialty palliative care provided by the palliative care team for more complex cases—is unique from palliative care in adults given its focus on care of the child and the larger family. In this review, we focus on advancements in the specific domains within pediatric palliative oncology care including family-centered communication, assessment and management of physical symptoms and distress, psychosocial concerns, and spiritual considerations of the patient, parents, and siblings.


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