Goals of Care Communication and Higher-Value Care for Patients with Advanced-Stage Cancer: A Systematic Review of the Evidence

Author(s):  
Larry D. Cripe ◽  
Laura B. Vater ◽  
Jason A. Lilly ◽  
Angeline Larimer ◽  
Mary Lynn Hoffmann ◽  
...  
JAMA Oncology ◽  
2019 ◽  
Vol 5 (9) ◽  
pp. 1369
Author(s):  
Tanjila Taskin ◽  
Gladys Ibañez ◽  
Purnima Madhivanan

2021 ◽  
pp. 026921632110254
Author(s):  
Bria Browne ◽  
Nuriye Kupeli ◽  
Kirsten J Moore ◽  
Elizabeth L Sampson ◽  
Nathan Davies

Background: Dementia is a life-limiting condition that affects 50 million people globally. Existing definitions of end of life do not account for the uncertain trajectory of dementia. People living with dementia may live in the advanced stage for several years, or even die before they reach the advanced stage of dementia. Aim: To identify how end of life in people with dementia is measured and conceptualised, and to identify the factors that contribute towards identifying end of life in people with dementia. Design: Systematic review and narrative synthesis. Data Sources: Electronic databases MEDLINE, EMBASE, PsychInfo and CINAHL, were searched in April 2020. Eligible studies included adults with any dementia diagnosis, family carers and healthcare professionals caring for people with dementia and a definition for end of life in dementia. Results: Thirty-three studies met the inclusion criteria. Various cut-off scores from validated tools, estimated prognoses and descriptive definitions were used to define end of life. Most studies used single measure tools which focused on cognition or function. There was no pattern across care settings in how end of life was defined. Healthcare professionals and family carers had difficulty recognising when people with dementia were approaching the end of life. Conclusion: End-of-life care and research that focuses only on cognitive and functional decline may fail to recognise the complexities and unmet needs relevant to dementia and end of life. Research and clinical practice should adopt a needs-based approach for people with dementia and not define end of life by stage of disease.


2004 ◽  
Vol 28 (4) ◽  
pp. 342-350 ◽  
Author(s):  
Wolfgang Hoffmann ◽  
Heike Munzinger ◽  
Elisabeth Horstkotte ◽  
Eberhard Greiser

2002 ◽  
Vol 20 (16) ◽  
pp. 3495-3507 ◽  
Author(s):  
Michelle M. Lobchuk ◽  
Lesley F. Degner

PURPOSE: This study used a comparative descriptive design to compare family caregivers’ and advanced-stage cancer patients’ perceptions of patients’ multidimensional symptom experiences on presence, frequency, severity, and distress. PATIENTS AND METHODS: A convenience sample of 98 dyads, composed of advanced-stage heterogeneous cancer patients and their caregivers, completed the Memorial Symptom Assessment Scale in the home care setting on a one-time basis. This scale is a 32-item Likert-type scale for assessing the presence, frequency, severity, and distress arising from symptoms in cancer patients. RESULTS: There was confirmation of trends previously described in related studies where, for example, caregivers tend to overreport on symptom experiences. However, the degree of absolute difference between patient and caregiver responses was normally around 1 unit (on a theoretical range of 0 to 4 units). Levels of patient-caregiver agreement were better on more concrete questions related to symptom frequency, severity, and distress than on broad questions related to the presence of a symptom. Patients and caregivers achieved better levels of agreement on physical versus psychological symptoms. CONCLUSION: The findings indicated that family caregivers can provide reasonable proxy or complementary reports on patient symptom experiences of frequency, severity, and distress. However, family caregivers have greater difficulty in achieving high levels of accuracy on psychological versus physical symptoms.


Hepatology ◽  
2017 ◽  
Vol 67 (1) ◽  
pp. 422-435 ◽  
Author(s):  
Richard S. Finn ◽  
Andrew X. Zhu ◽  
Wigdan Farah ◽  
Jehad Almasri ◽  
Feras Zaiem ◽  
...  

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