scholarly journals Experience of symptom control, anxiety and associating factors in a palliative care unit evaluated with Support Team Assessment Schedule Japanese version

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tetsuya Ito ◽  
Emi Tomizawa ◽  
Yuki Yano ◽  
Kiyozumi Takei ◽  
Naoko Takahashi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Laboratory Data ◽  
Japanese Version ◽  
Palliative Care Unit ◽  
Current Status ◽  
Physical Factors ◽  
Patient Anxiety ◽  
Team Assessment ◽  
Support Team

AbstractVarious physical and psychosocial difficulties including anxiety affect cancer patients. Patient surroundings also have psychological effects on caregiving. Assessing the current status of palliative care intervention, specifically examining anxiety and its associated factors, is important to improve palliative care unit (PCU) patient quality of life (QOL). This study retrospectively assessed 199 patients admitted to a PCU during August 2018–June 2019. Data for symptom control, anxiety level, disease insight, and communication level obtained using Support Team Assessment Schedule Japanese version (STAS-J) were evaluated on admission and after 2 weeks. Palliative Prognostic Index (PPI) and laboratory data were collected at admission. Patient anxiety was significantly severer and more frequent in groups with severer functional impairment (p = 0.003) and those requiring symptom control (p = 0.006). Nevertheless, no relation was found between dyspnea and anxiety (p = 0.135). Patients with edema more frequently experienced anxiety (p = 0.068). Patient survival was significantly shorter when family anxiety was higher after 2 weeks (p = 0.021). Symptoms, edema, and disabilities in daily living correlate with patient anxiety. Dyspnea is associated with anxiety, but its emergence might be attributable mainly to physical factors in this population. Family members might sensitize changes reflecting worsened general conditions earlier than the patients.

Reliability and validity of the Japanese version of the Support Team Assessment Schedule (STAS-J)

2004 ◽  
Vol 2 (4) ◽  
pp. 379-385 ◽  
Author(s):  
MITSUNORI MIYASHITA ◽  
KAZUKO MATOBA ◽  
TOMOYO SASAHARA ◽  
YOSHIYUKI KIZAWA ◽  
MISAE MARUGUCHI ◽  
...  
Keyword(s):  
Palliative Care ◽  
Reliability And Validity ◽  
Japanese Version ◽  
Palliative Care Unit ◽  
Complete Agreement ◽  
Validity Study ◽  
Team Assessment ◽  
Back Translation ◽  
Valid Instrument ◽  
Support Team

Objective: The aim of this project was to develop an appropriate and valid instrument for assessment by medical professionals in Japanese palliative care settings.Methods: We developed a Japanese version of the Support Team Assessment Schedule (STAS-J), using a back translation method, and tested its reliability and validity. In the reliability study, 16 nurses and a physician who work in a palliative care unit evaluated 10 hypothetical cases twice at 3-month intervals. For the validity study, external researchers interviewed 50 patients with matignancy and their families and compared the results with ratings by the nurses in the palliative care unit.Results: Our results with hypothetical cases were: interrater reliability weighted κ = 0.53–0.77 and intrarater reliability weighted κ = 0.64–0.85. In the validity study comparing nurse evaluations and the results of interviews with patients and families, complete agreement was 36–70%, and close agreement (±1) was 74–100%. As a whole, weighted κ were low: between −0.07 and 0.51. Our results were similar to those in the United Kingdom and Canada.Significance of results: Although this research was conducted under methodologically limited conditions, we concluded that the STAS-J is a reliable tool and its validity is acceptable. The STAS-J should become a valuable tool, not only for daily clinical use, but also for research.

Safety Aspects of Acupuncture in Palliative Care

2001 ◽  
Vol 19 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Jacqueline Filshie
Keyword(s):  
Palliative Care ◽  
Symptom Management ◽  
Tumour Progression ◽  
Clinical Stage ◽  
Symptom Control ◽  
Alternative Therapies ◽  
Current Status ◽  
Neutropenic Patients ◽  
Full Knowledge ◽  
Clotting Disorder

Acupuncture can mask symptoms of cancer and tumour progression. It is not safe to use such a therapy without full knowledge of the clinical stage of the disease, and the current status of orthodox therapy. Contraindications to acupuncture needling include an unstable spine, severe clotting disorder, neutropenia and lymphoedema. Whilst semi-permanent needles are used increasingly in symptom control and pain management they should not be used in patients with valvular heart disease or in vulnerable neutropenic patients. Acupuncture has an increasing role in support for pain and symptom management, but patients should not be advised to abandon conventional treatments in favour of complementary or alternative therapies alone, and should not have their hopes raised inappropriately, or have any guilt projected on to them for the cause of their cancer.

scholarly journals Palliative approach in acute neurological events: a five-year study

2018 ◽  
Vol 64 (9) ◽  
pp. 833-836
Author(s):  
Nuno Ferreira Monteiro ◽  
Patrícia Cipriano ◽  
Elga Freire
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Orotracheal Intubation ◽  
Feeding Tube ◽  
Tertiary Hospital ◽  
High Morbidity ◽  
Neurological Illness ◽  
Support Team ◽  
Gcs Score ◽  
Care Support

SUMMARY INTRODUCTION Acute neurological illness often results in severe disability. Five-year life expectancy is around 40%; half the survivors become completely dependent on outside help. OBJECTIVE Evaluate the symptoms of patients admitted to a Hospital ward with a diagnosis of stroke, subarachnoid hemorrhage or subdural hematoma, and analyze the role of an In-Hospital Palliative Care Support Team. MATERIAL AND METHODS Retrospective, observational study with a sample consisting of all patients admitted with acute neurological illness and with a guidance request made to the In-Hospital Palliative Care Support Team of a tertiary Hospital, over 5 years (2012-2016). RESULTS A total of 66 patients were evaluated, with an age median of 83 years old. Amongst them, there were 41 ischaemic strokes, 12 intracranial bleedings, 12 subdural hematomas, and 5 subarachnoid hemorrhages. The median of delay between admission and guidance request was 14 days. On the first evaluation by the team, the GCS score median was 6/15 and the Palliative Performance Scale (PPS) median 10%. Dysphagia (96.8%) and bronchorrhea (48.4%) were the most prevalent symptoms. A total of 56 patients had a feeding tube (84.8%), 33 had vital sign monitoring (50.0%), 24 were hypocoagulated (36.3%), 25 lacked opioid or anti-muscarinic therapy for symptom control (37,9%); 6 patients retained orotracheal intubation, which was removed. In-hospital mortality was 72.7% (n=48). DISCUSSION AND CONCLUSION Patients were severely debilitated, in many cases futile interventions persisted, yet several were under-medicated for symptom control. The delay between admission and collaboration request was high. Due to the high morbidity associated with acute neurological illness, palliative care should always be timely provided.

scholarly journals A Systematic Review of the Use of the Palliative Care Outcome Scale and the Support Team Assessment Schedule in Palliative Care

2015 ◽  
Vol 50 (6) ◽  
pp. 842-853.e19 ◽  
Author(s):  
Emily S. Collins ◽  
Jana Witt ◽  
Claudia Bausewein ◽  
Barbara A. Daveson ◽  
Irene J. Higginson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Team Assessment ◽  
Palliative Care Outcome Scale ◽  
Support Team ◽  
Care Outcome

scholarly journals Impact of Palliative Care Unit Admission on Symptom Control Evaluated by the Edmonton Symptom Assessment System

2005 ◽  
Vol 30 (4) ◽  
pp. 367-373 ◽  
Author(s):  
Caterina Modonesi ◽  
Emanuela Scarpi ◽  
Marco Maltoni ◽  
Stefania Derni ◽  
Laura Fabbri ◽  
...  
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Symptom Assessment ◽  
Assessment System ◽  
Palliative Care Unit ◽  
Edmonton Symptom Assessment System

scholarly journals Strategies for introducing outpatient specialty palliative care in gynecologic oncology.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 111-111
Author(s):  
Casey M. Hay ◽  
Carolyn Lefkowits ◽  
Marie Bakitas ◽  
Megan Crowley-Makota ◽  
Renata Urban ◽  
...  
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Gynecologic Oncology ◽  
Relationship Building ◽  
Future Research ◽  
Patient Anxiety ◽  
Telephone Interviews ◽  
Care Services ◽  
Qualitative Interview Study ◽  
Palliative Care Services

111 Background: Concern that patients will react negatively to the idea of palliative care is cited as a barrier to timely referral. Strategies to successfully introduce specialty palliative care to patients have not been well-described. We sought to understand how gynecologic oncologists introduce outpatient specialty palliative care. Methods: We conducted a national qualitative interview study at six geographically diverse academic cancer centers with well-established palliative care clinics between September 2015 and March 2016. Thirty-four gynecologic oncologists participated in semi-structured telephone interviews focusing on attitudes, experiences, and practices related to outpatient palliative care. A multidisciplinary team analyzed interview transcripts using constant comparative methods to inductively develop and refine a coding framework. This analysis focuses on practices for introducing palliative care. Results: Mean participant age was 47 years (± 10). Mean interview length was 25 minutes (± 7). Gynecologic oncologists described three main strategies for introducing outpatient specialty palliative care: first establish a strong primary relationship and trust with patients in order to alleviate fear and increase acceptance of referral; focus initial palliative care referral on symptom control to gain a “foot in the door”, facilitate early relationship-building with palliative care clinicians, and dissociate palliative care from end-of-life; and normalize and explain palliative care referral to decrease patient anxiety and confusion. These strategies aimed to decrease negative patient associations and encourage acceptance of early referral to palliative care specialists. Conclusions: Gynecologic oncologists have developed strategies for introducing palliative care services to alleviate patient concerns. Future research should examine patient perception of these strategies and assess impact on rates of acceptance of outpatient specialty palliative care referral.

Hypodermoclysis (HDC) for Symptom Control Vs. the Edmonton Injector (EI)

1991 ◽  
Vol 7 (4) ◽  
pp. 5-8 ◽  
Author(s):  
Robin L. Fainsinger ◽  
Eduardo Bruera
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Terminally Ill ◽  
Palliative Care Unit ◽  
New Method ◽  
Time Saving ◽  
Treatment Methods ◽  
Terminally Ill Patients

Hypodermoclysis (HDC) is a well-known method of providing symptom control in terminally ill patients. In this article we make reference to two previous reports describing our use of HDC and a new method of subcutaneous narcotic delivery called the Edmonton Injector (El). The rationale for using HDC mainly for rehydration and the El when subcutaneous narcotics are needed is explored. The controversy surrounding the treatment of dehydration in the terminally ill is examined. Finally, the advantages on our palliative care unit of the convenience, increased flexibility, and cost and time saving of these two treatment methods are discussed.

Symptom Control during the Last Week of Life on a Palliative Care Unit

1991 ◽  
Vol 7 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Robin Fainsinger ◽  
Melvin J. Miller ◽  
Eduardo Bruera ◽  
John Hanson ◽  
Tara Maceachern
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Palliative Care Unit
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