Predicting survival in patients with advanced disease

2021 ◽  
pp. 1083-1093
Author(s):  
Christian T. Sinclair
Keyword(s):  
Palliative Care ◽  
Service Composition ◽  
Policy Development ◽  
Predictive Analytics ◽  
Clinical Settings ◽  
Care Planning ◽  
Clinical Decisions ◽  
Life Planning ◽  
Prognosis Research ◽  
Existing Data

Prognostication is an important part of care planning. It is also an essential skill to assist patients and their families in care and life planning. Every day, clinicians depend on their experience, knowledge, current research, and models to make prognostic estimates, which are the foundation of many clinical decisions. This chapter reviews current research and understanding about how clinicians formulate and utilize prognostic estimates in clinical settings. Palliative care clinicians must understand prognosis research since it informs individual clinical decisions as well as research design, policy development, and service composition. While no prognostic model is universal, this chapter will prepare clinicians to make the best use of the existing data in prognosis science. Limitations of prognostic methods and the future of predictive analytics will also be explored.

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multidisciplinary Team ◽  
Biopsychosocial Model ◽  
Family Members ◽  
Clinical Decisions ◽  
Goals Of Care ◽  
Complex Needs ◽  
Aspiration Risk ◽  
Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

Demenz aus palliativmedizinischer Perspektive: warum ein krankheitsspezifisches Advance Care Planning wichtig ist

2018 ◽  
Vol 75 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Ralf J. Jox ◽  
Francesca Bosisio ◽  
Eve Rubli Truchard
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care ◽  
Menschen Mit Demenz

Zusammenfassung. Die Palliative Care muss sich im Zuge des demographischen Wandels vieler Gesellschaften rund um den Globus tiefgreifend wandeln. Sie muss mehr und mehr mit der Geriatrie zusammenarbeiten und geriatrische Expertise integrieren. Eine der zentralen Herausforderungen Geriatrischer Palliative Care ist die ethisch angemessene Therapieentscheidung für Menschen, die nicht mehr urteilsfähig sind. Nachdem der bisherige Ansatz herkömmlicher Patientenverfügungen erwiesenermassen enttäuscht hat, wird aktuell, gerade auch in deutschsprachigen Ländern, das systemische Konzept des Advance Care Planning (ACP) verfolgt. In diesem Artikel wird zunächst ACP mit seinen Zielen, Elementen und Effekten vorgestellt. Sodann wird gezeigt, weshalb es für Menschen mit Demenz eines adaptierten ACP-Programms bedarf und was ein solches demenzspezifisches ACP beinhalten muss.

Communication around palliative care principles and advance care planning between oncologists, children with advancing cancer and families

2021 ◽  
Author(s):  
Erica C. Kaye ◽  
Cameka Woods ◽  
Kendall Kennedy ◽  
Srilakshmi Velrajan ◽  
Melanie Gattas ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care

Welche Relevanz hat Advance Care Planning für die pädiatrische Intensivstation?

intensiv ◽  
2021 ◽  
Vol 29 (02) ◽  
pp. 99-106
Author(s):  
Simone Keller
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care

Advance Care Planning hat in der Palliative Care einen hohen Stellenwert. Dabei werden Wünsche und Bedürfnisse von Patienten und deren Familien erfasst, Therapieziele und Maßnahmen für den Krankheitsverlauf und das Lebensende frühzeitig diskutiert und festgehalten. Bei der Betreuung von kritisch kranken Kindern auf der Intensivstation sind Kommunikation und Entscheidungsfindungsprozesse von großer Wichtigkeit, und sie stellen hohe Anforderungen an das Behandlungsteam. Der folgende Beitrag zeigt den Nutzen und die positiven Aspekte von Advance Care Planning, auch für das Setting der Intensivstation.

Predictors of the Willingness to Promote Advance Care Planning among Nurses in Palliative Care Settings in Yogyakarta, Indonesia

2021 ◽  
Vol 11 (3) ◽  
pp. 336-345
Author(s):  
Ike Wuri Winahyu Sari ◽  
Rizqi Wahyu Hidayati
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Pearson Correlation ◽  
Related Factor ◽  
Care Planning ◽  
Cross Sectional ◽  
Correlation Test ◽  
Care Education ◽  
Palliative Care Education ◽  
Advance Care

Background: While previous studies showed that oncology nurses were highly inclined to promote advance care planning (ACP), there is a limited study focusing on ACP that concerns the willingness to promote ACP among palliative nurses in Indonesia. This issue needs to be investigated to determine the causative factors so that interventions for nurses can be arranged to improve ACP in Indonesia.Purpose: This study aimed to identify predictors of the willingness to promote ACP among nurses in palliative care settings.Methods: This study used a descriptive-analytical design with a cross-sectional approach. A total of 150 registered nurses with at least one year of experience were purposively recruited. Data were collected using the Indonesian version of the willingness to promote ACP instrument (I-WPACP) with a possible score range of 24 to 120; the higher the score, the higher the willingness to promote ACP. The descriptive statistic, independent t-test, Pearson correlation test, Spearman rank correlation test, and multiple linear regression test were used to analyze the data.Results: The willingness to promote ACP showed a mean score of 84.73±9.36. The score indicates a high willingness to promote ACP. The experience of receiving palliative care education became a related factor as well as the most closely related factor to the willingness to promote ACP in the palliative care settings (β=0.184; p=0.028).Conclusion: The willingness to promote ACP among nurses is high and closely related to their experience of receiving education about palliative care. Education about palliative care and training on ACP needs to be developed so that nurses can discuss ACP with patients and family caregivers.

scholarly journals Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Maaike Kok ◽  
Gertruud F. M. van der Werff ◽  
Jenske I. Geerling ◽  
Jaap Ruivenkamp ◽  
Wies Groothoff ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Care Needs ◽  
Advance Care ◽  
Palliative Care Needs
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