Patient awareness of palliative care: systematic review

2021 ◽  
pp. bmjspcare-2021-003072
Author(s):  
Bahrami Masoud ◽  
Bagheri Imane ◽  
Salmani Naiire
Keyword(s):  
Palliative Care ◽  
Hospice Care ◽  
Scientific Information ◽  
Limited Information ◽  
Patient Awareness ◽  
Current State ◽  
Comprehensive Information ◽  
Information Set ◽  
Islamic Science ◽  
Bereavement Care

BackgroundOne of the barriers to the integration of palliative care within the process of patient care and treatment is the lack of awareness of patients about palliative care. In order to develop efficient resources to improve patient awareness, comprehensive information is required to determine the specific aspects of palliative care where a paucity of evidence on patient awareness exists. This review aims to synthesise evidence from previous studies in order to provide a comprehensive information set about the current state of patient awareness of palliative care.MethodsIn this systematic literature review, PubMed, Scopus, Web of Science, ProQuest, Magiran, Scientific Information Database(SID) and Islamic Science Citation (ISC) were searched to identify articles published between 2000 and 2021 that considered patients’ awareness of palliative care.ResultsOf the 5347 articles found, 22 studies were retained after quality evaluation; three full-text articles were excluded. Nineteen articles are included in this review. More than half of the patients did not have any information about palliative care or hospice care. Some patients accurately defined hospice care and palliative care; other patients had misunderstandings about palliative care. Patients had limited information about pastoral care, social care and bereavement care. Patients’ awareness about individuals or centres providing palliative care or hospice care was limited. Video presentation and distribution of information at the community level indicated that this method would be beneficial in increasing the awareness.ConclusionThe review points to the need for patient education programmes and interventional studies to increase patients’ awareness.

scholarly journals Hospices in the infrastructure of the cities of the RF

2021 ◽  
pp. 162-168
Author(s):  
Asmik Klochko
Keyword(s):  
Palliative Care ◽  
Russian Federation ◽  
Hospice Care ◽  
Care Organization ◽  
Current State ◽  
World Class ◽  
The Russian Federation

The author analyzes the current state of hospices and palliative centers in the Russian Federation, as well as the problems and opportunities they face. The presence of world-class hospices along with the regions of zero palliative care for the population is revealed in the infrastructure of the RF. The article studies the basic forms of care organization and reveals the necessity of taking into account territorial and regional peculiarities of a particular region. It also outlines the necessary components of hospice care and highlights the ethical sense of its provision.

scholarly journals Palliative Care in Advanced Dementia: Comparison of Strategies in Three Countries

Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 44
Author(s):  
Shelley A. Sternberg ◽  
Shiri Shinan-Altman ◽  
Ladislav Volicer ◽  
David J. Casarett ◽  
Jenny T. van der Steen
Keyword(s):  
Palliative Care ◽  
The Netherlands ◽  
Hospice Care ◽  
The United States ◽  
Artificial Nutrition ◽  
Advanced Dementia ◽  
Case Scenario ◽  
Artificial Nutrition And Hydration ◽  
Positive Elements ◽  
The Us

Palliative care including hospice care is appropriate for advanced dementia, but policy initiatives and implementation have lagged, while treatment may vary. We compare care for people with advanced dementia in the United States (US), the Netherlands, and Israel. We conducted a narrative literature review and expert physician consultation around a case scenario focusing on three domains in the care of people with advanced dementia: (1) place of residence, (2) access to palliative care, and (3) treatment. We found that most people with advanced dementia live in nursing homes in the US and the Netherlands, and in the community in Israel. Access to specialist palliative and hospice care is improving in the US but is limited in the Netherlands and Israel. The two data sources consistently showed that treatment varies considerably between countries with, for example, artificial nutrition and hydration differing by state in the US, strongly discouraged in the Netherlands, and widely used in Israel. We conclude that care in each country has positive elements: hospice availability in the US, the general palliative approach in the Netherlands, and home care in Israel. National Dementia Plans should include policy regarding palliative care, and public and professional awareness must be increased.

Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis

2021 ◽  
pp. 104990912110186
Author(s):  
James Alton Croker ◽  
Julie Bobitt ◽  
Sara Sanders ◽  
Kanika Arora ◽  
Keith Mueller ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Fast Track ◽  
Hospice Care ◽  
Cannabis Use ◽  
Care Plan ◽  
Medical Cannabis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Eol Care

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.

scholarly journals 523. COVID-19 Preparedness in Hospice and Palliative Care

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S328-S328
Author(s):  
Monika Pogorzelska-Maziarz ◽  
Jeannette Kates ◽  
Jingjing Shang ◽  
Angela M Gerolamo
Keyword(s):  
Palliative Care ◽  
Hospice Care ◽  
Group Discussion ◽  
Discussion Board ◽  
Community Group ◽  
Care Community ◽  
Care Services ◽  
Do It Yourself ◽  
Hospice And Palliative Care ◽  
The Impact

Abstract Background Due to the emergence of COVID-19 and resulting pandemic, there is an increased demand for palliative care and hospice care services. However, the impact of COVID-19 on the hospice and palliative agencies is unknown. Methods An electronic survey was disseminated via the Hospice & Palliative Nurses Association newsletter, posted to the Sigma Theta Tau Hospice and Palliative Care Community Group discussion board and advertised through social media from May 7–28, 2020. Summary statistics were computed. Results We collected 36 surveys representing all U.S. regions. Most respondents (78%) reported that their agency has cared for confirmed COVID-19 patients. Only half of agencies had access to laboratory facilities for surveillance and detection of the presence of outbreaks in both patients and staff (58%) and the ability to test patients and providers for COVID-19 (55%). Due to COVID-19, participants stated that the agency added new protocols regarding aerosol-generating procedures policies (58%), use of surface barriers (61%) and PPE usage (e.g. donning and doffing) in patient homes (56%). The majority (76%) reported that their agency required field clinicians to call ahead to ascertain COVID-19 exposure/symptoms before a home visit. More than half (58%) reported that their agency lacked supplies, including N95 respirators (45%), cleaning/disinfectant product (23%), alcohol based sanitizer (18%), eye protection (18%), gowns (18%), and surgical masks (14%). Overall, participants shared that field clinicians had to reuse (76%), extend (73%) or ration (30%) PPE supplies. Respondents reported that their agency accessed supplemental PPE through state/local resources (67%), private/community donations (67%), and do-it-yourself efforts (55%). One third (31%) reported that their agency was experiencing staffing shortages due to COVID-19; of these, 60% reported that shortages were due to staff infected with/quarantined due to COVID-19. Conclusion Our findings suggest that COVID-19 has presented significant challenges for palliative care and hospice agencies as they provide care to patients and families at an unprecedented rate. Disclosures All Authors: No reported disclosures

Cost effectiveness in palliative care setting

2018 ◽  
Vol 21 (2) ◽  
pp. 62-71
Author(s):  
Henry O’Lawrence ◽  
Rohan Chowlkar
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
Hospice Care ◽  
Home Health ◽  
Data Set ◽  
Content Type ◽  
Care Services ◽  
The Cost

Purpose The purpose of this paper is to determine the cost effectiveness of palliative care on patients in a home health and hospice setting. Secondary data set was utilized to test the hypotheses of this study. Home health care and hospice care services have the potential to avert hospital admissions in patients requiring palliative care, which significantly affects medicare spending. With the aging population, it has become evident that demand of palliative care will increase four-fold. It was determined that current spending on end-of-life care is radically emptying medicare funds and fiscally weakening numerous families who have patients under palliative care during life-threatening illnesses. The study found that a majority of people registering for palliative and hospice care settings are above the age group of 55 years old. Design/methodology/approach Different variables like length of stay, mode of payment and disease diagnosis were used to filter the available data set. Secondary data were utilized to test the hypothesis of this study. There are very few studies on hospice and palliative care services and no study focuses on the cost associated with this care. Since a very large number of the USA, population is turning 65 and over, it is very important to analyze the cost of care for palliative and hospice care. For the purpose of this analysis, data were utilized from the National Home and Hospice Care Survey (NHHCS), which has been conducted periodically by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Descriptive statistics, χ2 tests and t-tests were used to test for statistical significance at the p<0.05 level. Findings The Statistical Package for Social Sciences (SPSS) was utilized for this result. H1 predicted that patients in the age group of 65 years and up have the highest utilization of home and hospice care. This study examined various demographic variables in hospice and home health care which may help to evaluate the cost of care and the modes of payments. This section of the result presents the descriptive analysis of dependent, independent and covariate variables that provide the overall national estimates on differences in use of home and hospice care in various age groups and sex. Research limitations/implications The data set used was from the 2007 NHHCS survey, no data have been collected thereafter, and therefore, gap in data analysis may give inaccurate findings. To compensate for this gap in the data set, recent studies were reviewed which analyzed cost in palliative care in the USA. There has been a lack of evidence to prove the cost savings and improved quality of life in palliative/hospice care. There is a need for new research on the various cost factors affecting palliative care services as well as considering the quality of life. Although, it is evident that palliative care treatment is less expensive as compared to the regular care, since it eliminates the direct hospitalization cost, but there is inadequate research to prove that it improves the quality of life. A detailed research is required considering the additional cost incurred in palliative/hospice care services and a cost-benefit analysis of the same. Practical implications While various studies reporting information applicable to the expenses and effect of family caregiving toward the end-of-life were distinguished, none of the previous research discussed this issue as their central focus. Most studies addressed more extensive financial effect of palliative and end-of-life care, including expenses borne by the patients themselves, the medicinal services framework and safety net providers or beneficent/willful suppliers. This shows a significant hole in the current writing. Social implications With the aging population, it has become evident that demand of palliative/hospice care will increase four-fold. The NHHCS have stopped keeping track of the palliative care requirements after 2007, which has a negative impact on the growing needs. Cost analysis can only be performed by analyzing existing data. This review has recognized a huge niche in the evidence base with respect to the cost cares of giving care and supporting a relative inside a palliative/hospice care setting. Originality/value The study exhibited that cost diminishments in aggressive medications can take care of the expenses of palliative/hospice care services. The issue of evaluating result in such a physically measurable way is complicated by the impalpable nature of large portions of the individual components of outcome. Although physical and mental well-being can be evaluated to a certain degree, it is significantly more difficult to gauge in a quantifiable way, the social and profound measurements of care that help fundamentally to general quality of care.

scholarly journals Palliative Care Gaps in Providing Psychological Treatment: A Review of the Current State of Research in Multidisciplinary Palliative Care

2017 ◽  
Vol 35 (3) ◽  
pp. 505-510 ◽  
Author(s):  
Elissa Kozlov ◽  
Bahar Niknejad ◽  
M. C. Reid
Keyword(s):  
Mental Health ◽  
Palliative Care ◽  
Intervention Studies ◽  
Psychological Symptoms ◽  
Psychological Intervention ◽  
Psychological Treatment ◽  
Future Research ◽  
Psychological Outcome ◽  
Current State ◽  
Care Intervention

Background: Patients with advanced illness often have high rates of psychological symptoms. Many multicomponent palliative care intervention studies have investigated the efficacy of overall symptom reduction; however, little research has focused explicitly on how interventions address psychological symptoms associated with serious illness. Methods: The current study reviewed 59 multicomponent palliative care intervention articles and analyzed the mental health components of palliative care interventions and their outcomes in order to better understand the current state of psychological care in palliative care. Results: The majority of articles (69.5%) did not provide any details regarding the psychological component delivered as part of the palliative care intervention. Most (54.2%) studies did not specify which provider on the team was responsible for providing the psychological intervention. Studies varied regarding the type of outcome measure utilized; multi-symptom assessment scales were used in 54.2% of studies, mental health scales were employed in 25.4%, quality of life and distress scales were used in 16.9%, and no psychological scales were reported in 28.8%. Fewer than half the studies (42.4%) documented a change in a psychological outcome. Discussion and Conclusion: The majority of analyzed studies failed to describe how psychological symptoms were identified and treated, which discipline on the team provided the treatment, and whether psychological symptoms improved as a result of the intervention. Future research evaluating the effects of palliative care interventions on psychological symptoms will benefit from using reliable and valid psychological outcome measures and providing specificity regarding the psychological components of the intervention and who provides it.

scholarly journals Heliceculture as a promising area of agricultural production

2020 ◽  
pp. 33-41
Author(s):  
Ivan Zubar ◽  
Yuliia Onyshchuk
Keyword(s):  
Agricultural Production ◽  
Systematic Approach ◽  
Production Capacity ◽  
World Market ◽  
Economic Science ◽  
Limited Information ◽  
Current State ◽  
Promising Area ◽  
Definition Of ◽  
Effective Development

Purpose. The aim of the article is research of theoretical, organizational and economic aspects of functioning and effective development of farms for growing and processing of snails and substantiation of prospects of heliceculture as a branch of agriculture on the basis of analysis of world experience. Methodology of research. In the course of the research the methods of general scientific (analysis, synthesis, abstraction) and empirical methods (observations, questionnaires, conversations) of economic science are used, which are based on a systematic approach, which allowed to characterize the current state of production and export of heliceculture products, as well as identify key issues in this area of agricultural production. Findings. The concept of “heliceculture” is substantiated and its content is analysed in terms of prospects as a new direction of agricultural production. The historical genesis of the development of traditions of snail products consumption has been studied, as a result of which the first mentions in the history of Ancient Rome, as well as France and Italy have been revealed. An analysis of the dynamics and current state of development of domestic heliculture entrepreneurship, which showed a rapid increase in the number of snail farms and increasing exports of snails to Europe. An overview of the world market for edible snails is made, where there is a noticeable tendency to a gradual annual increase in the consumption of heliculture products. The key elements of the technological process of growing edible snails are analysed, which allowed to systematize a number of basic technological processes and to conclude about the complexity and complexity of this production. The commodity assortment of heliculture has been determined, which includes meat, caviar and snail secretion. The key advantages of Ukraine as a producer and exporter of heliculture products are highlighted, including the availability of labour, proximity to markets, high land supply and dissatisfaction with global demand for these products, which makes it significant for the development of heliculture as an agricultural production. The key problems that hinder the development of snail farming are summarized, namely: legislative unregulation, limited industrial production capacity, lack of diversified processing, limited information and scientific research. The key directions of development of the heliceculture industry are determined, among which: organization of production and marketing heliceculture cooperatives, provision of in-depth processing and year-round uninterrupted production, development of agro-tourism on the basis of snail farms. Originality. A systematic approach to clarifying the definition of “heliceculture” is proposed. On the basis of a thorough study of official statistical information on the state of production of snail products, the importance of heliculture as a promising area of agricultural production is substantiated. Practical value. The obtained research results can be used in the development of an effective concept for the development of the heliculture industry. Key words: heliceculture, heliceculture market, snail farming, small business, family farm.

scholarly journals Is Down Syndrome Doomed? How State Statutes Can Help Expectant Parents Make Informed Decisions about Prenatal Down Syndrome Diagnoses*

2012 ◽  
Vol 6 (2) ◽  
Author(s):  
Teresa Santin
Keyword(s):  
Down Syndrome ◽  
First Amendment ◽  
Healthcare Providers ◽  
Current State ◽  
Comprehensive Information ◽  
State Statutes ◽  
Syndrome Diagnosis ◽  
Expectant Mothers ◽  
Federal Laws ◽  
The Many

Giving birth to a child with Down syndrome is a choice and one that should be well-informed. It has become a trend for expectant parents to abort fetuses with Down syndrome before fully weighing their options.[1] Expectant parents may automatically assume that an individual with Down syndrome will not lead a worthwhile life and that raising the child will pose too many challenges for them.[2] In order to minimize the number of fetuses with Down syndrome that are being aborted (which may be greater than 90%),[3] expectant parents need access to up-to-date, comprehensive information about all aspects of raising a child with Down syndrome, including the many positive aspects. Whatever decision a parent makes regarding raising a child with Giving birth to a child with Down syndrome is a choice and one that should be well-informed. It has become a trend for expectant parents to abort fetuses with Down syndrome before fully weighing their options.[1] Expectant parents may automatically assume that an individual with Down syndrome will not lead a worthwhile life and that raising the child will pose too many challenges for them.[2] In order to minimize the number of fetuses with Down syndrome that are being aborted (which may be greater than 90%),[3] expectant parents need access to up-to-date, comprehensive information about all aspects of raising a child with Down syndrome, including the many positive aspects. Whatever decision a parent makes regarding raising a child with consent. Part IV examines current state and federal laws that require healthcare providers to give information to expectant mothers who receive a prenatal Down syndrome diagnosis. Part IV also addresses why a law requiring post-Down syndrome diagnosis information is not unduly burdensome. Specifically, Part IV looks closely at the Prenatally and Postnatally Diagnosed Conditions Awareness Act and state statutes in Missouri, New Jersey, Alabama, and Virginia.  Part V discusses why laws already enacted on this issue are inadequate and proposes a model statute that all states can follow in crafting their own similar laws. Finally, Part V addresses potential concerns related to the proposed law like cost, enforcement, and First Amendment rights, and how those issues may be resolved.

scholarly journals MODERN METHODS OF TREATMENT IN PALLIATIVE CARE

2019 ◽  
Vol 72 (7) ◽  
pp. 1229-1235
Author(s):  
Ewa Kucharska ◽  
Aleksandra Kucharska ◽  
Aleksander Sieroń ◽  
Mariusz Nowakowski ◽  
Karolina Sieroń
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Hospice Care ◽  
Clinical Symptoms ◽  
Care Patient ◽  
Unique Type ◽  
Modern Methods ◽  
High Dynamics ◽  
Methods Of Treatment

The palliative care patient is definitely a unique type of patient. Due to the complexity of the symptoms requires a holistic therapeutic approach. Modern methods of treatment in palliative and hospice care underline an important role of physio, kinesiotherapy and pharmacological treatment coexistence. The rehabilitation reduces clinical symptoms, accompanying the basic disease and increases the quality of life of palliative patients and their families. It becomes an inseparable element of treatment, both in outpatient care as well as in stationary care and home care. Due to the high dynamics onset of cancer in the group of geriatric patients there is a need for a broader analysis of the topic. The goal of palliative care is to achieve the best possible quality of life for patients and their families.

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