Factors related to spiritual well-being in the last days of life in three East Asian countries: An international multicenter prospective cohort study

2021 ◽  
pp. 026921632110221
Author(s):  
Yusuke Hiratsuka ◽  
Sang-Yeon Suh ◽  
Sun-Hyun Kim ◽  
Shao-Yi Cheng ◽  
Seok-Joon Yoon ◽  
...  
Keyword(s):  
Palliative Care ◽  
East Asian ◽  
Well Being ◽  
Asian Countries ◽  
Factors Associated ◽  
Spiritual Well Being ◽  
Palliative Care Units ◽  
Multicenter Prospective Cohort Study ◽  
International Multicenter ◽  
Multicenter Prospective Cohort

Background: Some factors associated with spiritual well-being in dying patients have previously been reported. However, there has been no cross-cultural study comparing factors related to spiritual well-being. The current investigation may shed light on this under-investigated area through a comparison of diverse factors. Aim: We aimed to (1) examine factors associated with spiritual well-being in the last days and (2) compare those factors across three East Asian countries. Design: This is an international multicenter prospective cohort study. Setting/participants: Newly admitted inpatients with far advanced cancer in palliative care units in Japan, Korea and Taiwan were enrolled. Each patient was classified into one of two groups based on spiritual well-being score in the last days of life. Univariate and multivariate analyses were performed to identify the factors related to better spiritual well-being score in each country. Results: A total of 1761 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. Seven variables were significant in Japan, three in Korea, and five in Taiwan. “Good death scale [acceptance],” “fatigue” and “expressed wish for hastened death” were unique in Japan. “Visit from a pastoral care worker within 48 h of death” was unique in Korea. “Patient’s preferences for place of death,” “dyspnea” and “continuous deep sedation” were unique in Taiwan. Conclusions: This study found novel factors related to spiritual well-being in the last days of life, several of which differed according to country. Recognition of factors associated with spiritual well-being can improve the quality of palliative care.

scholarly journals Is spiritual well-being related to survival time of inpatients with advanced cancer? An East Asian cohort study

2021 ◽  
Author(s):  
Yusuke Hiratsuka ◽  
Sang-Yeon Suh ◽  
Seon Hye Won ◽  
Sung Eun Choi ◽  
Sun Hyun Kim ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cohort Study ◽  
Survival Time ◽  
Advanced Cancer ◽  
East Asian ◽  
Well Being ◽  
Cox Proportional Hazards Model ◽  
Spiritual Well Being ◽  
Palliative Care Units ◽  
The Relationship

Abstract Purpose: It has been suggested that psychosocial factors are related to survival time in patients with cancer. However, there is no cross-cultural study examining the relationship between spiritual well-being (SWB) and survival time among countries. This study investigated the relationship between SWB and survival time among three East Asian countries. Methods: This international multicenter cohort study is a secondary analysis involving newly admitted inpatients with advanced cancer in palliative care units in Japan, South Korea and Taiwan. SWB was measured at admission. We performed multivariate analysis using the Cox proportional hazards model to identify independent prognostic factors. Results: A total of 2638 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. The median survival time was 18.0 days (95% confidence interval [CI] 16.5 to 19.5) in Japan, 23.0 days (95% CI 19.9 to 26.1) in Korea and 15.0 days (95% CI 13.0 to 17.0) in Taiwan. Four variables were significant in Japan, Korea and Taiwan. SWB was a significant factor correlated with survival in Taiwan (hazard ratio [HR] 1.27; 95% CI 1.01 to 1.59; p = 0.04), while it was insignificant in Japan (HR 1.10; 95% CI 1.00 to 1.22; p = 0.06), and Korea (HR 1.02; 95% CI 0.77 to 1.35; p = 0.89). Conclusion: SWB of patients with advanced cancer was related to survival time in Taiwan but not in Japan or Korea. The findings suggest that spiritual care may contribute to prolonged survival in patients with far advanced cancer.

Differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units: A multicenter prospective cohort study (EASED)

2021 ◽  
pp. 026921632198956
Author(s):  
Takahiro Higashibata ◽  
Takayuki Hisanaga ◽  
Shingo Hagiwara ◽  
Miho Shimokawa ◽  
Ritsuko Yabuki ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Urinary Catheterization ◽  
Urinary Catheters ◽  
Advanced Cancer Patients ◽  
Appropriate Use ◽  
Palliative Care Units ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort

Background: Studies on the appropriate use of urinary catheters for cancer patients at the end of life are limited. Aim: To clarify the differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units. Design: Pre-planned secondary analysis of a multicenter, prospective cohort study; East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED). Setting/participants: This study enrolled consecutive advanced cancer patients admitted to palliative care units between January and December 2017. The final study group comprised 1212 patients from 21 institutions throughout Japan. Results: Out of the 1212 patients, 380 (31.4%; 95% confidence interval, 28.7%–34.0%) underwent urinary catheterization during their palliative care unit stay, and the prevalence of urinary catheterization in patients who died at palliative care units by institution ranged from 0.0% to 55.4%. When the 21 participating institutions were equally divided into three groups according to the institutional prevalence of catheterization, patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation were more likely to be catheterized in institutions with a high prevalence of catheterization than in those with a low or moderate prevalence ( p < 0.008, p = 0.008, and p < 0.008, respectively). Conclusion: This study revealed that the institutional prevalence of urinary catheterization in advanced cancer patients at palliative care units widely varied. Further studies are needed to establish the appropriate use of urinary catheters, especially in patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation.

scholarly journals Death in hospital following ICU discharge: insights from the LUNG SAFE study

2021 ◽  
Author(s):  
Fabiana Madotto ◽  
Bairbre McNicholas ◽  
Emanuele Rezoagli ◽  
Tài Pham ◽  
John Laffey ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Severe Respiratory Failure ◽  
Factors Associated ◽  
Icu Discharge ◽  
Severity Scores ◽  
Hospital Patients ◽  
Multicenter Prospective Cohort Study ◽  
To Receive ◽  
International Multicenter ◽  
Multicenter Prospective Cohort

Abstract Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward.Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted across 459 ICUs from 50 countries globally. This study aimed to understand the frequency and factors associated with death in hospital in patients who survived their ICU stay. We examined outcomes in the subpopulation discharged with no limitations of life sustaining treatments (‘treatment limitations’), and the subpopulations with treatment limitations.Results: 2,186 (94%) patients with no treatment limitations discharged from ICU survived, while 142 (6%) died in hospital. 118 (61%) of patients with treatment limitations survived while 77 (39%) patients died in hospital. Patients without treatment limitations that died in hospital after ICU discharge were older, more likely to have COPD, immunocompromise or chronic renal failure, less likely to have trauma as a risk factor for ARDS. Patients that died post ICU discharge were less likely to receive neuromuscular blockade, or to receive any adjunctive measure, and had a higher pre- ICU discharge non-pulmonary SOFA score. A similar pattern was seen in patients with treatment limitations that died in hospital following ICU discharge.Conclusions: A significant proportion of patients die in hospital following discharge from ICU, with higher mortality in patients with limitations of life-sustaining treatments in place. Non-survivors had higher systemic illness severity scores at ICU discharge than survivors.Trial Registration: ClinicalTrials.gov NCT02010073

scholarly journals Death in Hospital Following ICU Discharge: Insights from the LUNG SAFE Study

2020 ◽  
Author(s):  
Fabiana Madotto ◽  
Bairbre McNicholas ◽  
Emanuele Rezoagli ◽  
Tài Pham ◽  
John Laffey ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Severe Respiratory Failure ◽  
Factors Associated ◽  
Icu Discharge ◽  
Severity Scores ◽  
Hospital Patients ◽  
Multicenter Prospective Cohort Study ◽  
To Receive ◽  
International Multicenter ◽  
Multicenter Prospective Cohort

Abstract Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge.Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted across 459 ICUs from 50 countries globally. This current study aimed to understand the frequency and factors associated with death in hospital in patients who survived their ICU sta. We examined outcomes in the subpopulation discharged with no limitations of life sustaining treatments (‘treatment limitations’), and the subpopulations with treatment limitations.Results: 2,186 (94%) patients with no treatment limitations discharged from ICU survived, while 142 (6%) died in hospital. 118 (61%) of patients with treatment limitations survived while 77 (39%) patients died in hospital. Patients without treatment limitations that died in hospital after ICU discharge were older, more likely to have COPD, immunocompromise or chronic renal failure, less likely to have trauma as a risk factor for ARDS. Patients that died post ICU discharge were less likely to receive neuromuscular blockade, or to receive any adjunctive measure, and had a higher pre- ICU discharge non-pulmonary SOFA score. A similar pattern was seen in patients with treatment limitations that died in hospital following ICU discharge.Conclusions: A significant proportion of patients die in hospital following discharge from ICU, with higher mortality in patients with limitations of life-sustaining treatments in place. Non-survivors had higher systemic illness severity scores at ICU discharge than survivors. Trial Registration: ClinicalTrials.gov NCT02010073

scholarly journals Death in hospital following ICU discharge: insights from the LUNG SAFE study

2020 ◽  
Author(s):  
Fabiana Madotto ◽  
Bairbre McNicholas ◽  
Emanuele Rezoagli ◽  
Tài Pham ◽  
John Laffey ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Word Count ◽  
Factors Associated ◽  
Icu Discharge ◽  
Severity Scores ◽  
Hospital Patients ◽  
Multicenter Prospective Cohort Study ◽  
To Receive ◽  
International Multicenter ◽  
Multicenter Prospective Cohort

Abstract Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward.Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted across 459 ICUs from 50 countries globally. This study aimed to understand the frequency and factors associated with death in hospital in patients who survived their ICU stay. We examined outcomes in the subpopulation discharged with no limitations of life sustaining treatments (‘treatment limitations’), and the subpopulations with treatment limitations.Results: 2,186 (94%) patients with no treatment limitations discharged from ICU survived, while 142 (6%) died in hospital. 118 (61%) of patients with treatment limitations survived while 77 (39%) patients died in hospital. Patients without treatment limitations that died in hospital after ICU discharge were older, more likely to have COPD, immunocompromise or chronic renal failure, less likely to have trauma as a risk factor for ARDS. Patients that died post ICU discharge were less likely to receive neuromuscular blockade, or to receive any adjunctive measure, and had a higher pre- ICU discharge non-pulmonary SOFA score. A similar pattern was seen in patients with treatment limitations that died in hospital following ICU discharge.Conclusions: A significant proportion of patients die in hospital following discharge from ICU, with higher mortality in patients with limitations of life-sustaining treatments in place. Non-survivors had higher systemic illness severity scores at ICU discharge than survivors. (Word count 251)Trial Registration: ClinicalTrials.gov NCT02010073

scholarly journals Death in hospital following ICU discharge: insights from the LUNG SAFE study

2020 ◽  
Author(s):  
Fabiana Madotto ◽  
Bairbre McNicholas ◽  
Emanuele Rezoagli ◽  
Tài Pham ◽  
John Laffey ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Severe Respiratory Failure ◽  
Factors Associated ◽  
Icu Discharge ◽  
Severity Scores ◽  
Hospital Patients ◽  
Multicenter Prospective Cohort Study ◽  
To Receive ◽  
International Multicenter ◽  
Multicenter Prospective Cohort

Abstract Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward.Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted across 459 ICUs from 50 countries globally. This study aimed to understand the frequency and factors associated with death in hospital in patients who survived their ICU stay. We examined outcomes in the subpopulation discharged with no limitations of life sustaining treatments (‘treatment limitations’), and the subpopulations with treatment limitations.Results: 2,186 (94%) patients with no treatment limitations discharged from ICU survived, while 142 (6%) died in hospital. 118 (61%) of patients with treatment limitations survived while 77 (39%) patients died in hospital. Patients without treatment limitations that died in hospital after ICU discharge were older, more likely to have COPD, immunocompromise or chronic renal failure, less likely to have trauma as a risk factor for ARDS. Patients that died post ICU discharge were less likely to receive neuromuscular blockade, or to receive any adjunctive measure, and had a higher pre- ICU discharge non-pulmonary SOFA score. A similar pattern was seen in patients with treatment limitations that died in hospital following ICU discharge.Conclusions: A significant proportion of patients die in hospital following discharge from ICU, with higher mortality in patients with limitations of life-sustaining treatments in place. Non-survivors had higher systemic illness severity scores at ICU discharge than survivors. Trial Registration: ClinicalTrials.gov NCT02010073

Social Capital and Sustainable Health Care: An Analysis of Community Based Palliative Care Model of Kerala

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Abdul Azeez. E.P
Keyword(s):  
Social Capital ◽  
Palliative Care ◽  
Social Services ◽  
Social Inclusion ◽  
Well Being ◽  
Vital Role ◽  
Voluntary Organizations ◽  
Community Based ◽  
The Social ◽  
Palliative Care Units

Social Capital is the most crucial asset which significantly influence the efficacy and resilience of any community. Social capital is a dependent variable that depends upon the competence and coherence of the individuals in the community and mode of social relationships, trust and networks they maintain. It is one of the most sustainable social resources that originate from human relations and results on the mutual support of people. Utilization of Social capital has a wide applicability in the process of social inclusion, especially in dealing with the vulnerable and disadvantaged sections in the community itself. Voluntary organizations are very keen to utilize the social capital for community/social services and community development in a sustainable manner. Community based de-institutionalized Palliative Care is one of the foremost among such organizations that made social capital in a strategic way for social inclusion and community well being. This paper analyses the extent to which different elements of social capital helps in initiating the sustainable community based palliative care movement by assessing the unique intervention strategies carried out by the palliative care. This paper explores conceptual questions of how social capital and voluntary community based services are correlated. A case study method was adopted for the study in which ten palliative care units were analyzed. The results show that a number of social capital elements are playing a vital role in the sustainability of community palliative care movement in Kerala.

The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis

2021 ◽  
pp. 026921632199472
Author(s):  
Natalia Salamanca-Balen ◽  
Thomas V Merluzzi ◽  
Man Chen
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Palliative Care ◽  
Meta Analysis ◽  
Symptom Burden ◽  
Well Being ◽  
Medium Effect ◽  
Spiritual Well Being ◽  
Quasi Experimental

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.

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