scholarly journals Screening Patients With Cancer Admitted to Hanoi Medical University Hospital for Palliative Care Needs

2020 ◽  
pp. 1321-1327
Author(s):  
Quang V. Le ◽  
Huy L. Trinh ◽  
Kim Ngan T. Mai ◽  
Manh D. Pham ◽  
Paul A. Glare
Keyword(s):  
Palliative Care ◽  
Screening Tool ◽  
Performance Status ◽  
Locally Advanced ◽  
Eastern Cooperative Oncology Group ◽  
University Hospital ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical University

PURPOSE To evaluate a screening tool for identifying which patients admitted to the oncology ward of a Vietnamese hospital should be referred to specialist palliative care (PC). METHODS We performed a cross-sectional survey of consecutive patients hospitalized in the Department of Oncology and Palliative Care at Hanoi Medical University Hospital between June 2019 and September 2019. We translated a validated 11-item screening tool into Vietnamese and used a total score of ≥ 5 as a positive screen. RESULTS One hundred participants were recruited. Forty-four patients (44%) screened positive. Of these, 37 (84%) had locally advanced or metastatic disease, 31 (70%) had uncontrolled symptoms, and 43 (98%) requested a PC consultation. A score ≥ 5 was significantly more common in patients with stage IV disease versus earlier stage, performance status of Eastern Cooperative Oncology Group (ECOG) 2 versus ECOG 0, and when life-limiting complications of cancer were present. Screening identified four patients overlooked by oncologists as needing referral, and 34% of patients requesting a referral had scores < 5. CONCLUSION This screening tool provided oncologists with easy-to-use criteria for referring patients for PC. At the same time, it relieved the work load for under-resourced PC physicians by screening out requests with low-level need. This tool should be part of routine assessment on admission in all oncology units in Vietnam.

scholarly journals Hyponatremia in Cancer Patients Hospitalized in a Palliative Care Department: A Cross-Sectional Analysis

2021 ◽  
Vol 34 (13) ◽  
Author(s):  
José Ferraz Gonçalves ◽  
Mariana Brandão ◽  
Ana Arede ◽  
Bárbara Prucha ◽  
Inês Grilo ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Serum Sodium ◽  
Group Performance ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Cross Sectional ◽  
Care Department ◽  
Median Serum ◽  
Metastatic Sites

Introduction: Hyponatremia is frequent in cancer patients, as many studies carried out in these patients have shown. However, there are only a few studies carried out at the end of life and in palliative care. The aim of this study was to determine the prevalence of hyponatremia in cancer patients in the palliative care department of an oncology center and its association with survival.Material and Methods: The study included the first 300 patients hospitalized in the palliative care department in 2017. Survival was measured from the day of hospitalization until death.Results: Serum sodium was measured in 170 (59%) patients. The median serum concentration was 135 mmol/L (109 to 145). Among 91 (54%) patients, serum sodium was within the normal range, 59 (35%) had mild hyponatremia, 13 (8%) had moderate and seven (4%) had profound hyponatremia. The median survival was 13 days (1 to 1020). Serum sodium was not significantly associated with survival (p = 0.463). Regarding other variables, the Eastern Cooperative Oncology Group performance status was significantly associated with survival, while gender, age, primary cancer and number of metastatic sites were not.Discussion: Hyponatremia, mainly mild and moderate, was found in almost half of the patients included in this study. However, unlike other studies, hyponatremia was not associated with a poorer prognosis.Conclusion: Hyponatremia is common in cancer patients receiving palliative care but did not seem to influence survival.

scholarly journals Perceptions and Attitudes about the Concept and Approach of Palliative Care among Carer’s and Family Members of Patients on End-of-Life Care: A Cross-sectional Survey

2019 ◽  
Author(s):  
Sameena Shah ◽  
Faizan Qaisar ◽  
Iqbal Azam ◽  
Khairunnisa Mansoor
Keyword(s):  
Palliative Care ◽  
Multivariable Analysis ◽  
Education Level ◽  
Social Needs ◽  
University Hospital ◽  
P Value ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Correct Knowledge ◽  
Care Givers

Abstract BACKGROUND It is necessary to assess carer's understanding of palliative care. The objectives of this study were to ascertain the attitudes and perceptions about the concept and components of palliative care. METHODS A cross-sectional survey was conducted. Data was collected from the Aga Khan University Hospital in-patient and out-patient departments and home-based palliative care services from mid 2015 to 2016. All adult care-givers who met the inclusion criteria and gave informed consent were approached by trained data collectors till the sample size was reached.Univariate and multivariable analysis and results were reported as crude prevalence’s, crude and adjusted prevalence ratios with 95% confidence intervals using Cox-proportional hazard algorithm. Mean difference of knowledge and attitude scores by care giver variables was assessed using one-way ANOVA. SPSS version 18 was used and a p-value of less than 5 percent was treated as significant. RESULTS Out of 250 care givers more than 60% were 40 years or less and the majority were males. Majority were at least graduates. Approximately 70% of the respondents agreed with the opinion that the person suffering from cancer should be informed about the diagnosis and disease progression. About forty five percent (95% C.I.: 39.03%, 51.37%) of the study respondents had correct knowledge about palliative care. Age and relationship with patient had the most variation in response in terms of significance. CONCLUSION Young individuals aged <40 years, with an education level of matric, children or relations of the patient were found to have significantly more and correct knowledge. The majority believed that the patient should be informed about the diagnosis and that patients should be encouraged to carry out routine activities and be facilitated to fulfill their wishes. Two foundational aspects showed a consistently good understanding and therefore correct knowledge across age groups, gender, education level, and relationship with the patient. Firstly, that palliative care should be offered to everyone suffering from an incurable disease and, secondly, that this approach encompasses not just physical, but also psychological and social needs of the patient, in addition to the needs of the family caring for the patient.

scholarly journals Perceptions and Attitudes towards the Concept and Approach of Palliative Care among Caregiver's of Patients on End-of-Life Care: A Cross-sectional Survey

2020 ◽  
Author(s):  
Sameena Shah ◽  
Faizan Qaisar ◽  
Iqbal Azam ◽  
Khairunnisa Mansoor
Keyword(s):  
Palliative Care ◽  
Multivariable Analysis ◽  
Education Level ◽  
Social Needs ◽  
University Hospital ◽  
P Value ◽  
Cross Sectional Survey ◽  
Adult Care ◽  
Cross Sectional ◽  
Care Givers

Abstract BACKGROUND As care-giver’splay an integral role for patients as disease progresses, it is necessary to assess their knowledge and understanding of palliative care to ensure meaningful uptake before developing an appropriate palliative care program.METHODS A cross-sectional survey was conducted. Data was collected from the Aga Khan University Hospital in-patient and out-patient departments and home-based palliative care services from mid 2015 to 2016. All adult care-giver’swho met the inclusion criteria and consented completed a questionnaire till the sample size was reached.Univariate and multivariable analysis and results were reported as crude prevalence’s, crude and adjusted prevalence ratios with 95% confidence intervals using Cox-proportional hazard algorithm. Mean difference of knowledge and attitude scores by care-giver variables was assessed using one-way ANOVA. SPSS version 18 was used and a p-value of less than 5 percent was treated as significant.RESULTS Out of 250 care givers more than 60% were 40 years or less and the majority were males and at least graduates. Approximately 70% of the respondents agreed with the opinion that the person suffering from cancer should be informed about the diagnosis and disease progression. About forty five percent (95% C.I.: 39.03%, 51.37%) of the study respondents had enhanced understandingabout palliative care. Individuals aged <40 years, with an education level of Grade 10, children or relations of the patient were found to have significantly more knowledge and understanding about palliative care. The majority believed that the patient should be informed about the diagnosis and should be facilitated to carry out routine activities and fulfill wishes.CONCLUSION Nearly half of care giver’s of patients affected by incurable conditions have enhanced understanding of the PC approach.Two foundational aspects showed a consistently enhanced understanding across age groups, gender, education level, and relationship with the patient. Firstly, that palliative care should be offered to everyone suffering from an incurable disease and, secondly, that this approach encompasses not just physical, but also psychological and social needs of the patient and the family. These findings should help inform the establishment of a palliative care program that fills the gaps in knowledge and understanding of this beneficial approach in care givers.

Circumstances of hospital admissions in palliative care: A cross-sectional survey of patients admitted to hospital with palliative care needs

2018 ◽  
Vol 32 (5) ◽  
pp. 1030-1036 ◽  
Author(s):  
Jackie Robinson ◽  
Merryn Gott ◽  
Rosemary Frey ◽  
Christine Ingleton
Keyword(s):  
Palliative Care ◽  
Hospital Admissions ◽  
Community Services ◽  
Ageing Population ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care At Home ◽  
Palliative Care Needs ◽  
At Home

Background: On average, people will experience 2.28 hospital admissions in the last year of life with the likelihood of a hospital admission increasing in the last 2 weeks of life. Reducing hospital admissions has become a focus for high-income countries as they work to manage the financial implications of an ageing population. However, the circumstances by which patients with palliative care needs are admitted to hospital remain poorly understood. Aim: To explore the circumstances of hospital admissions for patients with palliative care needs. Design: Cross-sectional survey design using face-to-face questionnaires. Setting/participants: In total, 116 patients aged >18 years admitted to a tertiary hospital with palliative care needs. Results: Those with a non-cancer diagnosis and those aged over 75 years were less likely to have hospice involved prior to the admission ( x2 (1, n = 116) = 10.19, p = 0.00). Few patients recognised community services as having a role in enabling them to remain at home. Those with cancer placed a significantly higher priority on receiving information about their illness ( t(114) = 2.03, p = 0.04) and receiving tests and investigations ( t(114) = 2.37, p = 0.02) in hospital. Conclusion: This study has demonstrated the complexity of hospital admissions in palliative care. Further research is needed to explore patient perceptions of care at home and the role of community services to enable them to remain at home. Understanding the motivation to come to hospital in the context of an incurable illness and limited treatment options may help to inform the development of services that can enable better care at home.

Medical oncologists’ and palliative care physicians’ opinions towards thromboprophylaxis for inpatients with advanced cancer: a cross-sectional study

2019 ◽  
pp. bmjspcare-2019-001861 ◽  
Author(s):  
Breffni Hannon ◽  
Nathan Taback ◽  
Camilla Zimmermann ◽  
John Granton ◽  
Monika Krzyzanowska
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Fractional Factorial ◽  
Patient Factors ◽  
Cross Sectional ◽  
Medical Oncologists ◽  
The Impact ◽  
Reason For Admission

BackgroundPatients with advanced cancer are increasingly discharged from inpatient settings following focused symptom management admissions. Thromboprophylaxis (TP) is recommended for patients with cancer admitted to acute care settings; less is known about TP use in palliative care (PC) settings. This study explored the opinions of Canadian medical oncologists (MO) and PC physicians regarding the use of TP for inpatients with advanced cancer.MethodsA fractional factorial survey designed to evaluate the impact of patient factors (age, clinical setting, reason for admission, pre-admission performance status (Eastern Cooperative Oncology Group; ECOG), and risk of bleeding on anticoagulation) and physician demographics on recommending TP was administered by email to Canadian MO and PC physicians. Each respondent received eight vignettes randomly selected from a set of 32. Hierarchical regression was used to evaluate the odds of prescribing TP adjusted for patient factors.Results606 MO and 491 PC physicians were surveyed; response rates were 11.1% and 15.0%, respectively. MO were predominantly male (59.7%); PC female (60.3%); most worked in academic environments (90.3% MO; 73.9% PC). Multivariable hierarchical logistic regression demonstrated that all patient factors except age were associated with prescribing TP (ORs range: from 1.34 (95% CI 1.01 to 1.77) for good ECOG, to 2.53 (95% CI 1.9 to 3.37), for reversible reason for admission). Controlling for these factors, medical specialty was independently associated with recommending TP (OR for MO 2.09 (95% CI 1.56 to 2.8)).ConclusionsMO have higher odds of recommending TP for inpatients with advanced cancer than PC physicians. Further research exploring the drivers of these differing practices is warranted.

scholarly journals Predictors of patient-related benefit, burden and feeling safe in relation to hospital admissions in palliative care: A cross-sectional survey

2017 ◽  
Vol 32 (1) ◽  
pp. 167-171 ◽  
Author(s):  
Jackie Robinson ◽  
Merryn Gott ◽  
Rosemary Frey ◽  
Clare Gardiner ◽  
Christine Ingleton
Keyword(s):  
Palliative Care ◽  
Hospital Admissions ◽  
Hospital Setting ◽  
Urban Hospital ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Cross Sectional ◽  
Medical Wards ◽  
Palliative Care Needs

Background: Research exploring patient experience of palliative care in the hospital setting has previously been limited to negative aspects of care. However, recent studies have shown that patients with palliative care needs experience benefits being in hospital. Little is known about how experiences of benefit and burden vary according to socio-demographic and illness-related factors and how these experiences influence patient preferences to return to hospital. Aim: To identify factors influencing experiences of benefit and burden and the predictors associated with a preference to return to hospital in palliative care. Design: Cross-sectional design using a questionnaire survey. Setting/participants: In total, 116 hospital inpatients admitted with palliative care needs in an urban hospital in New Zealand. Recruitment was from an oncology ward, four general medical wards and a respiratory ward. Results: Those living in more deprived areas experienced more benefit being in hospital ( F(4, 109) = 3.15, p = 0.017), while younger people ( F(4, 109) = 4.44, p = 0.00) and those from Asian or Pacific cultures ( F(2, 111) = 7.78, p = 0.000) experienced more burden. Those with a non-cancer diagnosis felt less safe in hospital ( p = 0.04). ‘Feeling safe’ was a significant ( B = 0.14, p = 0.03) predictor for a preference to return to hospital. Conclusion: Deprivation, diagnosis, age and ethnicity influenced experiences of benefit and burden in hospital. ‘Feeling safe’ was a significant predictor for a preference to return to hospital. Further research is needed to understand why certain patient factors influence experiences of hospitalisation and how ‘feeling safe’ can be replicated in other care environments.

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 Burnout of Healthcare Workers amid the COVID-19 Pandemic: A Japanese Cross-Sectional Survey

2021 ◽  
Vol 18 (5) ◽  
pp. 2434
Author(s):  
Yoshito Nishimura ◽  
Tomoko Miyoshi ◽  
Hideharu Hagiya ◽  
Yoshinori Kosaki ◽  
Fumio Otsuka
Keyword(s):  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
General Medicine ◽  
Maslach Burnout Inventory ◽  
University Hospital ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Past

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.

scholarly journals A New Approach to the Identification of Palliative Care Needs and Advanced Chronic Patients among Nursing Home Residents

2021 ◽  
Vol 18 (6) ◽  
pp. 3171
Author(s):  
Ana A. Esteban-Burgos ◽  
María José Lozano-Terrón ◽  
Daniel Puente-Fernandez ◽  
César Hueso-Montoro ◽  
Rafael Montoya-Juárez ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Homes ◽  
Statistical Significance ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Care Needs ◽  
Chronic Patients ◽  
Cross Sectional ◽  
Surprise Question ◽  
Palliative Care Needs

Background: Proper planning of Palliative Care in nursing homes requires advanced knowledge of the care needs that residents show. The aim of the study was to evaluate Palliative Needs and other conditions such as fragility, complexity, and prognosis and also to suggest new indicators for the establishment of the resident’s advanced chronic condition. Methods: Cross-sectional study conducted in 149 nursing homes Complex Chronic residents evaluated by trained professionals. Palliative Care Needs, assessed by the NECPAL ICO-CCOMS© tool, and fragility, case and palliative complexity and prognosis were evaluate through a comprehensive assessment. Descriptive analyses and association measures were performed setting the statistical significance at 0.05. Results: More than 50% of the residents had positive Surprise Question and other Palliative Needs and were classified as Advanced Chronic Patients. Distress and/or Severe Adaptative Disorder was the most frequent need shown by the residents and significant differences in levels of frailty and other characteristics, were found between the Positive and the Negative Surprise Question Groups. Statistically significant correlations were also found between aspects of both groups. Conclusions: Nursing homes residents show Palliative Needs regardless of the response to the Surprise Question of the NECPAL tool. Other characteristics such as presence of an intermediate level of frailty are suggested as a new perspective to identify advanced chronic patients among nursing homes residents.

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