Interdisciplinary palliative care for patients with lung cancer.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 130-130
Author(s):  
Betty R. Ferrell ◽  
Virginia Sun ◽  
Arti Hurria ◽  
Mihaela C. Cristea ◽  
Dan Raz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
Psychological Distress ◽  
Supportive Care ◽  
Usual Care ◽  
Usual Care Group ◽  
Intervention Group ◽  
Well Being ◽  
Care Group ◽  
Ambulatory Care Setting

130 Background: Palliative care, including symptom management and attention to quality of life (QOL) concerns, should be addressed throughout the trajectory of a serious illness such as lung cancer. This study tested the effectiveness on an interdisciplinary palliative care intervention for patients with stage I-IV non-small cell lung cancer (NSCLC). Methods: Patients undergoing treatments for NSCLC were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. Patients in the intervention group were presented at interdisciplinary care meetings and appropriate supportive care referrals were made. They also received four educational sessions. In both groups, QOL, symptoms, and psychological distress were assessed at baseline and 12 weeks using surveys which included the FACT-L, FACIT-Sp-12, LCS, and the Distress Thermometer. Results: A total of 491 patients were included in the primary analysis. Patients who received the intervention had significantly better scores for QOL (109.1 vs. 101.4; p < .001), symptoms (25.8 vs. 23.9; p < .001), spiritual well-being (38.1 vs. 36.2; p < .001), and lower psychological distress (2.2 vs. 3.3; p < .001) at 12 weeks, after controlling for baseline scores, compared to patients in the usual care group. Patients in the intervention group also had significantly higher numbers of completed advance care directives (44% vs. 9%; p < .001), and overall supportive care referrals (61% vs. 28%; p < .001). Conclusions: Interdisciplinary palliative care in the ambulatory care setting resulted in significant improvements in QOL, symptoms, and distress for NSCLC patients.

scholarly journals A Proactive Telephone-Delivered Risk Communication Intervention for Smokers Participating in Lung Cancer Screening: A Pilot Feasibility Trial

2017 ◽  
Vol 13 (3) ◽  
pp. 137-144 ◽  
Author(s):  
Steven B. Zeliadt ◽  
Preston A. Greene ◽  
Paul Krebs ◽  
Deborah E. Klein ◽  
Laura C. Feemster ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Usual Care ◽  
Usual Care Group ◽  
Intervention Group ◽  
Lung Cancer Screening ◽  
Feasibility Trial ◽  
Care Group ◽  
Telephone Counselling ◽  
Tobacco Treatment

Introduction: Many barriers exist to integrating smoking cessation into delivery of lung cancer screening including limited provider time and patient misconceptions.Aims: To demonstrate that proactive outreach from a telephone counsellor outside of the patient's usual care team is feasible and acceptable to patients.Methods: Smokers undergoing lung cancer screening were approached for a telephone counselling study. Patients agreeing to participate in the intervention (n = 27) received two telephone counselling sessions. A 30-day follow-up evaluation was conducted, which also included screening participants receiving usual care (n = 56).Results/Findings: Most (89%) intervention participants reported being satisfied with the proactive calls, and 81% reported the sessions were helpful. Use of behavioural cessation support programs in the intervention group was four times higher (44%) compared to the usual care group (11%); Relative Risk (RR) = 4.1; 95% CI: 1.7 to 9.9), and seven-day abstinence in the intervention group was double (19%) compared to the usual care group (7%); RR = 2.6; 95% CI: 0.8 to 8.9).Conclusions: This practical telephone-based approach, which included risk messages clarifying continued risks of smoking in the context of screening results, suggests such messaging can boost utilisation of evidence-based tobacco treatment, self-efficacy, and potentially increase the likelihood of successful quitting.

scholarly journals Rice farming care as a novel method of green care farm in East Asian context: an implementation research

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chiaki Ura ◽  
Tsuyoshi Okamura ◽  
Sachiko Yamazaki ◽  
Masaya Shimmei ◽  
Keisuke Torishima ◽  
...  
Keyword(s):  
East Asia ◽  
Usual Care ◽  
Usual Care Group ◽  
Well Being ◽  
Care Group ◽  
Rice Farming ◽  
People With Dementia ◽  
Significant Difference ◽  
Positive Experiences ◽  
Green Care Farms

Abstract Background Green care farms, which offer care for people with dementia in a farm setting, have been emerging in the Netherlands. The aim of this study was to 1) implement green care farms which use rice farming in Japan, 2) explore the positive experiences of rice farming care, and 3) compare the effect of rice farming care to that of usual care on well-being and cognitive ability. Methods We developed a new method of green care farm in Japan which uses rice farming, a farming that is practiced all over East Asia. The participants were 15 people with dementia (mean age = 75.6 ± 9.8 years) who participated in a one-hour rice farming care program once a week for 25 weeks. We also collected qualitative data on the positive experiences of study participants after the program. As a reference data, we also collected the corresponding data of the usual care group which included 14 people with dementia (mean age = 79.9 ± 5.8 years) who were attending the near-by day-care. Results The mean participation rate on the rice farming care group was 72.1%. After the intervention, participants reported experiencing enjoyment and connection during the program. It also changed the staff’s view on dementia. The green care farm group showed a significant improvement in well-being but no significant difference in cognitive function compared to the usual care group. Conclusions Green care farms by using rice farming is promising care method which is evidence-based, empowerment-oriented, strengths-based, community-based dementia service, which also delivers meaningful experience for the people with dementia in East Asia. Trial registration UMIN, UMIN000025020, Registered 1 April 2017.

Effect of Artificial Intelligence on Nutritional Status of children post cardiac surgery; A Randomized Controlled Trial (Preprint)

2022 ◽  
Author(s):  
Maryam Zahid ◽  
Ume Sughra
Keyword(s):  
Nutritional Status ◽  
Usual Care ◽  
Usual Care Group ◽  
Mobile Application ◽  
Controlled Trial ◽  
Intervention Group ◽  
Care Group ◽  
Randomized Controlled ◽  
Nutritional Status Of Children ◽  
Post Cardiac Surgery

BACKGROUND Malnutrition is the most common problem in congenital heart diseases patients. Health based mobile applications play an important role in planning and tracking of diet for better nutritional status OBJECTIVE To assess the effect of artificial intelligence on nutritional status of children post cardiac surgery in comparison to usual care group. To assess usefulness of diet related mobile application in comparison to usual care group. METHODS This is a two arm randomized controlled trial that was conducted at a Tertiary Care Hospital, Rawalpindi. The study duration was 6 months from February 2021 till July 2021. Sample size was calculated to be 88. Intervention group was given a diet related mobile application and usual care group was handed a pamphlet with diet instructions on discharge. RESULTS Mean weight of all participants was 15 ± 5.7 kg at the time of discharge whereas at the end of 8th week mean weight of the participants in usual care group was 16.5 ± 7.2 kg and intervention group was 17.1 ± 5 kg. Average calories consumed by usual care group was 972 ± 252 kcal and 1000.75 ± 210 kcal by intervention group after 8 weeks of discharge. Average proteins consumed by the usual care group was 34.3 ± 12.5 grams and 39± 6.4 grams by intervention group after 8 weeks of discharge. At the end of intervention preferred diet planning tool for 79% of the participants was mobile application. At 8th week 93% of the participants considered the visual cues useful, 80% think that the mobile application language was understandable, 79% of the participants think nutritional goal setting is a useful feature in mobile application and 55% of the participants think the recipes in the application were useful. CONCLUSIONS The study showed strength for the future of scalable modern technology for self-nutrition monitoring. There was slight increase in the weight and nutritional intake of both groups as interventions period was limited. CLINICALTRIAL Study was registered on clinicaltrial.gov website with trial identity number NCT04782635.

scholarly journals Impact of pharmacist-led care on glycaemic control of patients with uncontrolled type 2 diabetes: a randomised controlled trial in Nigeria

2021 ◽  
Vol 19 (3) ◽  
pp. 2402
Author(s):  
Emmanuel A. David ◽  
Rebecca O. Soremekun ◽  
Isaac O. Abah ◽  
Roseline I. Aderemi-Williams
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Usual Care ◽  
Usual Care Group ◽  
Intervention Group ◽  
Glycated Haemoglobin ◽  
Care Group ◽  
Laboratory Parameters ◽  
Randomised Controlled

Background: Diabetes mellitus is a chronic, degenerative disease, requiring a multi-dimensional, multi-professional care by healthcare providers and substantial self-care by the patients, to achieve treatment goals. Objective: To evaluate the impact of pharmacist-led care on glycaemic control in patients with uncontrolled Type 2 Diabetes Methods: In a parallel group, single-blind randomised controlled study; type 2 diabetic patients, with greater than 7% glycated haemoglobin (A1C) were randomised into intervention and usual care groups and followed for six months. Glycated haemoglobin analyzer, lipid analyzer and blood pressure monitor/apparatus were used to measure patients’ laboratory parameters at baseline and six months. Intervention group patients received pharmacist-structured care, made up of patient education and phone calls, in addition to usual care. In an intention to treat analysis, Mann-Whitney U test was used to compare median change at six months in the primary (A1C) and secondary outcome measures. Effect size was computed and proportion of patients that reached target laboratory parameters were compared in both arms. Results: All enrolled participants (108) completed the study, 54 in each arm. Mean age was 51 (SD 11.75) and majority were females (68.5%). Participants in the intervention group had significant reduction in A1C of -0.75%, compared with an increase of 0.15% in the usual care group (p<0.001; eta-square= 0.144). The proportion of those that achieved target A1C of <7% at 6 months in the intervention and usual care group was 42.6% vs 20.8% (p=0.02). Furthermore, intervention patients were about 3 times more likely to have better glucose control; A1C<7% (aOR 2.72, 95%CI: 1.14-6.46) compared to usual care group, adjusted for sex, age, and duration of diabetes. Conclusions: Pharmacist-led care significantly improved glycaemic control in patients with uncontrolled T2DM.

scholarly journals Effect of targeted fluid minimization and diuretic therapy on hospital- acquired heart failure and adverse outcomes in patients with no preexisting cardiac dysfunction

2021 ◽  
Author(s):  
Kwannate Intarawongchot ◽  
Sutep Gonlachanvit ◽  
Sarinya Puwanant
Keyword(s):  
Hospital Mortality ◽  
Usual Care ◽  
Cardiac Dysfunction ◽  
Usual Care Group ◽  
Intervention Group ◽  
Care Group ◽  
Mechanical Ventilator ◽  
Icu Admission ◽  
Intervention Protocol ◽  
Hospital Acquired

Abstract Background This study aimed to investigate: 1) the incidence of hospital-acquired heart failure (HF) in patients with no preexisting cardiac disorder, and 2) whether the use of an intervention protocol comprised of targeted fluid minimization and diuretic therapy can reduce the incidence of hospital-acquired HF and adverse outcomes.Methods We conducted a single-center, open-labeled, prospective cohort study enrolling patients with no preexisting cardiac dysfunction who were admitted to the medical wards and had a positive intravenous fluid balance > 4 L within 3 days. We assigned patients in a 1:1 ratio to the intervention protocol (intervention group) or usual care. The primary outcome was hospital-acquired HF. The secondary outcomes included in-hospital mortality, intensive critical unit (ICU) admission, mechanical ventilator usage, or prolonged hospital stay > 30 days.Results A total of 98 patients (mean age 66; 52% male) were enrolled (intervention group, 49; usual care group, 49). The incidence of hospital-acquired HF among all patients was 21%. Patients with hospital-acquired had higher rates of in-hospital mortality (48% vs.13%; p = 0.001), ICU admission (33% vs.10%; p = 0.010) and mechanical ventilator usage (62% vs. 35%; p = 0.027). Prolonged hospital stay > 30 days rates were similar in patients with and without hospital-acquired HF. Hospital-acquired HF was not found statistically different between groups (intervention group 18% vs. usual care group 25%; p = 0.460). Patients in the intervention group did have lower rates of subsequent ICU admission (8%vs.23%; p = 0.049) and hospitalizattion > 30 days. (8%vs.27%; p = 0.018) compared with the usual care group. In-hospital mortality and mechanical ventilator usage were not different between groups.Conclusions The incidence of hospital-acquired HF in patients with no preexisting cardiac dysfunction who had a positive cumulative fluid balance of > 4 L within 3 days was not uncommon, about one in five patients. Hospital-acquired HF can lead to increased in-hospital mortality and co-morbidities. Targeted fluid minimization and diuretics did show a reduced rate of ICU admission and prolonged hospitalization. However, no statistical difference in rates of hospital-acquired HF and in-hospital mortality compared to the control group were found.

Test of weight gain prevention intervention in stage II and III breast cancer patients receiving neoadjuvant chemotherapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20523-e20523 ◽  
Author(s):  
K. Basen-Engquist ◽  
H. Y. Perkins ◽  
C. L. Carmack Taylor ◽  
D. C. Hughes ◽  
J. L. Jovanovic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Neoadjuvant Chemotherapy ◽  
Usual Care ◽  
Cancer Patients ◽  
Usual Care Group ◽  
Intervention Group ◽  
Care Group ◽  
Weight Gain Prevention ◽  
Breast Cancer Patients

e20523 Background: Weight gain is common in women with breast cancer and is worrisome, as may affect prognosis and risk of other chronic diseases. This randomized study pilot tested a weight gain prevention intervention for breast cancer patients receiving neoadjuvant chemotherapy. Methods: Breast cancer patients receiving neoadjuvant chemotherapy were randomized to a weight gain prevention intervention or a usual care control arm. The intervention used a body acceptance approach, which emphasized changes in diet (low energy density food) and exercise behavior (resistance training) rather than focusing on weight loss. It was administered in weekly sessions delivered in-person and by telephone. Assessments were done at baseline, mid-chemotherapy, pre-surgery, after surgical recovery, after a 9 week post-surgical booster intervention, and 6 months after surgery. The data on weight changes from baseline (T0) to mid-chemotherapy (T1) and presurgery (T2) is presented. Results: 33 participants were randomized the intervention (n=16) or usual care (n=17). Three control participants withdrew before assessments were done. Of the 30 remaining women, 70% had stage II and 30% had stage III breast cancer. Their mean age was 49.7 (SD=12.2), and half were premenopausal. Mean BMI was 29.3 (SD=6.1) and 70% were physically inactive. The sample was diverse with regard to self-reported ethnicity (57% white, 27% African-American, 7% Hispanic, 10% other). Change in weight from T0 to T1 was -0.9 kg in the intervention group and +1.4 kg in the usual care group (n=27, p=0.126); from T0 to T2 the change was -2.0 kg in the intervention group and +0.8 kg in the usual care group (n=20, p=0.056). When weights from a chart review were used for patients with missing assessments the T0 to T2 changes were -2.9 kg for the intervention group and 0 kg for the usual care group (n=30, p=0.065). Conclusions: Based on a preliminary analysis, there was a trend approaching statistical significance for weight loss from a diet and exercise intervention based on the body acceptance approach compared to a usual care control group. These results indicate this intervention should be tested in a larger randomized controlled trial. No significant financial relationships to disclose.

scholarly journals Home-Based Kidney Care, Patient Activation, and Risk Factors for CKD Progression in Zuni Indians

2018 ◽  
Vol 13 (12) ◽  
pp. 1801-1809 ◽  
Author(s):  
Robert G. Nelson ◽  
V. Shane Pankratz ◽  
Donica M. Ghahate ◽  
Jeanette Bobelu ◽  
Thomas Faber ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Confidence Interval ◽  
Usual Care ◽  
Usual Care Group ◽  
Short Form ◽  
Intervention Group ◽  
Patient Activation ◽  
Care Group ◽  
Home Based

Background and objectivesThe burden of CKD is greater in ethnic and racial minorities and persons living in rural communities, where access to care is limited.Design, setting, participants, & measurementsA 12-month clinical trial was performed in 98 rural adult Zuni Indians with CKD to examine the efficacy of a home-based kidney care program. Participants were randomized by household to receive usual care or home-based care. After initial lifestyle coaching, the intervention group received frequent additional reinforcement by community health representatives about adherence to medicines, diet and exercise, self-monitoring, and coping strategies for living with stress. The primary outcome was change in patient activation score, which assesses a participant’s knowledge, skill, and confidence in managing his/her own health and health care.ResultsOf 125 randomized individuals (63 intervention and 62 usual care), 98 (78%; 50 intervention and 48 usual care) completed the 12-month study. The average patient activation score after 12 months was 8.7 (95% confidence interval, 1.9 to 15.5) points higher in the intervention group than in the usual care group after adjusting for baseline score using linear models with generalized estimating equations. Participants randomized to the intervention had 4.8 (95% confidence interval, 1.4 to 16.7) times the odds of having a final activation level of at least three (“taking action”) than those in the usual care group. Body mass index declined by 1.1 kg/m2 (P=0.01), hemoglobin A1c declined by 0.7% (P=0.01), high-sensitivity C-reactive protein declined by 3.3-fold (P<0.001), and the Short-Form 12 Health Survey mental score increased by five points (P=0.002) in the intervention group relative to usual care.ConclusionsA home-based intervention improves participants’ activation in their own health and health care, and it may reduce risk factors for CKD in a rural disadvantaged population.

scholarly journals The effects of telemedicine on the quality of life of patients with lung cancer: a systematic review and meta-analysis

2020 ◽  
Vol 11 ◽  
pp. 204062232096159
Author(s):  
Lanlan Pang ◽  
Zefu Liu ◽  
Sheng Lin ◽  
Zhidong Liu ◽  
Hengyu Liu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Systematic Review ◽  
Usual Care ◽  
Cancer Patients ◽  
Usual Care Group ◽  
Meta Analysis ◽  
Care Group ◽  
Lung Cancer Patients

Background and aims: Lung cancer patients suffer from deterioration in their physical and psychological function, which exerts a negative influence on their quality of life (QOL). Telemedicine has been proven to be an effective intervention for patients with several chronic diseases. The aim of this systematic review and meta-analysis was to investigate the efficacy of telemedicine in improving QOL in lung cancer patients. Methods: PubMed, Cochrane Library, EMBASE, Web of Science and Scopus databases were searched for randomized controlled trials that investigated the effectiveness of telemedicine in lung cancer patients. Review Manager 5.3 and Stata 15.1 were used to perform data analysis. Results: Our meta-analysis included eight clinical trials with a total of 635 lung cancer patients. The results showed that the telemedicine group had significantly higher QOL than the usual care group [standard mean difference (SMD) 0.96, 95% confidence interval (CI) 0.29–1.63, I2 = 91%]. In addition, the telemedicine group had lower anxiety (SMD −0.44, 95% CI −0.66 to −0.23, I2 = 3%) and depression scores (SMD −0.48, 95% CI −0.91 to −0.05, I2 = 66%) than the usual care group. However, no significant differences were found in fatigue and pain outcomes between the two groups. Conclusion: Telemedicine may be an effective method of improving QOL in lung cancer patients and the further development and use of telemedicine care is recommended.

scholarly journals Predictors of Change in Osteoporosis Knowledge, Health Beliefs, and Self-Efficacy After an Education Intervention

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 453-453
Author(s):  
Philippe Ronel Labrias ◽  
Richard Feinn ◽  
Shanthi Johnson ◽  
Katherine McLeod
Keyword(s):  
Usual Care ◽  
Health Beliefs ◽  
Self Efficacy ◽  
Usual Care Group ◽  
Intervention Group ◽  
Care Group ◽  
Education Intervention ◽  
Mineral Density ◽  
Osteoporosis Knowledge ◽  
Bone Mineral Density Testing

Abstract Education interventions that increase osteoporosis knowledge and address health beliefs and self-efficacy help older adults make informed decisions to prevent and manage the disease. The aim of this study was to determine if clinical risk factors for osteoporosis moderate the effect of a multifaceted education intervention on osteoporosis knowledge, health beliefs, and self-efficacy. Patients 50 years and older with no prior diagnosis of or treatment for osteoporosis were referred by their primary care provider for bone mineral density testing by DXA and randomized to an osteoporosis education intervention group (n = 102) or usual care group (n = 101). Demographic and health history questionnaires, and validated tools to assess osteoporosis knowledge, health beliefs and self-efficacy were completed at baseline and 6-month follow-up. Results of the linear mixed-effects model showed a significant interaction with younger age (p=.024) on self-efficacy among patients in the intervention group compared to the usual care group. Patients with higher BMI had greater perceived health motivation (p=.026) in the intervention group. Compared to the usual care group, patients in the intervention group with higher vitamin D intake had greater perceived exercise (p=.020) and calcium benefits (p=.012) and those with a family history of osteoporosis had greater perceived susceptibility to osteoporosis (p=.045). By understanding the key factors that predict change in knowledge, health beliefs and self-efficacy after an education intervention compared to usual care, we can better tailor interventions to enhance prevention and management of osteoporosis.

Preparing Families of Intensive Care Patients for Withdrawal of Life Support: A Pilot Study

2008 ◽  
Vol 17 (2) ◽  
pp. 113-121
Author(s):  
Karin T. Kirchhoff ◽  
Jenna Palzkill ◽  
Jennifer Kowalkowski ◽  
Anne Mork ◽  
Elfa Gretarsdottir
Keyword(s):  
Intensive Care ◽  
Usual Care ◽  
Usual Care Group ◽  
Life Support ◽  
Negative Mood ◽  
Self Regulation ◽  
Intervention Group ◽  
Care Group ◽  
Specific Information ◽  
Tailored Messages

Background Most deaths in intensive care occur after withdrawal of life support. Although preparation of patients’ families is recommended, the specific information required has not been theoretically developed or tested. Objective To assess the feasibility of testing 4 tailored messages to prepare families of patients having a planned withdrawal of life support, to assess barriers to conducting such a study, and to obtain preliminary data on measurable effects that could be used to compare such preparation with usual care. Self-regulation theory was used to structure the messages. Methods Families were randomly assigned to usual care (n=10) or to an intervention group (n=10) that received 1 of 4 tailored messages to prepare them for withdrawal of life support. They were contacted 2 to 4 weeks later to complete the Profile of Mood States and to give their evaluation of the experience, inclusive of the information received. Results Compared with the usual-care group, the intervention group was significantly more satisfied with the information they received and understood better what was to happen. The intervention group had lower negative mood scores and higher positive mood scores than did the usual-care group, although the difference was not significant. Unsolicited comments by the usual-care participants were requests for the specific information that had been received by the intervention group. Conclusions The information provided was considered helpful. A larger sample might yield more significant differences. Further work is needed on other aspects of preparation such as healthcare support, spiritual issues, and preparation for funeral arrangements.

Sign in / Sign up

Export Citation Format

Share Document