Perspectives From the Other Side: A Physician and Cancer Survivor

ASCO has made great strides to integrate palliative care into the comprehensive care model. However, much work remains to ensure that all patients, whether receiving curative or palliative therapy, have a good quality of life.

Download Full-text

A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol

F1000Research ◽

10.12688/f1000research.7040.1 ◽

2015 ◽

Vol 4 ◽

pp. 872 ◽

Cited By ~ 4

Author(s):

Lufei Young ◽

Kathleen Healey ◽

Mary Charlton ◽

Kendra Schmid ◽

Rana Zabad ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Intervention Group ◽

Care Program ◽

Comprehensive Care ◽

Care Model ◽

Patient Centered ◽

Home Based ◽

Comprehensive Care Model

Background Disability is prevalent in individuals with multiple sclerosis (MS), leading to difficulty in care access, significant caregiver burden, immense challenges in self-care and great societal burden. Without highly coordinated, competent and accessible care, individuals living with progressive MS experience psychological distress, poor quality of life, suffer from life-threatening complications, and have frequent but avoidable healthcare utilizations. Unfortunately, current healthcare delivery models present severe limitations in providing easily accessible, patient-centered, coordinated comprehensive care to those with progressive MS. We propose a home-based comprehensive care model (MAHA) to address the unmet needs, challenges, and avoidable complications in individuals with progressive MS with disabling disease.Objective The article aims to describe the study design and methods used to implement and evaluate the proposed intervention. Method The study will use a randomized controlled design to evaluate the feasibility of providing a 24-month, home-based, patient-centered comprehensive care program to improve quality of life, reduce complications and healthcare utilizations overtime (quarterly) for 24 months. A transdisciplinary team led by a MS-Comprehensivist will carry out this project. Fifty MS patients will be randomly assigned to the intervention and usual care program using block randomization procedures. We hypothesize that patients in the intervention group will have fewer complications, higher quality of life, greater satisfaction with care, and reduced healthcare utilization. The proposed project is also expected to be financially sustainable in fee-for-service models but best suited for and gain financial success in valued-based care systems. Discussion This is the first study to examine the feasibility and effectiveness of a home-based comprehensive care management program in MS patients living with progressive disability. If successful, it will have far-reaching implications in research, education and practice in terms of providing high quality but affordable care to population living with severe complex, disabling conditions.

Download Full-text

Pain Relief as an Integral Part of the Palliative Care

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.163 ◽

2018 ◽

Vol 6 (4) ◽

pp. 739-741 ◽

Cited By ~ 3

Author(s):

Marija Sholjakova ◽

Vesna Durnev ◽

Andrijan Kartalov ◽

Biljana Kuzmanovska

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Pain Relief ◽

Pain Control ◽

Palliative Therapy ◽

The Other ◽

Spiritual Problems ◽

Active Care ◽

Different Origin

BACKGROUND: Palliative therapy represents active care for patients whose illness has such nature that is not responding to the curative treatment. The palliative care aims to provide comfort and prevention from the suffering of the patients at the end of their life. Treatment of the pain presents an important integral part of palliative care.AIM: This article aims to discuss and answer to some of the analgesic regimes and therapeutic dilemmas.RESULTS: Pain control, in addition to the other treatments such as alleviation of psychological, sociological and spiritual problems, has a priority. The proper pain management can achieve a better quality of life for the patients and their families.CONCLUSION: It can be concluded that because of the different origin of the pain, the use of analgesic therapy should be individualised and adapted to the real need of every person. Finally, only a good organisation and institutionalisation of the palliative care in one society could permit better prevention of suffering at the end of the life.

Download Full-text

Perioperative management of wounds with nanosilver dressing after neoadjuvant chemotherapy for breast cancer

Materials Express ◽

10.1166/mex.2021.1984 ◽

2021 ◽

Vol 11 (6) ◽

pp. 912-919

Author(s):

Yaqing Liu ◽

Zhaoyang Huang ◽

Sujuan Yang ◽

Cuiyun Zhou ◽

Mei Chen

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Wound Healing ◽

Perioperative Management ◽

Negative Emotions ◽

Comprehensive Care ◽

Care Model ◽

Comprehensive Care Model ◽

Postoperative Quality

Neoadjuvant chemotherapy (NAC) can improve the success rate of breast cancer surgery; however, most patients have obvious negative thoughts about NAC. Failure to effectively relieve these negative emotions or thoughts will adversely affect the quality of life of the patients after treatment. Therefore, a majority of nursing staff are committed toward reducing patients’ negative emotions through good perioperative management as well as improving the treatment effects and postoperative quality of life of patients. A good perioperative management of breast cancer should include postoperative wound and patient psychological care. This study found that patients using nanosilver dressings have greatly reduced total wound drainage, drainage tube removal time, and postoperative complications within four days after surgery and that the rate of wound healing was obviously improved. This suggests that nanosilver dressings can improve the rate of wound healing and reduce the risk of complications. At the same time, we found that postoperative negative emotions of patients receiving comprehensive care were effectively relieved and their mental flexibility was also improved. In addition, the quality of sleep, quality of life, and nursing satisfaction of patients receiving comprehensive care were significantly higher than those receiving traditional care models. This shows that the comprehensive care model is capable of reducing the negative emotions of patients during the perioperative period and also helps to improve the quality of life of patients after surgery. Therefore, this study demonstrates that the use of nanosilver dressings as a comprehensive care model can reduce the risk of negative emotions and complications in addition to improving the rate of wound healing and postoperative quality of life.

Download Full-text

Chemotherapy use and quality of life in cancer patients at the end of life: an integrative review

Health and Quality of Life Outcomes ◽

10.1186/s12955-020-01580-0 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Elham Akhlaghi ◽

Rebecca H. Lehto ◽

Mohsen Torabikhah ◽

Hamid Sharif Nia ◽

Ahmad Taheri ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

End Of Life ◽

Cancer Patients ◽

Advanced Cancer ◽

Palliative Chemotherapy ◽

Palliative Therapy ◽

Related Quality ◽

Health Related

Abstract Background When curative treatments are no longer available for cancer patients, the aim of treatment is palliative. The emphasis of palliative care is on optimizing quality of life and provided support for patients nearing end of life. However, chemotherapy is often offered as a palliative therapy for patients with advanced cancer nearing death. The purpose of this review was to evaluate the state of the science relative to use of palliative chemotherapy and maintenance of quality of life in patients with advanced cancer who were at end of life. Materials and methods Published research from January 2010 to December 2019 was reviewed using PRISMA guidelines using PubMed, Proquest, ISI web of science, Science Direct, and Scopus databases. MeSH keywords including quality of life, health related quality of life, cancer chemotherapy, drug therapy, end of life care, palliative care, palliative therapy, and palliative treatment. Findings 13 studies were evaluated based on inclusion criteria. Most of these studies identified that reduced quality of life was associated with receipt of palliative chemotherapy in patients with advanced cancer at the end of life. Conclusion Studies have primarily been conducted in European and American countries. Cultural background of patients may impact quality of life at end of life. More research is needed in developing countries including Mideastern and Asian countries.

Download Full-text

Quality of Life of Patients with Advanced Cancer in Palliative Therapy and in Palliative Care

Aquichan ◽

10.5294/aqui.2019.19.3.7 ◽

2019 ◽

Vol 19 (3) ◽

pp. 1-14

Author(s):

Leonel dos Santos Silva ◽

Bruna Eloise Lenhani ◽

Dabna Hellen Tomim ◽

Paulo Ricardo Bittencourt Guimarães ◽

Luciana Puchalski Kalinke

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Palliative Therapy ◽

Symptom Assessment ◽

Assessment System ◽

Life Questionnaire ◽

Edmonton Symptom Assessment System ◽

Quality Of Life Questionnaire ◽

Chronic Illness Therapy

Objective: To assess the quality of life of patients with advanced cancer in palliative therapy and in palliative care. Materials and Methods: Quantitative, observational, cross-sectional, and analytic study conducted in a teaching hospital in Paraná, Brazil, from January to June 2018, with 126 patients: 107 in palliative therapy; 19 in exclusive palliative care. The questionnaires for data collection were: Quality of Life Questionnaire-Core 15-Palliative, Functional Assessment of Chronic Illness Therapy-Palliative Care 14, and Edmonton Symptom Assessment System. The Spearman non-parametric coefficient test was used for the analysis. Results: The overall quality of life in palliative therapy and in palliative care was, respectively, 71.54/59.65; when correlating the total score of quality of life of the Quality of Life Questionnaire-Core 15-Palliative with the Functional Assessment of Chronic Illness Therapy-Palliative Care 14 (p = 0.001), and the Edmonton Symptom Assessment System (p = 0.001), significant difference of better quality of life was observed in the palliative therapy. Conclusion: Patients in palliative therapy have good overall quality of life, while the palliative care group reports regular quality of life. The symptoms were milder in the palliative therapy and more intense and with greater significance in palliative care; hence, knowing the compromise of quality of life will help professionals in planning interventions with transdisciplinary approach for patients and for their families.

Download Full-text

The Toll Death Takes: A Glimpse Into Home-Based Palliative Care Provision in India

Families in Society The Journal of Contemporary Social Services ◽

10.1177/1044389418808742 ◽

2018 ◽

Vol 99 (4) ◽

pp. 347-357

Author(s):

Aneka Paul

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Public Healthcare ◽

Care Provision ◽

Culturally Appropriate ◽

Care Model ◽

Home Based ◽

The World ◽

Health Related

Millions of people around the world die in pain or continue to live with serious health-related suffering. Palliative care is an approach that attempts to improve the quality of life of patients and their families, by relieving their pain holistically, across physical, psychological, social, and spiritual domains. Palliative care is practiced in a variety of ways in India, but the home-based palliative care model seems to be the most culturally appropriate and economically acceptable. This article analyzes home-based services offered across India by seven leading palliative care organizations, including elements that could be adapted into the country’s public healthcare system, thereby providing relief and solace to the countless suffering, within their very homes.

Download Full-text

The Quality of Life of Palliative Care Staff: A Personal Construct Approach

OMEGA - Journal of Death and Dying ◽

10.2190/a7y9-0f7j-tlr2-9byn ◽

1994 ◽

Vol 28 (3) ◽

pp. 201-217 ◽

Cited By ~ 6

Author(s):

Linda L. Viney ◽

Beverly M. Walker ◽

Betsy Lilley ◽

Barbara Tooth ◽

Pam Bell ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Content Analysis ◽

Social Interactions ◽

The Other ◽

Care Staff ◽

Anxiety And Depression ◽

Personal Construct ◽

Interview Schedule

Palliative care staff were compared with staff from burn and neonatal units, and with mature age general nursing trainees at the end of their training. Hypotheses, based on a personal construct model of their quality of life, sources of anxiety, and types of social interactions were tested. These tests were conducted by applying content analysis scales to their responses to an open-ended request in their interview schedule. The palliative care staff did express better quality of life, in terms of significantly less anxiety and depression, as well as more good feelings than the other staff groups. They showed, as predicted, significantly more anxiety about death, but less shame and diffuse anxiety. They also reported more helping and loving interactions but fewer influencing or vaguely defined, but shared interactions. The implications of these findings for the model and for the support of palliative care staff are considered.

Download Full-text

Patient centric integrative supportive care model at a tertiary cancer care center of India

Indian Journal of Medical Sciences ◽

10.25259/ijms_457_2020 ◽

2021 ◽

Vol 0 ◽

pp. 1-6

Author(s):

Anuradha Patel ◽

Sushma Bhatnagar ◽

Brajesh Ratre

Keyword(s):

Palliative Care ◽

Narrative Analysis ◽

Cancer Care ◽

Care Center ◽

Comprehensive Care ◽

Outpatient Services ◽

Care Model ◽

Patient’S Satisfaction ◽

Comprehensive Care Model ◽

Patient Centric

Palliative care is emerging as a recognized and needed branch all over the country. Integration of palliative care with oncology enhances patient’s quality of life, decreases suffering and depression, ensures good end of life care, better patient’s satisfaction, and decreases cost by avoiding unnecessary chemotherapy or ventilator support. The aim of this narrative analysis is to provide a truly integrated supportive model of palliative care practiced at DR BRA IRCH, AIIMS, Delhi, a tertiary cancer care center in India. It consists of inpatient and outpatient services with round the clock consultation teams. Integration of palliative care with other oncology has helped us in providing holistic and comprehensive care to the patients. We aim that this model might help in creating patient centric comprehensive care model in various other cancer centers with limited resources.

Download Full-text