scholarly journals PROGRAM OF PALLIATIVE CANCER CARE – OUR EXPERIENCE

2013 ◽  
Vol 56 (1) ◽  
pp. 29-32
Author(s):  
Iva Slánská ◽  
Jindřich Kopecký ◽  
Stanislav Filip

Introduction: Annually more than 27,000 persons die of cancer in the Czech Republic and the overall incidence of malignancies is still increasing. These data shows the need for affordable and good follow-up care especially for patients without any cancer treatment due to irreversible progression of tumor. Currently the outpatient palliative cancer care gets more into the forefront. Prerequisite for a well working outpatient palliative care is cooperation with general practitioners and home health care agencies. The purpose of the so called program of palliative cancer care is to guide a patient in palliative cancer care and to improve the cooperation among health care providers. Methods: During the period from January 2008 to October 2010 we evaluated in patient without any oncology treatment due to irreversible progression of tumor. Results: In palliative outpatient clinic we treated 446 patients, 119 of them received home care services with average length of 27.8 days. 77 patients died at home, 51 in health facilities and 41 in inpatient hospice care. Conclusion: We present pilot study focusing on outpatient palliative cancer care which shows the real benefit from early indication of palliative cancer care. This type of care allows patients to stay as long as possible at home among their close relatives.

2021 ◽  
Author(s):  
Maryam Esmaeili ◽  
Nahid Dehghan nayeri ◽  
Fatemeh Bahramnezhad ◽  
Samrand Fattah Ghazi ◽  
Parvaneh Asgari

Abstract Background: The number of patients with chronic diseases requiring invasive mechanical ventilation at home is increasing. Family caregiving for patients with home mechanical ventilation (HMV) is associated with a particularly heavy workload. Thus, identifying the challenges of this valuable type of care can be an elective step for achieving health-related goals. This study was carried out to determine the challenges faced by home health care providers.Methods: 15 participants (9 family caregivers, 3 home nurses, and 3 home care attendants) were selected. Data were collected through semi-structured interviews and structured observation. All the interviews were recorded, transcribed, and then analyzed using qualitative content analysis and Max Qualitative Data Analysis 2010.Results: Three themes emerged from the data analysis: (1) Hospital-based challenges with two subthemes the family unpreparedness for home care and the lack of continuous education, (2) Home health care agency challenges with two sub themes. Home health care workers and the deficiency in organizational policies, and (3) Economic challenges.Conclusions: Three themes of hospital-related challenges, home health care agency challenges, and economic challenges emerged in the study showed that support from the insurance system, improvement of home care agency policies, and holistic care for patients through a multidisciplinary team approach are essential for addressing the current challenges of home care for patients under invasive mechanical ventilation at home.


Author(s):  
Awad Al-Zaben ◽  
Lina M.K. Al-Ebbini ◽  
Badr Qatashah

In many situations, health care professionals need to evaluate the respiration rate (RR) for home patients. Moreover, when cases are more than health care providers’ capacity, it is important to follow up cases at home. In this paper, we present a complete system that enables healthcare providers to follow up with patients with respiratory-related diseases at home. The aim is to evaluate the use of a mobile phone’s accelerometer to capture respiration waveform from different patients using mobile phones. Whereas measurements are performed by patients themselves from home, and not by professional health care personnel, the signals captured by mobile phones are subjected to many unknowns. Therefore, the validity of the signals has to be evaluated first and before any processing. Proper signal processing algorithms can be used to prepare the captured waveform for RR computations. A validity check is considered at different stages using statistical measures and pathophysiological limitations. In this paper, a mobile application is developed to capture the accelerometer signals and send the data to a server at the health care facility. The server has a database of each patient’s signals considering patient privacy and security of information. All the validations and signal processing are performed on the server side. The patient’s condition can be followed up over a few days and an alarm system may be implemented at the server-side in case of respiration deterioration or when there is a risk of a patient’s need for hospitalization. The risk is determined based on respiration signal features extracted from the received respiration signal including RR, and Autoregressive (AR) moving average (ARMA) model parameters of the signal. Results showed that the presented method can be used at a larger scale enabling health care providers to monitor a large number of patients.


2017 ◽  
Vol 42 (1) ◽  
pp. 3-4
Author(s):  
Alex Fleming ◽  

The overall quality of life in palliative and hospice care facilities differs greatly from that in intensive care units. For example, the use of mechanical ventilation and powerful anesthetics and sedatives in the ICU can often leave otherwise informed patients incapacitated and unable to make their own health care decisions. Thus, discussions between patients and families about treatment options can be difficult, and families and surrogates are often left to do this on their own Treatments performed in the ICU are likely to be disproportionate to their needs, adding to suffering and distrust on the part of family members. To avoid this, it is important for health care providers to assess patients early and often and to discuss the proportionality of different treatments with their families and surrogates. Additionally, providers should encourage palliative and hospice care as alternatives to the many costly and likely disproportionate interventions taken in the ICU.


2018 ◽  
Vol 25 (6) ◽  
Author(s):  
W. Fingrut ◽  
L. A. Beck ◽  
D. Lo

Background Communities of practice (cops) have been shown to be effective models for achieving quality outcomes in health care.Objective Here, we describe the application of the cop model to the Canadian oncology context.Methods We established an oncology cop at our urban community hospital and its networks. Goals were to decrease barriers to access, foster collaboration, and improve knowledge of guidelines in cancer care. We hosted 6 in-person multidisciplinary meetings, focusing on screening, diagnosis, and management of common solid tumours. Health care providers affiliated with our hospital were invited to attend and to complete post-meeting surveys. Likert scales assessed whether cop goals were realized.Results Meetings attracted a mean of 57 attendees (range: 48–65 attendees), with a mean of 84% completing the surveys and consenting to the analysis. Attendees included family physicians (mean: 41%), specialist physicians (mean: 24%), nurses (mean: 10%), and allied health care providers (mean: 22%). Repeat attendance increased during the series, with 85% of attendees at the final meeting having attended 1 or more prior meetings. Across the series, most participants agreed or strongly agreed that the cop reduced barriers (mean: 76.0% ± 7.9%) and improved access to cancer care services (mean: 82.4% ± 8.1%) and subject matter experts (mean: 91.7% ± 4.2%); fostered teamwork (mean: 84.5% ± 6.8%) and a culture of collaboration (mean: 94.8% ± 4.2%); improved knowledge of cancer care services (mean: 93.3% ± 4.8%), standards of practice (mean: 92.3% ± 3.1%), and quality indicators (mean: 77.5% ± 6.3%); and improved cancer-related practice (mean: 88.8% ± 4.6%) and satisfaction in caring for cancer patients (mean: 82.9% ± 6.8%). Participant feedback carried a potential for bias.Conclusions We demonstrated the feasibility of oncology cops and found that participants perceived their value in reducing barriers to access, fostering collaboration, and improving knowledge of guidelines in cancer care.


2007 ◽  
pp. 155-170 ◽  
Author(s):  
Norm Archer

Health care is an industry with a diverse set of stakeholders: governments, private health care providers, medical practitioners (physicians, nurses, researchers, etc.), home health care providers and workers, and last but not least, clients/patients and their families. Overlapping and interacting environments include hospitals, clinics, long-term care facilities, primary care providers, homes, and so forth, involving acute, emergency, chronic, primary, and outpatient care. Patient transitions between these environments are often unnecessarily dif?cult due to an inability by providers to access pre-existing patient records. Mobile/wireless solutions can play an important role in supporting health care by providing applications that access health care records and reduce paperwork for clinical physicians, nurses, and other workers, community health care practitioners and their patients, or mobile chronically ill patients such as diabetics. This chapter makes the case for mobile health care and its solutions in the non-acute community health care environment, where critical issues include usability, adoption, interoperability, change management, risk mitigation, security and privacy, and return on investment. A proposed community health care application demonstrates how these issues are addressed.


2007 ◽  
Vol 49 (3) ◽  
pp. 327-337 ◽  
Author(s):  
Pia Markkanen ◽  
Margaret Quinn ◽  
Catherine Galligan ◽  
Stephanie Chalupka ◽  
Letitia Davis ◽  
...  

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