scholarly journals Perspectivas para os cuidados paliativos na atenção primária à saúde: estudo descritivo

2016 ◽  
Vol 15 (4) ◽  
pp. 683
Author(s):  
Cissa Azevedo ◽  
Camila Maria Pereira Rates ◽  
Juliana Dias Reis Pessalacia ◽  
Luciana Regina Ferreira Da Mata
Keyword(s):  
Palliative Care ◽  
Cardiovascular Diseases ◽  
Primary Healthcare ◽  
Medical Records ◽  
Professional Training ◽  
Health Sector ◽  
The Elderly ◽  
Karnofsky Performance Scale ◽  
Early Care ◽  
Performance Scale

Aim: To identify eligible patients for palliative care and characterize the  services  involved  in  primary  healthcare.  Method:  This  was  a  descriptive  and documental  study  conducted  in  19  health  units  in  a  municipality  in  the  countryside  of Minas  Gerais  in  Brazil.  The  Karnofsky  performance  scale  was  applied  to  the  medical records  of  patients  in  the  health  sector  with  the  largest  number  of  eligible  individuals. Results:  We  identified  2,715  eligible  individuals,  representing 3.59%  of  the  registered population  and  25.3%  of  patients  in  sector  seven,  which  had the  highest  number  of eligible  individuals.  Diabetes  was the most common  pathology,  followed  by  cancer  and cardiovascular   diseases.   Furthermore,   17.2%   of   these   individuals   have   required palliative  care  precociously;  9.7%,  required  exclusive  care,  and  the  elderly  above  60 years  constituted  the  highest  number  among  those  eligible.  Discussion:  The  data confirmed  the  need  for  structuring  the  primary  healthcare  for  early  care in  palliative care,  especially  for  the  elderly.  Conclusion:  It is  necessary to  structure  a  care  network that is integrated and ordained by PHC and professional training.

scholarly journals Identification of patients with noncancer diseases for palliative care services

2005 ◽  
Vol 3 (1) ◽  
pp. 5-14 ◽  
Author(s):  
CAROL GRBICH ◽  
IAN MADDOCKS ◽  
DEBORAH PARKER ◽  
MARGARET BROWN ◽  
EILEEN WILLIS ◽  
...  
Keyword(s):  
Palliative Care ◽  
Aged Care ◽  
Residential Aged Care ◽  
Karnofsky Performance Scale ◽  
Care Services ◽  
Aged Care Facilities ◽  
Palliative Care Services ◽  
Residential Aged Care Facilities ◽  
End Stage ◽  
Performance Scale

Objective: To identify criteria for measuring the eligibility of patients with end-stage noncancer diseases for palliative care services in Australian residential aged care facilities.Methods: No validated set if guidelines were available so five instruments were used: an adaptation of the American National Hospice Association Guidelines; a recent adaptation of the Karnofsky Performance Scale; the Modified Barthel Index; the Abbey Pain Score for assessment of people who are nonverbal and a Verbal Descriptor Scale, also for pain measurement. In addition, nutritional status and the presence of other problematic symptoms and their severity were also sought.Results: The adapted American National Hospice Association Guidelines provided an initial indicative framework and the other instruments were useful in providing confirmatory data for service eligibility and delivery.

Association of the Karnofsky Performance Scale with the quality of life of Brazilian Women Undergoing Palliative Care

2011 ◽  
Vol 27 (2) ◽  
pp. 164-169
Author(s):  
Carlos Henrique Debenedito Silva ◽  
Sirlei Siani Morais ◽  
Luis O. Sarian ◽  
Sophie F.M. Derchain
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Karnofsky Performance Scale ◽  
Performance Scale

Prevalence, incidence and associated factors of pressure ulcers in home palliative care patients: A retrospective chart review

2017 ◽  
Vol 32 (1) ◽  
pp. 299-307 ◽  
Author(s):  
Marco Artico ◽  
Angelo Dante ◽  
Daniela D’Angelo ◽  
Luciano Lamarca ◽  
Chiara Mastroianni ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Palliative Care ◽  
Pressure Ulcer ◽  
Associated Factors ◽  
Chart Review ◽  
Pressure Ulcers ◽  
Terminally Ill ◽  
Retrospective Chart Review ◽  
Karnofsky Performance Scale ◽  
Performance Scale

Background: Terminally ill patients are at high risk of pressure ulcers, which have a negative impact on quality of life. Data about pressure ulcers’ prevalence, incidence and associated factors are largely insufficient. Aim: To document the point prevalence at admission and the cumulative incidence of pressure ulcers in terminally ill patients admitted to an Italian home palliative care unit, and to analyse the patients’ and caregivers’ characteristics associated with their occurrence. Design: Retrospective chart review. Setting/participants: Patients ( n = 574) with a life expectancy ⩽6 months admitted to a palliative home care service were included in this study. Results: The prevalence and incidence rates were 13.1% and 13.0%, respectively. The logistic regression models showed body mass index ( p < 0.001), Braden score at risk ( p < 0.001), Karnofsky Performance Scale index <30 ( p < 0.001), patients’ female gender, patients’ age >70 and >1 caregiver at home as the dichotomous variables predictors of presenting with a pressure ulcer at time of admission and during home palliative care. Conclusion: The notable pressure ulcers’ incidence and prevalence rates suggest the need to include this issue among the main outcomes to pursue during home palliative care. The accuracy of body mass index, Braden Scale and Karnofsky Performance Scale in predicting the pressure ulcers risk is confirmed. Therefore, they appear as essential tools, in combination with nurses’ clinical judgment, for a structured approach to pressure ulcers prevention. Further research is needed to explore the home caregivers’ characteristics and attitudes associated with the occurrence of pressure ulcers and the relations between their strategies for pressure ulcer prevention and gender-related patient’s needs.

scholarly journals The Palliative Performance Scale predicts mortality in hospitalized patients with COVID-19

2020 ◽  
Vol 34 (9) ◽  
pp. 1228-1234 ◽  
Author(s):  
Michele Fiorentino ◽  
Sri Ram Pentakota ◽  
Anne C Mosenthal ◽  
Nina E Glass
Keyword(s):  
Palliative Care ◽  
Scale Score ◽  
Public Hospital ◽  
The Elderly ◽  
Hospitalized Patients ◽  
Risk Patients ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study ◽  
Performance Scale ◽  
Overall Mortality

Background: Coronavirus disease 2019 (COVID-19) has a substantial mortality risk with increased rates in the elderly. We hypothesized that age is not sufficient, and that frailty measured by preadmission Palliative Performance Scale would be a predictor of outcomes. Improved ability to identify high-risk patients will improve clinicians’ ability to provide appropriate palliative care, including engaging in shared decision-making about life-sustaining therapies. Aim: To evaluate whether preadmission Palliative Performance Scale predicts mortality in hospitalized patients with COVID-19. Design: Retrospective observational cohort study of patients admitted with COVID-19. Palliative Performance Scale was calculated from the chart. Using logistic regression, Palliative Performance Scale was assessed as a predictor of mortality controlling for demographics, comorbidities, palliative care measures and socioeconomic status. Setting/participants: Patients older than 18 years of age admitted with COVID-19 to a single urban public hospital in New Jersey, USA. Results: Of 443 admitted patients, we determined the Palliative Performance Scale score for 374. Overall mortality was 31% and 81% in intubated patients. In all, 36% (134) of patients had a low Palliative Performance Scale score. Compared with patients with a high score, patients with a low score were more likely to die, have do not intubate orders and be discharged to a facility. Palliative Performance Scale independently predicts mortality (odds ratio 2.89; 95% confidence interval 1.42–5.85). Conclusions: Preadmission Palliative Performance Scale independently predicts mortality in patients hospitalized with COVID-19. Improved predictors of mortality can help clinicians caring for patients with COVID-19 to discuss prognosis and provide appropriate palliative care including decisions about life-sustaining therapy.

scholarly journals The Palliative Care Screening Tool as an instrument for recommending palliative care for older adults

2019 ◽  
Vol 22 (5) ◽  
Author(s):  
Maykel Gonçalves Santa Clara ◽  
Valmin Ramos Silva ◽  
Rosana Alves ◽  
Maria Carlota de Rezende Coelho
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Medical Records ◽  
Screening Tool ◽  
Cross Sectional ◽  
Kappa Test ◽  
Religiosity And Spirituality ◽  
Excellent Tool ◽  
Performance Scale ◽  
Level Of Agreement

Abstract The objective of the present study was to evaluate the use of the Palliative Care Screening Tool (PCST) for the recommendation of palliative care among older patients admitted to an Intensive Care Unit, as well as to evaluate the prevalence of basic diseases, religion and agreement between the results of the PCST and the Palliative Performance Scale (PPS). A cross-sectional, descriptive, analytical, retrospective, documental study with a quantitative approach was performed. Analysis of 594 medical records revealed that cardiovascular diseases accounted for 26.8% of hospitalizations among older adults, followed by neoplasia 20.2% and renal failure 16.8%, and that aspects related to the religiosity and spirituality of the older adults were not considered. There was agreement of 1.0 between the PCST and PPS scales, as measured by the Kappa test, a score considered to be perfect. The PCST can therefore be considered an excellent tool for the evaluation of palliative care among older adults. It can be concluded that, in view of the significant level of agreement between the scales, new studies using the PCST with larger samples should be performed, with the aim of extending the use of the tool, and to assess if there is a need for adjustments aimed at adapting it more closely to the Brazilian population.

A new medical Internet system in healthcare: innovation of Telegeriatrics and healthcare demands of older patients of different age groups (Preprint)

2020 ◽  
Author(s):  
Yu Gong ◽  
Jianyuan Zhou
Keyword(s):  
Cardiovascular Diseases ◽  
General Practitioners ◽  
Older Patients ◽  
Metabolic Diseases ◽  
Treatment Plan ◽  
Age Groups ◽  
The Elderly ◽  
Diagnosis And Treatment ◽  
World Health ◽  
New Model

BACKGROUND Healthcare for older patients is a worldwide challenge for public health system. A new medical Internet system in healthcare which is a new model of telegeriatrics system has been established. The key innovation is the new telegeriatrics system was conducted jointly by general practitioners in the Community Health Service Center and specialists in university teaching hospital. Unlike the typical telemedicine that has been practiced in other countries, the new model provides a solution for the key issues in telemedicine where a doctor is unable to conduct a direct physical examination and the associated potential diagnostic error. OBJECTIVE This study is to introduce the operation mechanism of the new Telegeriatrics system and analyze healthcare demands of older patients in different age groups applying the new Telegeriatrics system. METHODS 472 older patients (aged≥60) were enrolled and divided into the young older group (aged 60 to 74), the old older group (aged 75 to 89) and the very old group (aged≥90) according to the age stratification of World Health Organization. Proportion of the top 10 diseases of older patients of different age groups was analyzed. RESULTS The process of older patients’ diagnosis and treatment made by specialist and general practitioners formed a closed loop. It ensures the timeliness and effectiveness of diagnosis and treatment of older patients. The treatment effect can be observed by general practitioners and specialist can adjust the treatment plan in time. In this study, it was found that older patients in different age groups have different healthcare demands. Coronary heart disease and type 2 diabetes mellitus were found to be the main diseases of the older patients and the young older patients as well as the old older patients applying Telegeriatrics. CONCLUSIONS The new telegeriatrics system can provide convenient and efficient healthcare services for older patients and overcome the disadvantage of currently used models of telegeriatrics. Older patients in different age groups have different medical care demands. Cardiovascular diseases and metabolic diseases have become the main diseases of the elderly applying the new Telegeriatrics system. Healthcare policy makers should invest more medical resources to the prevention of cardiovascular diseases and metabolic diseases in the elderly.

Stages for implementing the “Moscow Longevity” program

2020 ◽  
Vol 22 (4) ◽  
pp. 65-72
Author(s):  
MARINA V. KORNILOVA ◽  
Keyword(s):  
Professional Training ◽  
Senior Citizens ◽  
The Elderly ◽  
Foreign Languages ◽  
Primary Sources ◽  
Sociological Research ◽  
Active Lifestyle ◽  
Welfare Institutions ◽  
Cultural Sites ◽  
New Period

The article examines the work of the “Moscow Longevity” state project/program. The analysis is carried through on the assessments given by the elderly residents of Moscow, as well as specialists from social welfare institutions responsible for the implementation of the program. The program is newly established and has been working in Moscow for over two years. The author names 4 stages for the implementation of the program: preparatory, trial, main, and “special” stages. This staging is based on the existing legal acts regulating the implementation of the project, as well as on the analysis of sociological research. The primary sources of data are: interviews conducted by the author with elderly residents of Moscow regarding the “Moscow Longevity” program (April-May 2020); surveys and focus groups conducted by the author during her work at the Moscow Institute of Additional Professional Training of Social Workers (2016-2017). The article examines statistics and publications in the mass media concerning the success of the “Moscow Longevity” project. Elderly Muscovites and employees of social organizations highly appreciated the ongoing activities, noting their relevance and timeliness, both for involving senior citizens in an active lifestyle and for adapting the elderly to a new period of life “for themselves”. Participants of the program take computer courses, study foreign languages, attend dance lessons, go to sports classes, develop artistic and aesthetic skills, master tourism, and visit cultural sites in Moscow. However, the program also has significant drawbacks, eliminating which requires significant material and technical resources as well as personnel work. Each year the participants voiced the same problems associated with the poor condition of the premises and the lack of an individual approach to activities’ organization. The “special” stage related to the situation with the coronavirus pandemic revealed a lack of computer skills among the program participants (despite the conducted computer classes) and inability to quickly adapt to new conditions.

scholarly journals The effects of teaching methods of palliative care on life pattern of old women with chronic pain

2019 ◽  
Vol 29 (4) ◽  
Author(s):  
Elham Hesari ◽  
Zahra Sabzi ◽  
Shohreh Kolagari
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Teaching Methods ◽  
Social Life ◽  
Educational Program ◽  
Elderly Women ◽  
Intervention Group ◽  
The Elderly ◽  
Old People ◽  
Life Pattern

Chronic pain is among problems of old people and causes changes in their life pattern and processes. Teaching palliative care can help old people suffering from chronic pain to live an active life. The aim of this research was to determine effects of educating of palliative care on life pattern of elderly women with chronic pain. The present study was a Quasi-experimental design with pre-test and post test was conducted on 30 elderly women suffering from chronic pain in 2018 in Iran. The Questionnaire for evaluating the Pattern of Life with Pain in the elderly was filled before the intervention, group educating of palliative care was carried out using an educational package, and the questionnaire was completed again immediately and one and three months after. The data was analyzed using mean, standard deviations, Fisher’s F test, and Greenhouse-Geisser and Bonferroni post-hoc test by employing SPSS- 16. Mean changes before teaching palliative care significantly differed from those of immediately and one and three months after the educational program (p = 0.0), (p = 0.004). There were significant differences between the stages of immediately and one month after the educational program and that of three months after it (p = 0.001), (p = 0.002). Concerning the personal life patterns, there were statistically significant differences between the stage immediately after the educational program and those before the intervention and three months after it (p = 0.005), (p = 0.000). Regarding the social life pattern, only the stage of one month after the educational program significantly differed from that of three months (p = 0.005). Mean growth in life pattern of the old women suffering from chronic pain in the stages after the intervention indicated the importance of and the necessity for palliative care during old age. Moreover, the success of this education three months after the educational program as compared to immediately and one month after it indicates that allocation of sufficient time plays a very important role in transferring information and in teaching methods of palliative care to old people.

scholarly journals Orthostatic Hypotension and Falls in Hospitalized Older Adults

2021 ◽  
pp. 105477382098668
Author(s):  
Kathleen Schell ◽  
Denise Lyons ◽  
Barry Bodt
Keyword(s):  
Older Adults ◽  
Orthostatic Hypotension ◽  
Electronic Medical Records ◽  
Fall Prevention ◽  
Medical Records ◽  
The Elderly ◽  
Chi Square ◽  
Convenience Sample ◽  
Chi Square Test ◽  
Hospitalized Older Adults

The aim of this retrospective study was to determine the prevalence of orthostatic hypotension (OH) among a convenience sample of older adults on two Acute Care of the Elderly (ACE) units of the ChristianaCare™ in Delaware. Another aim was to determine if subjects with documented OH experienced falls. Retrospective de-identified data was obtained from electronic medical records for the years 2015 to 2018. Among all patients who had valid first orthostatic vital sign (OVS) readings ( n = 7,745), 39.2% had orthostatic hypotension on the first reading. Among the patients, 42.8% were found to be hypotensive during OVS. Thirty-one (0.9%) of those with OH fell at some point during their stay. The odds ratio for falls in the presence of OH was 1.34 with a 95% confidence interval (0.82, 2.21), but a chi-square test failed to find significance ( p = .2494). The results could not determine if OVS should be mandatory in fall prevention protocols.

Palliative Care in the Elderly Breast Cancer Patient

2009 ◽  
Vol 21 (2) ◽  
pp. 131-139 ◽  
Author(s):  
B.J.A. Laird ◽  
M.T. Fallon
Keyword(s):  
Breast Cancer ◽  
Palliative Care ◽  
Cancer Patient ◽  
Breast Cancer Patient ◽  
The Elderly
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