scholarly journals Evidence-Based Practice: Community-Based Palliative Cancer Care

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Jajang Ganjar Waluya ◽  
Nur Maziyya ◽  
Eva Nurlaela ◽  
Ita Vusfita ◽  
Ihda Al Adawiyah Mz ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Evidence Based Practice ◽  
Care Service ◽  
Palliative Care Service ◽  
The United States ◽  
Evidence Based ◽  
Community Based ◽  
Middle East Countries

Prevalence of  cancer is estimated will increase in the next two decades. Therefore, there is a challenge for health provider to encounter treatment and caring for the patients. Especially, the cancer patients face several problems not only physical but also psychological, emotional, spiritual and social cultural aspects.This study explored the evidence-based practice on community-based palliative cancer care. Literature study is done by making a summary of published articles related to the question. The searching method used several electronic databases such as Google Scholar, Proquest, and PubMed. Articles under the keywords of “Palliative Cancer Care”, “Community”, and “Nursing” reach as much as 1.804. The inclusion criteria for this literature review were articles that have been peer-reviewed, are in full-text, in either English or Indonesian, and publication year from 2008 to 2018. Meanwhile, the exclusion criteria include those that do not follow a standardized structure of an article (consisting of Abstract, Introduction, Method, Result, Discussion, Implication, and Reference), are in the form of a review, and whose content does not answer research questions.Results: The United States of America is on the highest place regarding palliative care service, following by community-based palliative cancer implementation in Europe. Asian countries had been applying palliative care service, integrated with national health care system. In the Middle East countries, palliative care program ranks the lowest, but in implementation, they have discreetly performed community-based palliative care. In Africa, it is not the main focus in the field of health. Palliative care for cancer patients that is potential for development in Indonesia is that of family-based.Conclusion: Community-based palliative care is a variant of palliative treatment long applied and being developed in many countries in the world. In continents such as America and Europe, the implementation of palliative care ranks the highest place. In Indonesia, it is done partially and only available in hospitals or non-governmental organization. In the level of community, family-based palliative care can be developed by involving trained family members.

Effect of Music on Pain in Cancer Patients in Palliative Care Service: A Randomized Controlled Study

2021 ◽  
pp. 003022282110598
Author(s):  
Gönül Düzgün ◽  
Ayfer Karadakovan
Keyword(s):  
Palliative Care ◽  
Music Therapy ◽  
Cancer Patients ◽  
Functional Capacity ◽  
Classical Music ◽  
Care Service ◽  
Palliative Care Service ◽  
Palliative Care Unit ◽  
Pain Anxiety ◽  
Randomized Controlled

This study aimed to investigate the effect of music on pain, anxiety, comfort, and functional capacity of cancer patients who received care in a palliative care unit. The population of this randomized controlled trial consisted of cancer patients hospitalized in the palliative care service between July 2018 and July 2019. The study included 60 patients (30 interventions/30 controls). The patients in the intervention group were given a total of six music sessions, 10 minutes each with the Turkish classical music in maqams of their choice (Hejaz or Rast accompanied by an expert tambour (drum) player). There was a significant difference between the mean total pain scores, anxiety, comfort, and functional capacity scores of the patients in the intervention and control groups before and after music therapy. Music therapy decreased the level of pain. It is demonstrated that Turkish classical music therapy improved the pain, anxiety, comfort, and functional capacity in the palliative care unit.

A comparison of liver cancer and lung cancer patients at two Veteran Affairs Medical Centers.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21642-e21642
Author(s):  
Sejal Kothadia ◽  
Zhen Wang ◽  
Sarah Lee ◽  
Victor Tsu-Shih Chang ◽  
Yucai Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
Liver Cancer ◽  
Cancer Patients ◽  
Care Service ◽  
Palliative Care Service ◽  
Pooled Analysis ◽  
Lung Cancer Patients ◽  
Medical Centers ◽  
Symptom Prevalence

e21642 Background: Little is known about palliative care for liver cancer. In this study, we examined palliative care for liver cancer and lung cancer patients. Methods: In an IRB approved protocol, we reviewed medical records of patients diagnosed with liver cancer who were seen by the palliative care service between 2006 and 2012 at 2 VA medical centers, and matched them to patients with lung cancer by year, KPS, and stage. Veterans were compared by symptom prevalence with the CMSAS and by palliative care interventions. Statistical analyses were performed with SAS Studio Version 3.5. Results: We analyzed a total of 138 male patients at 2 VA centers; 69 with lung cancer and 69 with liver cancer. The mean age in both groups was 65 years and 60% of patients self-identified as a minority. There was a high prevalence of symptoms in both groups. Symptom prevalence differed significantly between liver and lung cancer pts for weight loss and dyspnea at one site, and for feeling drowsy, constipation, at the other site. These differences disappeared in a pooled analysis. During palliative care evaluation, more lung cancer patients received treatment for constipation (n = 44 in lung, 29 in liver, p = 0.0107) and dyspnea treatment (n = 37 in lung, 22 in liver, p = 0.0167). More patients with lung cancer were evaluated by physical therapy (n = 41 in lung, n = 28 in liver, p = 0.0276) and psychiatry (n = 31 in lung, n = 20 in liver, p = 0.032). Conclusions: Differences between lung and liver cancer patients’ symptom prevalence and treatment by palliative care can vary by site. This reinforces the importance of local surveys of symptom prevalence . Further studies should be replicated in other sites.

The outcome of outpatient palliative care service at Yonsei Cancer Center, a tertiary cancer center in Korea.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 131-131
Author(s):  
Si Won Lee ◽  
Hye Jin Choi
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Group Performance ◽  
Care Service ◽  
Symptom Control ◽  
Palliative Care Service ◽  
Cancer Center ◽  
Anticancer Treatment ◽  
Tertiary Cancer Center

131 Background: The importance of palliative care in cancer patients continues to be emphasized and studies are proving its importance. Several studies proved the improvement of quality of life in advanced cancer patients. The efficacy of symptom control based on outpatient palliative care service has not yet been reported in Korea. The objective of this study is to review the outcome of outpatient palliative care service at Yonsei Cancer Center, a tertiary cancer center in Korea. Methods: We retrospectively reviewed 155 cancer patients who used outpatient clinic at Yonsei Cancer Center in Korea between April 2014 and December 2014. Symptom severity was measured by modified Korean version of Edmonton Symptom Assessment System. Twelve symptoms were assessed: pain, fatigue, nausea, depression, anxiety, drowsiness, dyspnea, sleep disorder, anorexia, constipation, wellbeing, financial distress. Higher score means worse symptom. ESAS scores at baseline and follow-up assessments were analyzed. Results: The 155 patients had following characteristics: female 52.3%, median age 65 years (range 58-75), Hepatobiliary-pancreatic cancer and lung cancer patients accounted for the largest portion (n = 37, 23.9%; n = 36, 23.2% respectively). Most patients were Eastern Cooperative Oncology Group performance status 1 (n = 28, 18.1%) or 2 (n = 24, 15.5%). Ninety-two (59.4%) patients were referred to the palliative care team after anti-cancer treatments were all finished. Overall the symptoms did not change significantly from baseline to 2 consecutive follow up assessment except anorexia ( p value = 0.0195). Patients who were on active anticancer treatment had tendency of higher ESAS score than those finished with the anticancer treatment. However, all symptoms except nausea were not statistically significant. Conclusions: Most patients in this study did not have severe symptom scores that would show the differences of the symptom changes. Nevertheless, although not statistically significant, we found that patients on active anticancer treatment had higher symptom burden than those who were finished with the anticancer treatment. More meticulous symptom management is necessary to improve the symptom control.

131 Preferred place of care in thoracic cancer patients within the palliative care service covering South Ribble, Preston and Chorley

Lung Cancer ◽  
2014 ◽  
Vol 83 ◽  
pp. S47-S48
Author(s):  
R. Knight ◽  
A.G. Sutherland ◽  
E. Shereston ◽  
A. Parr ◽  
L. Forman ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Care Service ◽  
Palliative Care Service ◽  
Thoracic Cancer

Are patients with advanced colon cancer availing of palliative care services?: Findings from a high-volume urban center.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23101-e23101
Author(s):  
Daniel S Jamorabo ◽  
Benjamin D Renelus ◽  
Pragnan Kancharla ◽  
William M Briggs
Keyword(s):  
Colon Cancer ◽  
Palliative Care ◽  
Cancer Patients ◽  
Care Service ◽  
Palliative Care Service ◽  
High Volume ◽  
Inpatient Setting ◽  
Cancer Stage ◽  
Advanced Colon Cancer ◽  
Significant Difference

e23101 Background: Palliative care is integral to cancer treatment. Our goal was to investigate the factors associated with palliative care service involvement for hospitalized colon cancer patients. Methods: We carried out a retrospective study of all colon cancer patients diagnosed and hospitalized at our institution from 1/1/2010 through 12/31/2017. We identified 667 patients, including 370 women (55%). We used Fisher’s exact test to find statistically significant differences in proportions of patients seen by the palliative care service based on sex, race, cancer stage, surgical intervention, and chemotherapy administration. Results: We found that 561/667 (84%) colon cancer patients were not evaluated by the palliative care service (including 301 women; 54%) and that overall they were unlikely to have been evaluated regardless of sex, race, cancer stage, or chemotherapy (Table). Patients who underwent surgery were equally likely to be seen by the team as those who did not have surgery. We found that 53% (150/285) of patients with Stage III and IV disease received neither chemotherapy nor palliative care evaluation. Conclusions: The palliative care service is underutilized at our facility even when patients with advanced stage disease are hospitalized. Even when patients are not on chemotherapy, the palliative care service remains uninvolved. This may be due to inadequate staffing, misconceptions that providers and patients have about palliative care, or lack of coordination between inpatient and outpatient providers. We did not find that palliative care service utilization led to a statistically significant difference in survival, but their involvement is critical to helping address patients’ goals of care and symptoms. It is also instrumental to improving cancer patients’ quality of life both in the outpatient and inpatient setting, regardless of cancer stage or survival, as in our patient population. More effort is needed to include the palliative care service in the care of patients with advanced colon cancer. [Table: see text]

scholarly journals Documentation of Assessment of Spiritual Concerns of Adult Advanced Cancer Patients: An Audit in a Hospital-based Specialist Palliative Care Service

2021 ◽  
Vol 0 ◽  
pp. 1-8
Author(s):  
Jayita Deodhar ◽  
Naveen Salins ◽  
Mary Ann Muckaden
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Care Service ◽  
Palliative Care Service ◽  
Practice Change ◽  
Care Staff ◽  
Specialist Palliative Care ◽  
Patient Assessment ◽  
Advanced Cancer Patients

Objectives: Spirituality is a significant dimension of quality palliative care service provision. The purpose of our audit was to assess current practice and improve documentation of spiritual concerns of adult advanced cancer patients in a specialist palliative care (SPC) service in a tertiary care cancer centre. Materials and Methods: In a standard-based audit, we measured the percentage of patient assessment forms with documentation of assessed spiritual concerns at a baseline and reaudit after practice change measures. We set the optimum standard that at least 60% of the case forms would have patients’ spiritual concerns recorded. We implemented the following measures – (1) engaging our palliative care staff in team discussions on existing practice and identifying problems and (2) conducting a structured 2 h training module for assessment and documentation of patients’ spiritual concerns. Results: About 70.8% and 93.4% of the patient assessment forms included had documentation of assessed spiritual concerns which is higher than the standard we set at 60% and 90% at baseline and after implementing practice change, respectively. In the reaudit, we found that documentation specific to spirituality and overall psychological assessment improved. We identified that a persisting problem was the lack of recording of spiritual assessment in the patients’ follow-up notes. Conclusion: We achieved the benchmark of a standard-based audit on documentation of assessed spiritual concerns of advanced cancer patients in our SPC service. Regular audits in clinical service delivery and documentation should be integrated into quality improvement measures in palliative care.

Economic and clinical outcomes of the nurse practitioner-led Sydney Adventist Hospital Community Palliative Care Service

2020 ◽  
Vol 44 (5) ◽  
pp. 791
Author(s):  
Sam G. Moreton ◽  
Emily Saurman ◽  
Glenn Salkeld ◽  
Julie Edwards ◽  
Dawn Hooper ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nurse Practitioner ◽  
Hospital Admissions ◽  
Care Service ◽  
Palliative Care Service ◽  
Hospitalisation Cost ◽  
Community Based ◽  
Care Services ◽  
Palliative Care Services ◽  
At Home

ObjectiveThe aim of this study was to assess the clinical, economic and personal impacts of the nurse practitioner-led Sydney Adventist Hospital Community Palliative Care Service (SanCPCS) MethodsParallel economic analysis of usual care was conducted prospectively with patients from the enhanced SanCPCS. A convenient retrospective sample from the initial service was used to determine the impact of the enhanced service on patient care. A time series survey was used with patients and carers from within the expanded service group in order to measure patient outcomes and values as they approached death. ResultsPatients of the SanCPCS were less likely to die in hospital and had fewer hospital admissions. In addition, the service halved the estimated hospitalisation cost per patient, but the length of hospital stay was not affected by the service. The SanCPCS was more beneficial for women in terms of fewer hospital admissions and lower costs. Patients’ choices regarding place of care and death and what was ‘important’ to them changed over time. For instance, patients tended to prefer being at home as they approached death, and being pain free doubled in importance. ConclusionsNurse practitioner-led community palliative care services have the potential to result in significant economic and personal benefits for patients and their families in need of such care. What is known about the topic?National trends show an emphasis on community services with the aim of promoting and supporting the choice of dying at home, and this coincides with drives to reduce hospital costs and length of stay. Community-based palliative care services may offer substantial economic and clinical benefits. What does this paper add?The SanCPCS was the first nurse practitioner-led community-based palliative care service in Australia. The expansion of this service led to significantly fewer admissions and deaths in hospital, and halved the estimated hospitalisation cost per patient. What are implications for practitioners?Nurse practitioner-led models for care in the out-patient or community setting are a logical direction for palliative services through the engagement of specialised providers uniquely trained to support, nurture, guide and educate patients and their carers.

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