scholarly journals The True Intention of Rescue Squads in Terms of the CPA Transportation of Cancer Patients in the Terminal Phase of the Disease Who Make a DNAR Order

2019 ◽  
Vol 14 (2) ◽  
pp. 67-72
Author(s):  
Masayo Miyabayashi ◽  
Chikako Nakamura
Keyword(s):  
Cancer Patients ◽  
Terminal Phase ◽  
True Intention

scholarly journals Hope in Hospitalized Patients with Terminal Cancer

2019 ◽  
Vol 16 (20) ◽  
pp. 3867 ◽  
Author(s):  
Bożena Baczewska ◽  
Bogusław Block ◽  
Beata Kropornicka ◽  
Antoni Niedzielski ◽  
Maria Malm ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Terminally Ill ◽  
Hospitalized Patients ◽  
Research Tool ◽  
Terminal Phase ◽  
Terminal Cancer ◽  
Professional Goals ◽  
Internal Structures ◽  
Different Types ◽  
Life Threatening

: Hope is of great importance for patients diagnosed with cancer, especially those that are terminally ill. The diagnosis often puts an end to the realization of personal, social, and professional goals. The aim of this study was to characterize the hope of hospitalized patients diagnosed with cancer in the terminal phase of the disease. The research tool used in the study was Block’s hope test (NCN-36; NCN- Nadzieja Chorych Nowotworowych - Hope of Cancer Patients), designed for patients with life-threatening diseases. The results showed that the patients were characterized by a moderate level of global hope. The highest levels of hope were noted in the spiritual-religious area and the lowest levels of hope concerned curing the disease. Patients exhibited varied levels of hope and varied internal structures of hope. They presented four different types of hope: optimistic, moderate, religious, and weak. Optimistic hope was found most frequently in patients diagnosed with a terminal phase of cancer, while weak hope was represented by the smallest group of these patients.

Survival prediction in terminally ill cancer patients: Description and validation of a new predictive score

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9595-9595
Author(s):  
A. M. Jimenez Gordo ◽  
J. Feliu ◽  
J. Dominguez ◽  
R. Molina ◽  
J. C. Camara ◽  
...  
Keyword(s):  
Predictive Model ◽  
Cancer Patients ◽  
Median Survival ◽  
Terminally Ill ◽  
Predictive Score ◽  
Terminal Phase ◽  
Survival Prediction ◽  
Validation Group ◽  
Survival Times ◽  
Terminally Ill Cancer Patients

9595 Background: Determining an accurate prognosis for terminally ill cancer patients is one of the biggest challenges that confronts a physician. Correct predictions can be done in only 20–40% of all cases. Although the current prognostic scales are helpful, they have significant limitations. Our objective consists of determining the potential indicators that influence the survival of these patients and develop and validate a new predictive model. Methods: A prospective, multicentric and observational study was conducted in 880 terminally ill cancer patients. At first, 40 clinical, demographic and laboratory variables were recorded in 406 patients. A forward stepwise regression method was applied for the multivariate survival analysis. Hence, a predictive model was constructed. Subsequent validation was performed in 474 patients. Results: Median age was 66.4 years (range 18–95). The median overall survival was 21 days in the first 406 patients studied and 19 days in the validation group. A prognostic model with 9 variables was constructed (age, ECOG, the amount of time between initial diagnosis up to being considered terminal phase, nauseas, anorexia, cognitive impairment, lymphocytes, LDH and albumin). Afterwards, to simplify the model, 4 variables that were considered more objective and with greater Odds ratio were selected and assigned one point per each prognostically poor category. We obtained a survival model that discriminates 3 prognostic categories: Good prognoses (score 0) with a median survival of 95 days (44–146), intermediate prognoses (score 1–2) with a median survival of 33 days (26.8–39.2) and bad prognoses (score 3–4) with a median survival of 15 days (11.1–18.9). In the validation group, median survival times were 60 (47.1–72.8), 27 (22.8–31.1) and 11 days (9.2–12.7) respectively. Conclusions: We propose a predictive score model that is objective and easy to use to help in accurately predicting life expectancy in terminally ill cancer patients. Its effectiveness has been validated in a group of independent centers. No significant financial relationships to disclose.

How to better help cancer patients face their coming death?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21505-e21505 ◽  
Author(s):  
Francois-Xavier Goudot ◽  
Milena Maglio ◽  
Sandrine Bretonniere
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Disease Duration ◽  
Hospice Care ◽  
Good Practice ◽  
Terminal Phase ◽  
Palliative Care Teams ◽  
Short Disease Duration ◽  
Impending Death ◽  
The Mean

e21505 Background: According to literature and medical experience, the doctor-patient relationship becomes strained when oncologists tell their patients that they have no more curative treatments to offer them. Patients often resist when they are told that it is in their best interest to meet with the palliative teams. Little is known about how to meet patients’ expectations at this advanced stage. Methods: We conducted a multicenter qualitative research in an oncology department, a hospital at home service and in an inpatient hospice care center. We met 47 patients (M = 21, F = 27, mean age = 65 yrs, mean disease duration = 5 yrs) for in-depth face to face interviews performed by a multi-disciplinary ethics team. Interviews were carried out between 1 and 3 months before death. Results: Qualitative analysis revealed 4 main results. 1/ For respondents, palliative care introduction meant impending death. 2/ Palliative care introduction meant loss of hope. Without hope, the cancer trajectory is impossible to sustain, they said. 3/ Hope was intricately interwoven with the request for more chemotherapy, even if doctors had clearly refused to provide it. 4/ The oncologist remained the referent physician, even for patients in hospice care. Patients for which the mean duration between cancer diagnosis and interview was 5 years or more, were more willing to talk about death and better accepted palliative care than patients for which the mean duration of cancer was inferior to 3 yrs. For patients with fast progressing cancer (n = 11), 10 were not willing to talk about death and 7 strongly resisted palliative care introduction. There was no difference between patients according to age, sex, type of cancer or center of inclusion. Conclusions: In the terminal phase of cancer, patients are unwilling to talk about death and are reluctant to meet with palliative care teams. Short disease duration strongly reinforces this attitude. If patients resist discussions about their impending death, should physicians continue to consider it good practice to introduce such discussions? Is it beneficent for patients?

Depression in patients with advanced illness: An examination of Ontario complex continuing care using the Minimum Data Set 2.0

2005 ◽  
Vol 3 (2) ◽  
pp. 99-105 ◽  
Author(s):  
ANDREA GRUNEIR ◽  
TREVOR FRISE SMITH ◽  
JOHN HIRDES ◽  
ROY CAMERON
Keyword(s):  
Cancer Patients ◽  
Rating Scale ◽  
Well Being ◽  
Terminal Phase ◽  
Continuing Care ◽  
Advanced Illness ◽  
Data Set ◽  
Patients With Cancer ◽  
Prevalence Of Depression ◽  
Definition Of

Objective: In this study, we examined the prevalence of depression, its recognition, and its treatment in continuing care patients with advanced illness (AI).Methods: All data were obtained from the Ontario (Canada) provincially-mandated MDS 2.0 form for chronic care. Of 3,801 patients, 524 met our empiric definition of AI, which was predicated on a previously validated algorithm. The MDS-embedded Depression Rating Scale (DRS) was used to measure psychological well-being and a score of 3 or greater indicated potential depression.Results: Twenty-nine percent of patients with AI scored greater than 3, making them nearly twice as likely to be potentially depressed as other patients (OR 1.8, 95% CI 1.5–2.2). Despite this patients with AI were less likely to have received antidepressants (28.9% vs. 38.2%), even among those with a diagnosis (45.3% vs. 58.4%). Using logistic regression, correlates of potential depression were identified and surprisingly patients with cancer were substantially less likely to be depressed (AOR 0.37, 95% CI 0.2–0.6). Further investigation revealed that cancer patients were more likely to be treated for depression and to be recognized as being within the terminal phase of illness.Significance of results: These findings suggest that a high proportion of terminally ill patients had unmet needs for psychological support. As well, they suggest that cancer patients received better targeted end-of-life care, which resulted in an overall decrease in psychological distress when compared to other patients with similarly advanced illness.

The Impact of Hospice Care on Families

1984 ◽  
Vol 13 (2) ◽  
pp. 153-165 ◽  
Author(s):  
Michael A. Godkin ◽  
Melvin J. Krant ◽  
Nancy J. Doster
Keyword(s):  
Cancer Patients ◽  
Late Stage ◽  
Hospice Care ◽  
Well Being ◽  
Terminal Phase ◽  
Large Problem ◽  
Loved One ◽  
Late Stage Cancer ◽  
The Impact ◽  
Practical Sense

The impact of a hospital-based Hospice service for late-stage cancer patients, on the families of fifty-eight bereaved spouses was studied, retrospectively. Hospice care in general was rated significantly higher when compared to the prior care ( p < .001) received by patients and families. Hospice care contributed to improved family functioning and well-being, with the vast majority of spouses reporting feelings of increased support, improved coping by all family members and increased closeness, when compared to prior care. Consequently, over three-quarters of the families reported being emotionally prepared, and prepared in a practical sense, for the death of their loved one. Families appear to be coping reasonably well during bereavement especially those who reported feeling emotionally prepared for the death. Health problems were reported as a large problem in 15 percent of the respondents, which compares favorably to previously documented research on bereavement and illness. These findings indicate that a Hospice mode of care, with its support of families during terminal and bereavement stages, impacts significantly on families' abilities to cope with the terminal phase and adapt afterwards.

scholarly journals Hope in Advanced Cancer Patients in the Terminal Phase of Neoplastic Disease and Stability of Basic Mood

2020 ◽  
Vol 9 (11) ◽  
pp. 3550
Author(s):  
Bożena Baczewska ◽  
Bogusław Block ◽  
Beata Kropornicka ◽  
Maria Malm ◽  
Dagmara Musiał ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Diagnostic Tools ◽  
Terminal Phase ◽  
Neoplastic Disease ◽  
Advanced Cancer Patients ◽  
Temporal Dimension ◽  
Spiritual Dimension ◽  
Life Threatening ◽  
The Stability

The aim of this research is to compare the hope experienced by advanced cancer patients in the terminal phase of neoplastic disease in relation to the stability of their basic mood. The study group consisted of 246 patients, average age 59.5. The youngest respondent was 18 and the oldest was 90. The diagnostic tools used in the work comprised the Personal Card designed by T. Witkowski (PC) and an NCN-36 test (Block’s Hope test), designed by B.L. Block to measure the strength of hope in people struggling with serious life-threatening diseases. The test consists of 4 subscales distinguished by factor analysis. Each subscale consists of 8 items. The test allows an evaluation of hope in the following dimensions: situational dimension (health, thelic-temporal dimension), goals to be achieved in the future, spiritual dimension (spirituality), religious beliefs, and emotional-motivational (affective) dimension (motivations). In cheerful patients who are in the terminal phase of cancer, mood stability does not constitute a major differentiating factor for experiencing hope. In sad people, on the other hand, mood stability affects the intensity of hope—those with an unstable mood are more likely to have a stronger emotional-motivational dimension of hope than sad people with a balanced mood.

“Achieve the best while rushing against time”: A grounded theory study on caring for low-income immigrant cancer patients at end of life

2020 ◽  
pp. 026921632097427
Author(s):  
Simona Sacchi ◽  
Roberto Capone ◽  
Francesca Ferrari ◽  
Federica Sforacchi ◽  
Silvia Di Leo ◽  
...  
Keyword(s):  
Grounded Theory ◽  
End Of Life ◽  
Cancer Patients ◽  
Low Income ◽  
Cultural Barriers ◽  
Constructivist Grounded Theory ◽  
Terminal Phase ◽  
Grounded Theory Study ◽  
Core Category ◽  
Clinical Conditions

Background: Between 2000 and 2020, Europe experienced an annual net arrival of approximately 1.6 million immigrants per year. While having lower mortality rates, in the setting of severe diseases, immigrants bear a greater cancer-related burden due to linguistic and cultural barriers and socio-economic conditions. Professionals face a two-fold task: managing clinical conditions while considering the social, economic, cultural, and spiritual sphere of patients and their families. In this regard, little is known about the care provision to low-income immigrant cancer patients in real contexts. Aim: To investigate the perspective of professionals, family members, and stakeholders on the caring process of low-income immigrant cancer patients at the end of life. Design: A Constructivist Grounded Theory study. Setting/participants: The study, conducted at a Hospital in Northern Italy, involved 27 participants among health professionals, family caregivers, and other stakeholders who had recently accompanied immigrant cancer patients in their terminal phase of illness. Results: Findings evidenced that professionals feel they were not adequately trained to cope with immigrant cancer patients, nonetheless, they were highly committed in providing the best care they could, rushing against the (short) time the patients have left. Analyses evidenced four main categories: “providing and receiving hospitality,” “understanding each other,” “addressing diversity,” and “around the patient,” which we conceptualized under the core category “Achieve the best while rushing against time.” Conclusions: The model reveals the activation of empathic and compassionate behavior by professionals. It evidences the need for empowering professionals with cultural competencies by employing interpreters and specific training programs.

Defining Cancer Patients As Being in the Terminal Phase: Who Receives a Formal Diagnosis, and What Are the Effects?

2005 ◽  
Vol 23 (30) ◽  
pp. 7411-7416 ◽  
Author(s):  
B. Aabom ◽  
J. Kragstrup ◽  
H. Vondeling ◽  
L.S. Bakketeig ◽  
H. Stovring
Keyword(s):  
Cancer Patients ◽  
Hospital Admissions ◽  
Admission Rate ◽  
The Elderly ◽  
Economic Benefits ◽  
Terminal Phase ◽  
Hospital Death ◽  
Related Factors ◽  
Hematologic Cancer ◽  
Terminal Diagnosis

Purpose Physicians either do not define cancer patients as being terminal, or their prognostic estimates tend to be optimistic. This might affect patients' appropriate and timely referral to specialist palliative care services or can lead to unintended acute hospitalization. Patients and Methods We used the Danish Cancer Register and four administrative registers to perform a retrospective cohort study in 3,445 patients who died as a result of cancer. We used the Danish “terminal declaration” issued by a physician as a proxy for a formal terminal diagnosis (prognosis of death within 6 months). The terminal declaration gives right to economic benefits and increased care for the dying. We investigated patient-related factors of receiving an explicit terminal diagnosis by logistic regression and then analyzed the effects of such a diagnosis on admission rate per week and place of death. Results Thirty-four percent of patients received a formal terminal diagnosis. Age of ≥ 70 years (odds ratio [OR], 0.44; 95% CI, 0.34 to 0.56; P < .001), women (OR, 0.81; 95% CI, 0.69 to 0.96; P = .02), hematologic cancer (OR, 0.20; 95% CI, 0.09 to 0.41; P < .001), and a less than 1-month survival time (OR, 0.10; 95% CI, 0.07 to 0.15; P < .001) were associated with a lesser likelihood of receiving a formal terminal diagnosis. Explicit terminal diagnosis was associated with lower admission rate and an adjusted OR of hospital death of 0.25 (95% CI, 0.21 to 0.29). Conclusion Women and the elderly were less likely to receive a formal terminal diagnosis. The formal terminal diagnosis reduced hospital admissions and increased the possibilities of dying at home.

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