scholarly journals Needs of Terminally ill Patients and their Families: An Experience with Fifty-three Patients Attending a Newly Organized Palliative Care Service in Bangladesh

2009 ◽  
pp. 38-43
Author(s):  
Nezamuddin Ahmad ◽  
Mustafa Kamal ◽  
AHM Mostak Anwar ◽  
AKM Shafiqur Rahman
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Symptom Relief ◽  
Terminally Ill ◽  
Palliative Care Service ◽  
Disease Status ◽  
Symptom Assessment ◽  
Cross Sectional ◽  
Terminally Ill Cancer Patients ◽  
Terminally Ill Patients

Objective: To identify the needed care of the terminally ill patients and their families in Bangladesh Design: Retrospective, descriptive cross-sectional study Setting: Out Patient Consultation, referred admitted patients and home care visits by the same palliative care team of Bangabandhu Sheikh Mujib Medical University (BSMMU) Participants: 53 terminally ill cancer patients registered with the palliative care service of BSMMU Results: Age range of 22 to 80 years, mostly from middle to poor class. Most of the patients needed relief from pain, anxiety, sleeplessness and constipation along with other symptom relief. Major concern of patients was financial whereas major concern of family members was not to inform the patient of the disease status.. Preferred site of care was at home when uncertainty about the disease status was reduced. Conclusion: even if a ‘good life' is not possible for all the people of Bangladesh, ‘a good death for most of the patients suffering from incurable diseases can be an affordable reality. Key words: need, symptom assessment, palliative care, Bangladesh   Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.38-43

A Way to Screen for Suffering in Palliative Care

1997 ◽  
Vol 13 (2) ◽  
pp. 22-26 ◽  
Author(s):  
Ramon Bayés ◽  
J.T. Limonero ◽  
P. Barreto ◽  
M.D. Comas
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Terminally Ill ◽  
Palliative Care Service ◽  
Aids Patients ◽  
Terminally Ill Patients ◽  
Future Assessment ◽  
Starting Point ◽  
Good Starting Point

We report a new tool for screening the suffering of terminally ill patients in a palliative care service. We systematically asked 371 terminal oncological and AIDS patients on 665 different occasions, “How long did yesterday seem to you?”; we then asked them to assess their current condition. The simple answer about subjective length of time correlated well with subjective suffering in approximately half the patients. Thus it may be a good starting point for future assessment and more extensive explorations.

Abstract 68: Palliative Care Is Underutilized in Patients with Severe Intracerebral Hemorrhage

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
April Sisson ◽  
Karen C Albright ◽  
Michelle Peck ◽  
Linh M Nguyen ◽  
Michael Lyerly ◽  
...  
Keyword(s):  
Palliative Care ◽  
Poor Prognosis ◽  
Care Service ◽  
Care Center ◽  
Symptom Relief ◽  
Tertiary Care ◽  
Palliative Care Service ◽  
Code Status ◽  
Ich Score ◽  
Expected Mortality

Background and Purpose: Palliative care is an essential part of ICH care, particularly in patients with high ICH scores given their poor prognosis. Palliative care involves consultation by the Palliative Care Service and includes de-escalation of care, changing code status, and making pain and symptom relief the central goal of management. Methods: We performed a retrospective review of consecutive patients presenting to our tertiary care center from 2008-2013 with primary ICH. Demographic and clinical data were collected. Our sample included only patients who died or were transferred to hospice. We examined the proportion of patients that received an inpatient palliative care consult and compared this group to patients who did not receive an inpatient palliative care consult. Patients were categorized by ICH score. Results: Of the 99 ICH patients who died or were discharged to hospice, only 23% received a palliative care consult. Figure 1 displays death, predicted death, and palliative care consult proportions by ICH score. Patients that received a Palliative Care consult were older (mean age 65 vs. 73, p=0.018) and more frequently had evidence of infection (32% vs. 13%, p=0.038); no other significant differences were found between groups. Conclusions: In our sample of ICH patients, 23% of patients received a palliative care consult. In those with high ICH scores utilization was only 28%, despite 30 day expected mortality of 97% or greater. This raises concern that palliative care may be underutilized in patients who may benefit from it the most.

Quality matters: Patterns of palliative interventions in metastatic colorectal cancer (mCRC) patients.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 83-83
Author(s):  
Rebecca M. Prince ◽  
Shuyin Liang ◽  
Mantaj Brar ◽  
Stephanie Ramkumar ◽  
Adena Scheer ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Care Service ◽  
Quality Care ◽  
Symptom Relief ◽  
Palliative Care Service ◽  
Palliative Surgery ◽  
Cancer Center ◽  
The Mean ◽  
Mean Time

83 Background: Increasing recognition that high-quality end of life care is essential has resulted in internationally endorsed metrics allowing assessment of interventions at the end of life. Median survival for mCRC patients has improved to more than 24 months resulting in increased opportunity to undergo interventions for symptom relief at the end of life. We explored patterns of palliative interventions (chemotherapy, radiotherapy, surgery, endoscopy, drainage procedures) and outcomes in mCRC patients. Methods: A retrospective review was undertaken of all mCRC patients referred to the palliative care service from 2000 to 2010 at a tertiary cancer center in Toronto, Canada. Descriptive statistics, survival analysis and regression were employed. Results: A total of 542 patients were included of whom 52.8% were male, mean age was 62.8 years and 44.6% had stage 4 disease at diagnosis. Over the course of their disease 93.9% had an intervention at any time after their diagnosis including 27.5% of patients undergoing palliative surgery, 77% of patients had an intervention in the last year of life and 19.1% had an intervention in the last 30 days of life. The percentage of patients receiving interventions within the last 14 days of life were 1.23% for chemotherapy, 4.6% for radiotherapy, 0.5% for surgery, 10.4% for endoscopy and 23% drainage procedures. The mean time between referral to palliative care and death was 7 months (SD 10.4). For patients who received chemotherapy, the mean time between last chemotherapy and death was 9.5 months (SD 14.9). Overall survival for patients who did not receive chemotherapy was 28 months (SD 33) compared with 40 months (SD 32) for those who received chemotherapy. Regression analysis for risks of dying within 30 days of chemotherapy was limited by a low event rate. Increasing age was significantly associated with a lower risk of dying within 30 days of chemotherapy. Conclusions: In their final months of life, palliative mCRC patients undergo a significant number of interventions aiming to improve quality of life. These require considerable multi-disciplinary input with ramifications for quality care, planning for service provision and funding.

scholarly journals Family carer support in home and hospital: a cross-sectional survey of specialised palliative care

2019 ◽  
Vol 10 (4) ◽  
pp. e33-e33
Author(s):  
Maarten Vermorgen ◽  
Aline De Vleminck ◽  
Kathleen Leemans ◽  
Lieve Van den Block ◽  
Chantal Van Audenhove ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Palliative Care Unit ◽  
Information Support ◽  
Family Carers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services

ObjectivesTo evaluate: (1) to what extent family carers of people supported by specialised palliative care services felt they had been provided with information, support and aftercare and (2) how this varied by type of palliative care service, length of enrolment and characteristics of deceased.MethodsA cross-sectional postal survey was conducted using a structured questionnaire with nine items on information, support and aftercare provided by specialised palliative care services to family carers. Flemish family carers of people who had made use of specialised palliative care services at home or in hospital were contacted.ResultsOf all primary family carers (response rate of 53.5% resulting in n=1504), 77.7% indicated they were asked frequently by professionals how they were feeling. Around 75% indicated they had been informed about specific end-of-life topics and around 90% felt sufficiently supported before and immediately after the death. Family carers of people who had died in a palliative care unit, compared with other types of specialised palliative care services, indicated having received more information, support and aftercare.ConclusionsFamily carers evaluate the professional assistance provided more positively when death occurred in a palliative care unit. Policy changes might be needed to reach the same level of care across all specialised palliative care services.

Existential Issues in Palliative Care — Interviews with Cancer Patients

2000 ◽  
Vol 16 (2) ◽  
pp. 20-24 ◽  
Author(s):  
Ingrid Bolmsjö
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Terminally Ill Cancer Patients ◽  
Terminally Ill Patients ◽  
Existential Distress ◽  
Patients Experience ◽  
Existential Issues

A minority of terminally ill patients achieve a peaceful death. Many factors, including existential distress, contribute to the emotional disquiet of patients. This study focuses on the reactions of terminally ill cancer patients to questions concerning existential issues within the themes of meaning, relations, autonomy, guilt, dignity, and communication. The results of this study indicate that patients experience a number of problems dealing with existential issues, consider these questions important, and wish to be able to discuss these types of questions with someone.

Role of emergent palliative radiation therapy in the care of patients with cancer.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 201-201 ◽  
Author(s):  
Lisa Singer ◽  
Michael Zhang ◽  
Steve E. Braunstein ◽  
Shannon E. Fogh
Keyword(s):  
Palliative Care ◽  
Radiation Therapy ◽  
Background Radiation ◽  
Care Service ◽  
Symptom Relief ◽  
Palliative Care Service ◽  
Cord Compression ◽  
Patients With Cancer ◽  
Palliative Radiation Therapy ◽  
Chief Complaints

201 Background: Radiation therapy (RT) provides an important role in the palliative care of patients with cancer. For patients with metastatic spinal cord compression not amenable to surgery, the value of timely palliative RT is well established; however, the value of the rapid application of RT for other chief complaints is less clear. The importance of palliative care service (PCS) involvement in patients treated with RT is becoming increasingly recognized and rapidly instituted RT could compromise this involvement. The purpose of this study was to assess the efficacy of emergent RT in alleviating symptoms in patients with cancer and to assess the extent of PCS in the management of patients treated with emergent RT. Methods: Patients treated with emergent RT were retrospectively identified through automated search of our institution’s radiation oncology electronic health record (EHR). Emergent RT was defined as treatment with RT in 48 hours or less from the time of simulation and flagged as emergent in the EHR by the radiotherapy team. Patients without a diagnosis of cancer were excluded from the study. For patients meeting inclusion criteria, data was collected regarding the chief complaint, completion of treatment, length of RT, and the primary outcomes of involvement of PCS and symptom relief. Results: From January to July 2015, 22 patients with cancer were treated with emergent RT. Prior to RT, 21 of 22 patients received other medical and/or procedural interventions. Sixty-four percent of patients were treated with 5 or fewer fractions and all but 2 patients completed RT. Symptoms improved in 73% of patients. PCS were involved in the care of 36% of patients. Conclusions: Emergent palliative RT provided symptom relief in the majority of patients; however, this study identified a lack of PCS involvement in the care of patients treated emergently. Study of long-term patient outcomes is needed. Future work should focus on developing clinical workflows that will better integrate involvement of PCS in the treatment of patients with palliative RT administered both emergently and non-emergently.

scholarly journals Factors affecting attitudes towards caring for terminally ill patients among nursing students in Switzerland: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037553
Author(s):  
Pauline Laporte ◽  
Typhaine Juvet ◽  
Jean-François Desbiens ◽  
Diane Tapp ◽  
Jérôme Pasquier ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Students ◽  
Primary Outcome ◽  
Terminally Ill ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Terminally Ill Patients ◽  
Nursing Skills ◽  
Students Attitudes ◽  
Care Nursing

ObjectivesPositive attitudes towards end-of-life care are essential among nursing students to adequately support terminally ill patients and enable students to feel confident about providing end-of-life care. This study aimed to determine nursing students’ attitudes towards caring for terminally ill patients, as well as the associations between these attitudes and year of study, exposure to terminally ill people, self-perceived nursing skills and subjective impact of instruction.DesignCross-sectional study.SettingA health sciences school in Switzerland.ParticipantsAll preparatory students, first-year nursing students and third-year nursing students were invited to participate; 178 agreed to participate.Primary outcome measureAttitudes towards terminally ill patients were assessed using the Frommelt Attitudes Toward Care of the Dying Scale, Form B (FATCOD, Form B), as the primary outcome. Secondary measures were gender, age, year of study, number of terminally ill persons encountered, self-perceived palliative care nursing skills and subjective impact of instruction.ResultsMean FATCOD, Form B score was 117.7 (SD: 9.8, median: 118.0). Better attitudes towards terminally ill patients were significantly associated with being aged 24–26 years (β=6.97, 95% CI 2.00 to 11.95, p=0.006), year of study (β=3.47, 95% CI 1.69 to 5.25, p<0.001), professional encounters with terminally ill patients (β=3.59, 95% CI 2.23 to 4.95, p<0.001) and self-perceived palliative care nursing competence (β=1.23, 95% CI 0.41 to 2.04; p=0.003). In the multivariate analysis, professionally encountering terminally ill patients remained significant (β=3.00; 95% CI 1.43 to 4.57; p<0.001).ConclusionsNursing students’ attitudes towards caring for terminally ill patients were positive and improved as their year of study progressed. Professional exposure to terminally ill patients was the strongest factor, followed by private encounters, self-perceived palliative care nursing skills, year of study and age.

Perspectives on palliative care in Lebanon: Knowledge, attitudes, and practices of medical and nursing specialties

2009 ◽  
Vol 7 (3) ◽  
pp. 339-347 ◽  
Author(s):  
Huda Abu-Saad Huijer ◽  
Hani Dimassi ◽  
Sarah Abboud
Keyword(s):  
Palliative Care ◽  
Formal Education ◽  
Terminally Ill ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Terminally Ill Patients ◽  
Care Services ◽  
Palliative Care Services ◽  
Knowledge And Attitude ◽  
Knowledge Attitudes And Practices

AbstractObjective:Our objective was to determine the knowledge, attitudes, and practices of physicians and nurses on Palliative Care (PC) in Lebanon, across specialties.Method:We performed a cross-sectional descriptive survey using a self-administered questionnaire; the total number of completed and returned questionnaires was 868, giving a 23% response rate, including 74.31% nurses (645) and 25.69% physicians (223).Results:Significant differences were found between medical and surgical nurses and physicians concerning their perceptions of patients' and families' outbursts, concerns, and questions. Knowledge scores were statistically associated with practice scores and degree. Practice scores were positively associated with continuing education in PC, exposure to terminally ill patients, and knowledge and attitude scores. Acute critical care and oncology were found to have lower practice scores than other specialties.Significance of results:Formal education in palliative care and development of palliative care services are very much needed in Lebanon to provide holistic care to terminally ill patients.

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