Palliative Care

2006 ◽  
Vol 4 (8) ◽  
pp. 776 ◽  
Author(s):  
_ _
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cancer Care ◽  
Incurable Cancer ◽  
Disease Modifying Therapy ◽  
Hospice Movement ◽  
Life Issues ◽  
Care Guidelines ◽  
Recent Version

Over the past 20 years, increasing attention has been paid to quality-of-life issues in oncology. As the hospice movement has grown in this country, palliative care has developed into an integral part (rather than the antithesis) of comprehensive cancer care. Palliative care must be integrated earlier into the continuum of cancer care, and palliative, symptom-modifying therapy should be provided simultaneously with disease-modifying therapy from diagnosis. The goal of the NCCN palliative care guidelines is to help assure that each patient with cancer experiences the best possible quality of life throughout the illness trajectory. These guidelines are intended to help oncology teams provide the best care possible for their patients with incurable cancer. For the most recent version of the guidelines, please visit NCCN.org

Palliative Care Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (3) ◽  
pp. 394 ◽  
Keyword(s):  
Palliative Care ◽  
Social Workers ◽  
Anticancer Therapy ◽  
The Past ◽  
Hospice Movement ◽  
Life Issues ◽  
Care Guidelines ◽  
Collaborative Efforts ◽  
Recent Version

Over the past 20 years, increasing attention has been paid to quality-of-life issues in oncology. As the hospice movement has grown in this country, palliative care has developed into an integral part of comprehensive cancer care. The NCCN Palliative Care Guidelines were developed to facilitate the appropriate integration of palliative care into anticancer therapy. They were developed from the collaborative efforts of medical and surgical oncologists, neurologists, anesthesiologists, psychiatrists, internists, palliative care specialists, pastoral care counselors, social workers, and nurses. For the most recent version of the guidelines, please visit NCCN.org

High–Tech, Aggressive Palliative Care: In the Service of Quality of Life

1993 ◽  
Vol 9 (1) ◽  
pp. 37-41 ◽  
Author(s):  
David M. Dush
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Health Care ◽  
Palliative Care ◽  
Hospice Care ◽  
High Technology ◽  
The United States ◽  
High Tech ◽  
Hospice Movement

The hospice movement grew in part as a reaction to the perception that modern medical care had become too technological at the expense of being impersonal and insensitive to human psychological and spiritual concerns. In the United States, the institutionalization of hospice care under Medicare and other reimbursement systems has further established hospice as an alternative to high-technology, high-cost care. The present paper examines the question: What if hospice care becomes itself high-technology, aggressive, costly health care in order to remain true to its goal of maximizing quality of life? Implications for the goals and philosophical underpinnings of palliative care are discussed.

Communicating about sexuality in cancer care

2017 ◽  
Author(s):  
John W. Robinson ◽  
Joshua J. Lounsberry ◽  
Lauren M. Walker
Keyword(s):  
Quality Of Life ◽  
Sexual Functioning ◽  
Cancer Care ◽  
Information Needs ◽  
Healthcare Professionals ◽  
Intervention Models ◽  
Life Issues ◽  
Sexual Concerns ◽  
Plissit Model

Extensive research has shown that cancer, and the treatment thereof, can interfere with healthy sexual functioning. Indeed, sexual dysfunction is frequently cited as one of the top adverse effects of cancer treatment. However, while healthcare professionals routinely discuss quality-of-life issues with cancer patients, the literature suggest that too often this does not include an assessment of sexual concerns. This chapter explains how the responsibility to initiate discussion on sexuality rests with the healthcare professional. Establishing the sexuality information needs of the cancer patient can sometimes be difficult and it becomes more so when healthcare professionals make erroneous assumptions concerning sexuality. Whether or not to assess sexuality is no longer a question, it must be a routine part of cancer care. While there are several different intervention models for patients suffering from sexual difficulties, the PLISSIT model is frequently used in cancer centres and easily adapted to various types of practice.

HSR19-089: Misperceptions Regarding Palliative and Hospice Care Among Cancer Patients: What Can We Learn from Patient-Reported Treatment Decision Making

2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-089
Author(s):  
Sara Hayes ◽  
Brian M. Green ◽  
Shayna Yeates ◽  
Amrita Bhowmick ◽  
Kaitlyn McNamara ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Palliative Care ◽  
Cancer Care ◽  
Hospice Care ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Treatment Decision Making ◽  
Diagnosis Of Cancer

Background: Despite NCCN Guidelines and clear definition of palliative care, patients often carry misperceptions about palliative care and how it can be beneficially integrated into a patient’s care plan. In order to better understand the misinformation about palliative and hospice care, this study aims to assess patient-healthcare provider (HCP) communication regarding treatment decisions. Methods: An online survey was conducted with individuals who have had a diagnosis of cancer (n=1,517) to better understand their healthcare experiences as well as the impact their cancer diagnosis had on their quality of life. Measures included agreement scale questions assessing patient information needs surrounding treatment decision making. Open-ended questions where respondents were prompted to provide a written response allowed researchers to further assess patients’ understanding of palliative and hospice care. Responses to agreement-scale questions were evaluated using descriptive statistics. Openended question responses were analyzed using Dedoose qualitative data analysis software. Results: Among patients with a diagnosis of cancer, there were a broad range of patient misperceptions regarding palliative care, hospice care, and how they are used in cancer care. The majority of respondents (81%) stated that their HCP played a role when deciding on their treatment plan. Despite this, only 46% were confident they knew about the treatment’s impact on their daily life, 56% were confident they knew about the potential side effects of treatment, and 57% felt they had all of the information they needed. Themes identified through qualitative analysis include: patient conflation of palliative and hospice care, belief that palliative and hospice care are only relevant to end-of-life decision-making, and uncertainty about whether quality of life can actually be improved. Conclusions: Institutions and HCPs are recommended to integrate palliative care into cancer care. However, as this research shows, oncology patients are often misinformed about the benefits of palliative care. This follows a parallel concern of patients making treatment decisions without optimal information. A potential factor behind this unmet need may be lack of effective communication between patient and HCP. Palliative care may be mentioned by the HCP, but not discussed with enough empathy or depth, leading to patient misunderstanding and lack of inclusion in treatment plans.

scholarly journals Efficacy and cost-utility of the eHealth application ‘Oncokompas’, supporting patients with incurable cancer in finding optimal palliative care, tailored to their quality of life and personal preferences: a study protocol of a randomized controlled trial

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Anouk S. Schuit ◽  
Karen Holtmaat ◽  
Nienke Hooghiemstra ◽  
Femke Jansen ◽  
Birgit I. Lissenberg-Witte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cost Utility ◽  
Control Group ◽  
Incurable Cancer ◽  
Randomized Controlled

Abstract Background Patients with incurable cancer have to deal with a wide range of symptoms due to their disease and treatment, influencing their quality of life. Nowadays, patients are expected to adopt an active role in managing their own health and healthcare. Oncokompas is an eHealth self-management application developed to support patients in finding optimal palliative care, tailored to their quality of life and personal preferences. A randomized controlled trial will be carried out to determine the efficacy and cost-utility of Oncokompas compared to care as usual. Methods 136 adult patients with incurable lung, breast, colorectal and head and neck cancer, lymphoma and glioma, will be included. Eligible patients have no curative treatment options and a prognosis of at least three months. Patients will be randomly assigned to the intervention group or the control group. The intervention group directly has access to Oncokompas alongside care as usual, while the waiting list control group receives care as usual and will have access to Oncokompas after three months. The primary outcome measure is patient activation, which can be described as a patient’s knowledge, skills and confidence to manage his or her own health and healthcare. Secondary outcome measures comprise self-efficacy, health-related quality of life, and costs. Measures will be assessed at baseline, two weeks after randomization, and three months after the baseline measurement. Discussion This study will result in knowledge on the efficacy and cost-utility of Oncokompas among patients with incurable cancer. Also, more knowledge will be generated into the need for and costs of palliative care from a societal and healthcare perspective. Trial registration Netherlands Trial Register identifier: NTR 7494. Registered on 24 September 2018.

Quality of life issues identified by palliative care clients using two tools

2002 ◽  
Vol 12 (1) ◽  
pp. 31-41 ◽  
Author(s):  
Sue Lewis ◽  
Marie Bridge ◽  
Di Roughton ◽  
Janine Barelds ◽  
Sava Brenton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Life Issues

The oncologist’s role in delivering palliative care

2021 ◽  
pp. 787-799
Author(s):  
Nathan I. Cherny ◽  
Stein Kaasa
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Patient Care ◽  
Cancer Patients ◽  
Continuity Of Care ◽  
Cancer Care ◽  
Palliative Medicine ◽  
Collaborative Practice ◽  
Interdisciplinary Care

The division of cancer care into initial primary antitumour therapies followed by hospice or palliative care for patients who have progressive disease is anachronistic. Since the goals of medical oncology extend beyond the reduction of tumour burden and the deferral of death and incorporate a quality-of-life dimension, there is need for a continuum in patient care independent of whether the treatment intention is curative, life-prolonging, or symptomatic. Palliative care interventions should be integrated according to the clinical circumstances of the patient. This chapter outlines the oncologist’s role in the delivery of palliative care to cancer patients, emphasizing issues related to communication, interdisciplinary care, and collaborative practice with palliative medicine experts, and emphasizing principles of non-abandonment and continuity of care.

scholarly journals ‘Was it worth it?’ Intrathecal analgesia for cancer pain: A qualitative study exploring the views of family carers

2017 ◽  
Vol 32 (1) ◽  
pp. 287-293
Author(s):  
Nishi Patel ◽  
Melanie Huddart ◽  
Helen Makins ◽  
Theresa Mitchell ◽  
Jane L Gibbins ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Drug Delivery ◽  
Palliative Care ◽  
Side Effects ◽  
Cancer Pain ◽  
Family Carers ◽  
Incurable Cancer ◽  
Intrathecal Drug Delivery ◽  
The Individual

Background: Intrathecal drug delivery is known to reduce pain in patients where conventional systemic analgesia has been ineffective or intolerable. However, there is little information regarding the effects of intrathecal drug delivery on quality of life and function in those with advanced, incurable cancer. Aim: Retrospective exploration of the views of bereaved carers regarding the physical and psychosocial effects of external tunnelled intrathecal drug delivery in patients with advanced incurable cancer. Design: Thematic analysis of qualitative interviews with carers of deceased individuals who received percutaneous external tunnelled intrathecal drug delivery as part of their pain management, within two UK centres. Setting: A total of 11 carers were recruited from two UK Palliative Care centres. Family carers of adult patients who had received external tunnelled intrathecal drug delivery analgesia for cancer pain and had died between 6 and 48 months prior to contact were included. Carer relatives who were considered likely to be too vulnerable or who had lodged a complaint about treatment within the recruiting department or who had been treated directly by the interviewer were excluded. Results: In total, 11 interviews took place. The emerging themes were (1) making the decision to have the intrathecal – relatives described desperate situations with severe pain and/or sedation, meaning that the individual would try anything; (2) timing and knowing they were having the best – an increased access to pain and palliative care services, meant carers felt everything possible was being done, making the situation more bearable; (3) was it worth it? – the success of the external tunnelled intrathecal drug delivery was judged on its ability to enable the individual to be themselves through their final illness. Side effects were often considered acceptable, if the external tunnelled intrathecal drug delivery enabled improvements in quality of life. Conclusion: Carers perceived external tunnelled intrathecal drug delivery as most valuable when it improved quality of life towards the end of life, by reducing pain and side effects of conventional systemic analgesia to enable individuals ‘to be themselves’. Under these circumstances, the carers judged significant side effects to be acceptable.

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