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Quality and palliative care

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https://www.readbyqxmd.com/read/28547207/role-of-out-of-hours-primary-care-service-in-limiting-inappropriate-access-to-emergency-department
#1
Andrea Posocco, Maria Paola Scapinello, Irene De Ronch, Francesco Castrogiovanni, Gianluca Lollo, Guglielmo Sergi, Iginio Tomaselli, Loris Tonon, Marco Solmi, Daniele Pescador, Elena Battistuz, Stefano Traversa, Vincenzo Zambianco, Nicola Veronese
Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013...
May 25, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28545502/improving-care-for-people-with-heart-failure-in-uganda-serial-in-depth-interviews-with-patients-and-their-health-care-professionals
#2
Elizabeth Namukwaya, Liz Grant, Julia Downing, Mhoira Leng, Scott A Murray
BACKGROUND: The short prognosis of patients with advanced heart failure (HF) and the associated multidimensional distress as illustrated in literature from high income countries necessitates the integration of palliative care into the care of advanced HF patients to address these needs and improve their quality of life. These needs, which are subjective, have not been described from the patients' and health care professionals'(HPs) view point in the Ugandan setting, a low income country with a different socio-cultural context...
May 25, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28545181/hepatocellular-carcinoma-a-comprehensive-review-of-biomarkers-clinical-aspects-and-therapy
#3
Nathalia Martines Tunissiolli, Márcia Maria Urbanin Castanhole-Nunes, Patrícia Matos Biselli-Chicote, Érika Cristina Pavarino, Renato Ferreira da Silva, Rita de Cássia Martins Alves da Silva, Eny Maria Goloni-Bertollo
Hepatocellular carcinoma (HCC) is a cause of several deaths related to cancer worldwidely. In early stage, curative treatments such as surgical resection, liver transplant and local ablation can improve the patient ´s survival. However, the disease is detected in advanced stage; moreover some available therapies are restricted to palliative care and local treatment. Early detections of HCC and adequate therapy are crucial to increase survival as well as to improve the patient´s quality of life. Therefore, researchers have been investigating molecular biomarkers with high sensibility and reliability as Golgi 73 protein (GP73), Glypican-3 (GPC3), Osteopontin (OPN), microRNAs and others...
April 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28545037/an-instrument-to-measure-nurses-knowledge-in-palliative-care-validation-of-the-spanish-version-of-palliative-care-quiz-for-nurses
#4
Elena Chover-Sierra, Antonio Martínez-Sabater, Yolanda Raquel Lapeña-Moñux
BACKGROUND: Palliative care is nowadays essential in nursing care, due to the increasing number of patients who require attention in final stages of their life. Nurses need to acquire specific knowledge and abilities to provide quality palliative care. Palliative Care Quiz for Nurses is a questionnaire that evaluates their basic knowledge about palliative care. The Palliative Care Quiz for Nurses (PCQN) is useful to evaluate basic knowledge about palliative care, but its adaptation into the Spanish language and the analysis of its effectiveness and utility for Spanish culture is lacking...
2017: PloS One
https://www.readbyqxmd.com/read/28544780/spinal-metastatic-disease-a-review-of-the-role-of-the-multidisciplinary-team
#5
REVIEW
Mark Curtin, Robert P Piggott, Evelyn P Murphy, Sudarshan Munigangaiah, Joseph F Baker, John P McCabe, Aiden Devitt
Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We performed a database review including pertinent articles exploring the multidisciplinary management of spinal metastatic disease. The wide variation in clinical presentation and tumor response to treatment necessitates a multidisciplinary approach that integrates the diagnosis and treatment of the cancer, symptom management, and rehabilitation for optimal care of patients with spinal metastases...
May 24, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28544672/providing-end-of-life-care-in-disability-community-living-services-an-organizational-capacity-building-model-using-a-public-health-approach
#6
Andrea Grindrod, Bruce Rumbold
BACKGROUND: There is broad consensus within the disability field that the end-of-life care offered to people with intellectual disabilities should be of a quality consistent with that advocated by contemporary palliative care. In practice, however, various barriers are encountered when applying palliative care strategies to the end-of-life care of people with intellectual disabilities, particularly those in disability community living services. METHODS: A mixed-methods approach was used...
May 24, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28533106/trans-sectoral-care-of-geriatric-cancer-patients-based-on-comprehensive-geriatric-assessment-and-patient-reported-quality-of-life-results-of-a-multicenter-study-to-develop-and-pilot-test-a-patient-centered-interdisciplinary-care-concept-for-geriatric-oncology
#7
Heike Schmidt, Stephanie Boese, Katharina Lampe, Karin Jordan, Eckhard Fiedler, Ursula Müller-Werdan, Andreas Wienke, Dirk Vordermark
OBJECTIVES: For older patients with cancer the maintenance of independence, functionality and health-related quality of life (HRQOL) is of great importance. Aiming to maintain HRQOL of older patients with cancer we developed an interdisciplinary care program based on comprehensive geriatric assessment (CGA) and patient-reported HRQOL comprising tailored supportive measures and telephone-based counseling during 6month aftercare. MATERIALS AND METHODS: Pilot-testing of the intervention took place in three centers at the University Hospital Halle to examine feasibility, acceptance and potential benefit...
May 19, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28532739/quality-of-missing-data-reporting-and-handling-in-palliative-care-trials-demonstrates-that-further-development-of-the-consort-missing-data-reporting-guidance-is-required-a-systematic-review
#8
Jamilla A Hussain, Martin Bland, Dean Langan, Miriam J Johnson, David C Currow, Ian R White
OBJECTIVES: Assess (i) the quality of reporting and handling missing data in palliative care trials against current guidance, (ii) whether there are differences in the reporting of criteria specified by the CONSORT 2010 statement compared to those not specified, (iii) the association of the reporting of missing data with journal impact factor and CONSORT endorsement status. STUDY DESIGN AND SETTING: Systematic review of palliative care randomised controlled trials...
May 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28528421/end-of-life-care-for-glioblastoma-patients-at-a-large-academic-cancer-center
#9
Kamini E Kuchinad, Roy Strowd, Anne Evans, W Anthony Riley, Thomas J Smith
Glioblastoma (GBM) is a universally fatal disease, complicated by significant cognitive and physical disabilities, inherent to the disease course. The purpose of this study was to retrospectively analyze end-of-life care for GBM patients at an academic center and compare utilization of these services to national quality of care guidelines, with the goal of identifying opportunities to improve end-of-life care. Single center retrospective cohort study of GBM patients at Johns Hopkins Hospital (JHH) between 2009 and 2014, using electronic medical records and hospice records...
May 20, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28525294/the-cambia-sojourns-scholars-leadership-program-conversations-with-emerging-leaders-in-palliative-care
#10
Dulce M Cruz-Oliver, Rachelle Bernacki, Zara Cooper, Corita Grudzen, Seiko Izumi, Deborah Lafond, Daniel Lam, Thomas W LeBlanc, Jennifer Tjia, Jennifer Walter
BACKGROUND: There is a pressing workforce shortage and leadership scarcity in palliative care to adequately meet the demands of individuals with serious illness and their families. To address this gap, the Cambia Health Foundation launched its Sojourns Scholars Leadership Program in 2014, an initiative designed to identify, cultivate, and advance the next generation of palliative care leaders. This report intends to summarize the second cohort of Sojourns Scholars' projects and their reflection on their leadership needs...
May 19, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28524887/integrative-palliative-care-complementary-medicine-in-oncology%C3%A2
#11
Eran Ben-Arye, Yifat Katz, Daphna Wolf, Noah Samuels
This article presents the collaborative effort of two complementary and integrative medicine (CIM) professionals caring for three patients with cancer. The challenges facing the integration of CIM in an oncology setting are addressed, and the collaboration between the two CIM practitioners is discussed. The effect of the combined approach was synergistic, empowering the patients and the CIM practitioners, reducing symptom burdens, and improving quality of life and function. 
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June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28516435/management-considerations-in-cancer-patients-with-rheumatoid-arthritis
#12
Richard J Zogala, Kristina Goutsouliak, Maria E Suarez-Almazor
Rheumatoid arthritis is a common inflammatory disease that requires treatment with immunosuppressants to control symptoms and avoid joint destruction. Managing cancer in patients with concomitant rheumatoid arthritis poses special challenges that require close coordination of care between oncologists and rheumatologists. Potential clinical issues needing special consideration include: 1) perioperative management in patients undergoing cancer surgery, which often requires discontinuation of antirrheumatic therapy; 2) use of immunosuppressant therapies for rheumatoid arthritis, especially biologic agents that inhibit cytokine and immune pathways, which conceivably could affect immune-mediated antitumor responses (the issues are different in patients with active cancer vs those with a past history of cancer and no recurrences); 3) management in the palliative care setting; and 4) use of cancer immunotherapy, such as checkpoint inhibitor agents, in patients with pre-existing rheumatoid arthritis...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28511720/identifying-models-of-delivery-care-domains-and-quality-indicators-relevant-to-palliative-day-services-a-scoping-review-protocol
#13
Seán R O'Connor, Martin Dempster, Noleen K McCorry
BACKGROUND: With an ageing population and increasing numbers of people with life-limiting illness, there is a growing demand for palliative day services. There is a need to measure and demonstrate the quality of these services, but there is currently little agreement on which aspects of care should be used to do this. The aim of the scoping review will be to map the extent, range and nature of the evidence around models of delivery, care domains and existing quality indicators used to evaluate palliative day services...
May 16, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28508278/physiotherapy-programme-reduces-fatigue-in-patients-with-advanced-cancer-receiving-palliative-care-randomized-controlled-trial
#14
Anna Pyszora, Jacek Budzyński, Agnieszka Wójcik, Anna Prokop, Małgorzata Krajnik
PURPOSE: Cancer-related fatigue (CRF) is a common and relevant symptom in patients with advanced cancer that significantly decreases their quality of life. The aim of this study was to evaluate the effect of a physiotherapy programme on CRF and other symptoms in patients diagnosed with advanced cancer. METHODS: The study was designed as a randomized controlled trial. Sixty patients diagnosed with advanced cancer receiving palliative care were randomized into two groups: the treatment group (n = 30) and the control group (n = 30)...
May 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28506127/living-into-death-a-case-for-an-iterative-fortified-and-cross-sector-approach-to-advance-care-planning
#15
Rebecca Llewellyn, Chrystal Jaye, Richard Egan, Wayne Cunningham, Jessica Young, Peter Radue
Advance care planning (ACP) has been framed as best practice for quality palliative care, yet a growing body of literature affirms the need for an early iterative ACP process to begin when people are young and healthy. A significant gap appears to exist in the literature regarding the utility of death conversations outside the end-of-life context. Could 'death conversations' early in life be an effective tool by which doctor and patient can co-construct a more healthful way of life, and realistic relationship with death? And what variables must be taken into account for these conversations to proceed successfully? This paper provides a narrative exploration of the value of death conversations in the clinical context in New Zealand...
May 16, 2017: Anthropology & Medicine
https://www.readbyqxmd.com/read/28505689/-pain-management-in-palliative-care
#16
Martin B Steins, Corinna Eschbach, Matthias Villalobos, Michael Thomas
A consistent pain management together with treatment of dyspnoea belongs to the main issues in symptom control in particular in palliative thoracic oncology. Together with the medicamentous therapy the psychologic and social circumstances of the affected patients have to be considered as factors influencing the experience of pain. The therapeutic fundament according to the WHO guideline for cancer pain is the opiate based medicamentous adjustment combined with non-opioids. In principle, this should be performed preferably orally, as simply as possible, according to a fix drug schedule and individually adjusted to the needed dosage...
May 2017: Pneumologie
https://www.readbyqxmd.com/read/28503990/assessing-the-utilization-of-radiotherapy-near-end-of-life-at-a-finnish-university-hospital-a-retrospective-cohort-study
#17
Liisa K Rautakorpi, Johanna M Mäkelä, Fatemeh Seyednasrollah, Anna M Hammais, Tarja Laitinen, Outi M Hirvonen, Heikki Minn, Laura L Elo, Sirkku M Jyrkkiö
BACKGROUND: Palliative radiotherapy can improve quality of life for cancer patients during the last months of life. However, very short life expectancy may devastate the benefit of the treatment. This single center study assesses the utilization of radiotherapy during the last weeks of life. MATERIAL AND METHODS: All cancer patients (N = 38,982) treated with radiotherapy (N = 11,395) in Turku University Central Hospital during 2005-2013 were identified in the database consisting of electronic patient records...
May 13, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28503040/recommendations-to-support-nurses-and-improve-the-delivery-of-oncology-and-palliative-care-in-india
#18
Virginia T LeBaron, Gayatri Palat, Sudha Sinha, Sanjeeva Kumari Chinta, Beaulah John Battula Jamima, Usha Lakshmi Pilla, Nireekshana Podduturi, Yadamma Shapuram, Padma Vennela, Vineela Rapelli, Zahra Lalani, Susan L Beck
CONTEXT: Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training. AIM: The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care. METHODS: Qualitative ethnography. SETTING: The study was conducted at a government cancer hospital in urban South India...
April 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28501792/healing-ministry-and-palliative-care-in-christianity
#19
S Stephen Jayard, Nishant A Irudayadason, J Charles Davis
Death is inevitable, but that does not mean it can be planned or imposed. It is an ethical imperative that we attend to the unbearable pain and suffering of patients with incurable and terminal illnesses. This is where palliative care plays a vital role. Palliative care has been growing faster in the world of medicine since its emergence as a specialty in the last decade. Palliative care helps to reduce physical pain while affirming the aspect of human suffering and dying as a normal process. The goal of palliative care is to improve the quality of life both of the patient and the family...
May 3, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28501253/resection-of-the-primary-tumor-in-stage-iv-colorectal-cancer-when-is-it-necessary
#20
REVIEW
Leandro Feo, Michael Polcino, Garrett M Nash
Management of metastatic colorectal cancer requires accurate staging and multidisciplinary evaluation, leading to a consensus treatment plan with the ultimate goal of increasing survival and improving the quality of life, while taking into consideration the patient's performance status, disease burden, and goals of care. Since the introduction of multidrug chemotherapeutic regimens, survival of patients with metastatic colorectal cancer has improved. Many patients with unresectable disease are undergoing surgery for asymptomatic primary tumors despite evidence that it is usually a futile intervention...
June 2017: Surgical Clinics of North America
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