Integrative Palliative Care Service Model Improved End-of-Life Care and Overall Survival of Advanced Cancer Patients in Hong Kong: A Review of Ten-Year Territory-Wide Cohort

2021 ◽  
Author(s):  
Tai-Chung Lam ◽  
Sik-Kwan Chan ◽  
Cheuk-Wai Choi ◽  
Ka-Chun Tsang ◽  
Kwok-Keung Yuen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Overall Survival ◽  
Hong Kong ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Life Care ◽  
Service Model ◽  
Advanced Cancer Patients

Aggressiveness of end-of-life care before and after the utilization of a palliative care service.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 9135-9135
Author(s):  
W. Gonsalves ◽  
T. Tashi ◽  
T. Davies ◽  
S. Ortman ◽  
R. Thota ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Life Care ◽  
Before And After

Association between family satisfaction and caregiver burden in cancer patients receiving outreach palliative care at home

2017 ◽  
Vol 16 (3) ◽  
pp. 260-268 ◽  
Author(s):  
Yoko Naoki ◽  
Yoshinobu Matsuda ◽  
Isseki Maeda ◽  
Hideka Kamino ◽  
Yoko Kozaki ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Family Satisfaction ◽  
Life Care ◽  
Care At Home

ABSTRACTObjective:Little is known about the associations between family satisfaction with end-of-life care and caregiver burden. We conducted a researcher-assisted questionnaire survey to clarify the impact of caregiver burden on family satisfaction and to determine the types of burden that decrease family satisfaction.Method:Bereaved family caregivers of patients with advanced cancer who received our outreach palliative care service were retrospectively identified. Family satisfaction with the end-of-life care provided by the palliative care service and caregiver burden were quantified using the Japanese versions of the FAMCARE Scale and the Zarit Burden Interview (ZBI), respectively.Results:Our study subjects included 23 family caregivers. The mean scores on the FAMCARE Scale and the ZBI for the total population were 72.8 ± 11.2 and 22.8 ± 17.3, respectively, indicating moderate-to-high satisfaction and low-to-moderate burden. Caregiver burden had a strong negative correlation to family satisfaction with end-of-life care (Spearman's rho [ρ] = −0.560, p = 0.005), which remained after adjustment for potential confounders (standardized beta [β] = −0.563, p = 0.01). Several burden items—including loss of control, personal time, social engagement with others, feeling angry with the patient, feeling that the patient wants more help than he/she needs, and a wish to leave the care to someone else—were associated with decreased satisfaction. The major cause of dissatisfaction for family members included the information provided regarding prognosis, family conferences with medical professionals, and the method of involvement of family members in care decisions.Significance of results:Caregiver burden can be a barrier to family satisfaction with end-of-life care at home. A home care model focused on caregiver burden could improve end-of-life experiences for patients and family caregivers.

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.

scholarly journals Patterns of End-of-Life Care in Children With Advanced Solid Tumor Malignancies Enrolled on a Palliative Care Service

2015 ◽  
Vol 50 (3) ◽  
pp. 305-312 ◽  
Author(s):  
Tamara Z. Vern-Gross ◽  
Catherine G. Lam ◽  
Zachary Graff ◽  
Sara Singhal ◽  
Deena R. Levine ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Solid Tumor ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Life Care ◽  
Advanced Solid Tumor

A nurse practitioner-led community palliative care service in Australia

2019 ◽  
Vol 25 (5) ◽  
pp. 245-253 ◽  
Author(s):  
Julie Edwards ◽  
Dawn Hooper ◽  
Gillian Rothwell ◽  
Kerrie Kneen ◽  
John Watson ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Nurse Practitioner ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Community Setting ◽  
Essential Elements ◽  
Life Care ◽  
Community Based

Background: Patients want community-based palliative care, but there was no continuity of care for patients at the Sydney Adventist Hospital to receive palliative and end-of-life care within a community setting. A nurse practitioner (NP)-led community palliative care service was developed. Aims: To present the background, design, function, and essential elements of the Sydney Adventist Hospital Community Palliative Care Service (SanCPCS). Methods: Semi-structured and cyclical discussions with key informants alongside internal document reviews. Findings: This is the first description of an NP-led community palliative care service model. The NP role ensured specialist training and extended clinical practice within the community setting. The SanCPCS delivers accessible, continuous, community-based palliative care throughout the patient's palliative and end-of-life journey. Conclusion: NP-led models for palliative and end-of-life care in the outpatient or community setting are a logical direction to meet patient need.

scholarly journals Late referrals to home palliative care service affecting death at home in advanced cancer patients in Japan: a nationwide survey

2011 ◽  
Vol 22 (9) ◽  
pp. 2113-2120 ◽  
Author(s):  
S. Fukui ◽  
J. Fujita ◽  
M. Tsujimura ◽  
Y. Sumikawa ◽  
Yayoi Hayashi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Care Service ◽  
Palliative Care Service ◽  
Nationwide Survey ◽  
Advanced Cancer Patients ◽  
At Home

The importance of identifying preferred place of death

2015 ◽  
Vol 9 (1) ◽  
pp. 84-91 ◽  
Author(s):  
Maimoona Ali ◽  
Margred Capel ◽  
Gareth Jones ◽  
Terri Gazi
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Service ◽  
Healthcare Providers ◽  
Palliative Care Service ◽  
Service Evaluation ◽  
Place Of Death ◽  
Life Care ◽  
At Home

ObjectivesThe majority of people would prefer to die at home and the stated intentions of both statutory and voluntary healthcare providers aim to support this. This service evaluation compared the preferred and actual place of death of patients known to a specialist community palliative care service.DesignAll deaths of patients (n=2176) known to the specialist palliative care service over a 5-year period were examined through service evaluation to compare the actual place of death with the preferred place of death previously identified by the patient. Triggers for admission were established when the patients did not achieve this preference.ResultsBetween 2009 and 2013, 73% of patients who expressed a choice about their preferred place of death and 69.3% who wanted to die at home were able to achieve their preferences. During the course of their illness, 9.5% of patients changed their preference for place of death. 30% of patients either refused to discuss or no preference was elicited for place of death.ConclusionsDirect enquiry and identification of preferences for end-of-life care is associated with patients achieving their preference for place of death. Patients whose preferred place of death was unknown were more likely to be admitted to hospital for end-of-life care.

Palliative Prognostic Index application at an inpatient palliative care service from a Brazilian tertiary Hospital: A prospective observational study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11537-11537
Author(s):  
Tiago Pugliese Branco ◽  
Alze Pereira dos Santos Tavares ◽  
Mariana Sarkis Braz ◽  
Mariana Ribeiro Monteiro ◽  
Ana Beatriz Kinupe Abrahao ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Care Service ◽  
Prognostic Index ◽  
Palliative Care Service ◽  
Tertiary Hospital ◽  
Care Physician ◽  
Survival Prediction ◽  
Advanced Cancer Patients

11537 Background: Palliative Care Index (PPI) has been proposed to improve the accuracy of survival prediction for advanced cancer patients. The aim of this study is to investigate the feasibility and real-world prognosis survival of oncology inpatients from a Brazilian tertiary hospital using PPI. Methods: Hospitalized advanced cancer patients who have been referred to the Palliative Care Team were enrolled from May 2011 to December 2018. The PPI was collected within 24 hours of the referral by the palliative care physician. Primary endpoint was median overall survival (OS), estimated with the use of the Kaplan–Meier method, in three groups: PPI < 4.0; 4.0 ≤ PPI > 6.0 and PPI ≥ 6.0. Secondary endpoints were OS rate at 3-week for patients with PPI ≥ 6.0, and the most accurate PPI value to predict 6 and 3-week survival, calculated by ROC curve. Results: Total of 1.381 patients were included in this cohort with a median age of 68-year-old, and 51.3% of females. The most frequent primary cancer sites were lung/chest (17,2%), colorectal (14,3%), breast (11,2%), and biliopancreatic (10,9%). Among 454 patients with PPI < 4.0, median OS was 44 days (95% CI: 35,5-52,4); 20 days (95% CI: 15,4-24,5) for 260 patients with 4.0≤ PPI < 6.0 and 8 days (95% CI: 7-8,9) between 655 patients with PPI ≥ 6. Differences in OS among the groups adjusted for primary site, age and gender were significant (p < 0,001). OS rate at 3 weeks for PPI≥ 6.0 was 28.1% (OR 5,39 p < 0.001). PPI value of < 5,5 best predicted 6-week OS (79% sensibility, 55% specificity, AUC 0,714) and the PPI value of ≥ 5,5 predicted 3-week OS (67% sensibility, 73% specificity, AUC 0,753). Conclusions: PPI is feasible and suitable for routine clinical practice to predict survival among Brazilian patients with advanced cancer. In our study, PPI 5.5 seems to be the most accurate value to predict survival within 3 weeks.

Improving End-of-Life Care for Ventricular Assist Devices (VAD) Patients: Paradox or Protocol?

2013 ◽  
Vol 67 (1-2) ◽  
pp. 161-166 ◽  
Author(s):  
Peg McGonigal
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Hospital Admissions ◽  
Life Experience ◽  
Care Service ◽  
Palliative Care Service ◽  
Ventricular Assist Devices ◽  
Life Care ◽  
Ventricular Assist

When a person consents to have a ventricular assist device (VAD) implanted in one's heart, the intention is to extend life toward a new heart or toward more time. Complications may develop followed by frequent hospital admissions—most often in an intensive care unit (ICU) setting—rendering a transplant a distant reality and to discontinue the device means certain death. Emotional support for patient and family is critical. Regardless of the original goal for the device, palliative care provides assistance in communication, goal setting, and symptom management and yet its consultation is often more for brink-of-death care than end-of-life care provided at the time of diagnosis of a life-threatening disease such as heart failure. This study examined the recent deaths of hospitalized patients with VADs and the use of the palliative care service. Understanding the benefit and timing of palliative care for VAD patients—particularly in the ICU setting—may improve the end-of-life experience for patients, families, and healthcare providers.

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