scholarly journals Examining the support needs of older male spousal caregivers of people with a long‐term condition: A systematic review of the literature

Author(s):  
Anne Fee ◽  
Sonja McIlfatrick ◽  
Assumpta Ryan
2021 ◽  
Vol 10 (5) ◽  
pp. 1141
Author(s):  
Gianpaolo Marte ◽  
Andrea Tufo ◽  
Francesca Steccanella ◽  
Ester Marra ◽  
Piera Federico ◽  
...  

Background: In the last 10 years, the management of patients with gastric cancer liver metastases (GCLM) has changed from chemotherapy alone, towards a multidisciplinary treatment with liver surgery playing a leading role. The aim of this systematic review and meta-analysis is to assess the efficacy of hepatectomy for GCLM and to analyze the impact of related prognostic factors on long-term outcomes. Methods: The databases PubMed (Medline), EMBASE, and Google Scholar were searched for relevant articles from January 2010 to September 2020. We included prospective and retrospective studies that reported the outcomes after hepatectomy for GCLM. A systematic review of the literature and meta-analysis of prognostic factors was performed. Results: We included 40 studies, including 1573 participants who underwent hepatic resection for GCLM. Post-operative morbidity and 30-day mortality rates were 24.7% and 1.6%, respectively. One-year, 3-years, and 5-years overall survival (OS) were 72%, 37%, and 26%, respectively. The 1-year, 3-years, and 5-years disease-free survival (DFS) were 44%, 24%, and 22%, respectively. Well-moderately differentiated tumors, pT1–2 and pN0–1 adenocarcinoma, R0 resection, the presence of solitary metastasis, unilobar metastases, metachronous metastasis, and chemotherapy were all strongly positively associated to better OS and DFS. Conclusion: In the present study, we demonstrated that hepatectomy for GCLM is feasible and provides benefits in terms of long-term survival. Identification of patient subgroups that could benefit from surgical treatment is mandatory in a multidisciplinary setting.


2020 ◽  
Vol 8 (9S) ◽  
pp. 116-117
Author(s):  
Bianief Tchiloemba ◽  
Martin Kauke ◽  
Valentin Haug ◽  
Obada Abdulrazzak ◽  
Ali-Farid Safi ◽  
...  

Dementia ◽  
2021 ◽  
pp. 147130122110564
Author(s):  
Deborah Brooks ◽  
Elizabeth Beattie ◽  
Elaine Fielding ◽  
Katy Wyles ◽  
Helen Edwards

Background and objectives Many spousal caregivers experience stress, depression, loneliness, guilt and grief when placing a partner with dementia into long-term care. However, there is little research about their transitional support experiences, needs and preferences. This study aimed to gain a deeper understanding of these issues from spousal caregiver and long-term care facility staff perspectives, to inform subsequent support and intervention development. Research design and methods Semi-structured interviews and small group discussions were held separately with spousal caregivers ( n = 9) and care facility staff ( n = 11). Criterion and variation sampling aimed to ensure a range of experiences and perspectives. The ‘Framework’ approach was utilised for data analysis. Interpretation was with respect to underpinning models of stress-grief process in dementia caregiving. Findings A range of informational, psychoeducational and psychosocial supports were identified to help spousal caregivers cope better with the stressors and losses experienced throughout the transition from home to long-term care. Improved education about disease progression, information relating to long-term care provision, peer support and dementia-specific grief counselling were deemed important. Opportunities for better support within care facilities were also identified. Support should be tailored to individual needs and preferences. Discussion and implications The findings suggest a supportive care framework be developed, encompassing the trajectory from assessment for and admission into long-term care to end-of-life and post-bereavement support. Spousal caregivers should have their support needs assessed by trained health or social care professionals and be offered a range of support options as appropriate.


2017 ◽  
Vol 4 (4) ◽  
pp. 255-262
Author(s):  
Ryan Rhome ◽  
Isabelle M Germano ◽  
Ren-Dih Sheu ◽  
Sheryl Green

Abstract Background Growth hormone (GH)-secreting pituitary adenomas represent an uncommon subset of pituitary neoplasms. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) have been used as primary or adjuvant treatment. The purpose of this study is to report the long-term tumor control and toxicity from our institution and to perform a systematic literature review of acromegaly patients treated with FSRT. Methods We retrospectively reviewed all patients treated with FSRT (median dose 50.4 Gray [Gy], range 50.4–54 Gy) between 2005 and 2012 who had: 1) GH-secreting adenoma with persistently elevated insulin growth factor-1 (IGF-1) despite medical therapy and 2) clinical follow up >3 years after FSRT. Patients were treated with modern FSRT planning techniques. Biochemical control was defined as IGF-1 normalization. Systematic review of the literature was performed for FSRT in acromegaly. Results With a median follow-up of 80 months, radiographic control was achieved in all 11 patients and overall survival was 100%. Long-term biochemical control was achieved in 10 patients (90.9%) with either FSRT alone (36.4%) or FSRT with continued medical management (45.5%). No patient experienced new hypopituitarism, cranial nerve dysfunctions, or visual deficits. Our systematic review found published rates of biochemical control and hypopituitarism vary, with uniformly good radiographic control and low incidence of visual changes. Conclusions Adjuvant FSRT offered effective long-term biochemical control and radiographic control, and there was a lower rate of complications in this current series. Review of the literature shows variations in published rates of biochemical control after FSRT for acromegaly, but low incidence of serious toxicities.


2019 ◽  
pp. 1357633X1986295 ◽  
Author(s):  
Sophie McFarland ◽  
Anne Coufopolous ◽  
Deborah Lycett

Introduction Approximately 26 million people in the United Kingdom are living with one long-term condition and 10 million are living with two or more; these figures are projected to continue increasing (NHS England 2018). People with long-term conditions are two to three times more likely to have poor psychological wellbeing and utilise 50% of GP appointments, 64% of outpatient appointments and over 70 of inpatient bed days. Research in this population could help with increasing constraints on healthcare budgets and resources. Technology-enabled healthcare in the community might help improve quality of life and reduce healthcare costs of managing chronic disease but the overall impact is unclear, we therefore conducted a systematic review. Methods Keywords and MeSH terms were used to search MEDLINE and CINAHL. We included qualitative and quantitative studies that reported on adult home-care patients diagnosed with at least one long-term condition, comparing telehealth to usual home care. Meta-analyses and sensitivity analyses were conducted using RevMan 5. Qualitative findings were thematically synthesised and reported narratively. Results In total, 2568 studies were identified and nine (2611 participants) were included. Telehealth was not statistically significantly different versus standard home care for quality of life, psychological wellbeing, physical function, anxiety, depression, disease specific outcomes or bed days of care at 3, 6, 9 and 12 months. Qualitative findings showed patients found telehealth was beneficial for providing peace of mind and legitimising access to healthcare. Conclusion Telehealth may offer reassurance to those living in the community with long-term conditions; however, a lack of high-quality studies and heterogeneity between interventions makes conclusions difficult.


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