Intensity and treatment of symptoms in 3,030 palliative care patients: A cross-sectional survey of the EAPC Research Network

2018 ◽  
Vol 5 (1) ◽  
pp. 11 ◽  
Author(s):  
Eivor Alette Laugsand, PhD-student ◽  
Stein Kaasa, MD ◽  
Franco De Conno, MD ◽  
Geoffrey Hanks, MD ◽  
Pål Klepstad, MD
Keyword(s):  
Palliative Care ◽  
Symptom Management ◽  
Specific Treatment ◽  
Research Network ◽  
Poor Sleep ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Symptom Intensity ◽  
Who Pain Ladder ◽  
Prescription Practice

Objective: This study aimed to describe intensity and treatment of symptoms other than pain in European palliative care units.Patients: A total of 3,030 patients, including 2,064 that used an opioid, were included from 143 palliative care centers, in 21 European countries.Results: Pain was treated with analgesics corresponding to the WHO pain ladder step I (n = 374), II (n = 497), and III (n = 1,567). Frequencies of symptoms observed as moderate or severe were for generalized weakness (50 percent), fatigue (48 percent), anxiety (28 percent), anorexia (26 percent), constipation (18 percent), focal weakness (18 percent), depression (18 percent), and dyspnoea (15 percent). When comparing WHO-groups, cancer diagnoses, metastasis sites, countries, and genders, we found that some of the symptom intensities and treatments differed significantly between subgroups. A majority of patients used drugs for symptom management. Still, more than one-third of patients assessed to have moderate or severe constipation did not receive any treatment. The corresponding numbers for depression, confusion, nausea, vomiting, or anxiety were approaching 40 percent and for poor sleep about 50 percent. Prescription practice of antiemetics, laxatives, and psychotropic drugs varied widely between countries both in terms of preparation and percent of patients receiving a specific treatment.Conclusions: This survey shows that clinically relevant symptoms are frequent and that one-third to half of the patients with a symptom observed as moderate or severe do not receive any treatment aimed to reduce the symptom intensity. Several symptoms and treatments differed between WHO-groups, cancer diagnoses, metastasis locations, countries, and genders. Prescription practice varied between countries both in terms of medication administered and percent of patients receiving specific treatment.

Complementary medicine visits by palliative care patients: a cross-sectional survey

2020 ◽  
pp. bmjspcare-2020-002269
Author(s):  
Amie Steel ◽  
Janet Schloss ◽  
Helene Diezel ◽  
Per J Palmgren ◽  
Jean Baptiste Maret ◽  
...  
Keyword(s):  
Palliative Care ◽  
Complementary Medicine ◽  
Symptom Management ◽  
Clinical Care ◽  
Personal Characteristics ◽  
Primary Diagnosis ◽  
Cancer Site ◽  
Service Utilisation ◽  
Cross Sectional Survey ◽  
Cross Sectional

BackgroundThe paucity of empirical research examining complementary medicine (CM) use in palliative care in France compared with other countries results in a gap in scientific knowledge. This study aims to describe the frequency and the cause of palliative care patients consulting with a CM clinician along with the conventional physicians.MethodsThis study is an observational cross-sectional survey conducted in three palliative care centres in Lyon, France, between July 2017 and May 2018: two tertiary hospitals and one palliative care unit in a private hospital. Inpatients and outpatients visiting the palliative care clinics with a primary diagnosis of cancer were invited to participate in the study. Using a 19-item paper-based survey instrument, we collected data on the participants’ personal characteristics, health service utilisation and attitudes towards CM.ResultsFrom the 138 participants meeting the inclusion criteria, 100 (72.4%) were included in the study. On average, they were 62.9 years old (SD 12.4) and the majority were women (60%). The primary cancer site was mostly colorectal (29.0%), breast (15.0%) and gynaecological (11.0%). The most commonly visited CM clinician was the aromatherapist (72.7%), recording more than six consultations (78.1%) for symptom management (21.9%). Visits to an osteopath were reported by 28.6% of patients, and 45.8% of osteopathy users reported visiting an osteopath more than six times for symptom management (62.5%). Participants visiting a naturopath (15.3%) reported less than four visits and indicated symptom management as the most common reason (76.9%).ConclusionsOur findings show a substantial proportion of palliative care patients visit CM clinicians and primarily seek symptom management from CM clinical care.

Interfacility transfer communication of multidrug-resistant organism colonization or infection status: Practices and barriers in the acute-care setting

2021 ◽  
pp. 1-6
Author(s):  
Katherine D. Ellingson ◽  
Brie N. Noble ◽  
Genevieve L. Buser ◽  
Graham M. Snyder ◽  
Jessina C. McGregor ◽  
...  
Keyword(s):  
Acute Care ◽  
Infection Prevention ◽  
Multidrug Resistant ◽  
Research Network ◽  
Resistant Organism ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hospital Size ◽  
Academic Affiliation ◽  
Healthcare Epidemiology

Abstract Objective: To describe interfacility transfer communication (IFTC) methods for notification of multidrug-resistant organism (MDRO) status in a diverse sample of acute-care hospitals. Design: Cross-sectional survey. Participants: Hospitals within the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN). Methods: SRN members completed an electronic survey on protocols and methods for IFTC. We assessed differences in IFTC frequency, barriers, and perceived benefit by presence of an IFTC protocol. Results: Among 136 hospital representatives who were sent the survey, 54 (40%) responded, of whom 72% reported having an IFTC protocol in place. The presence of a protocol did not differ significantly by hospital size, academic affiliation, or international status. Of those with IFTC protocols, 44% reported consistent notification of MDRO status (>75% of the time) to receiving facilities, as opposed to 13% from those with no IFTC protocol (P = .04). Respondents from hospitals with IFTC protocols reported significantly fewer barriers to communication compared to those without (2.8 vs 4.3; P = .03). Overall, however, most respondents (56%) reported a lack of standardization in communication. Presence of an IFTC protocol did not affect whether respondents perceived IFTC protocols as having a significant impact on infection prevention or antimicrobial stewardship. Conclusions: Most respondents reported having an IFTC protocol, which was associated with reduced communication barriers at transfer. Standardization of protocols and clarity about expectations for sending and receipt of information related to MDRO status may facilitate IFTC and promote appropriate and timely infection prevention practices.

Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis

2021 ◽  
pp. 104990912110186
Author(s):  
James Alton Croker ◽  
Julie Bobitt ◽  
Sara Sanders ◽  
Kanika Arora ◽  
Keith Mueller ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Fast Track ◽  
Hospice Care ◽  
Cannabis Use ◽  
Care Plan ◽  
Medical Cannabis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Eol Care

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.

scholarly journals The Current Situation of Internet Addiction and Its Impact on Sleep Quality and Self-Injury Behavior in Chinese Medical Students

2020 ◽  
Vol 17 (3) ◽  
pp. 237-242
Author(s):  
Yanqiu Wang ◽  
Ying Zhao ◽  
Ling Liu ◽  
Yan Chen ◽  
Dong Ai ◽  
...  
Keyword(s):  
Medical Students ◽  
Sleep Quality ◽  
Internet Addiction ◽  
Detection Rate ◽  
Poor Sleep ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Self Injury ◽  
Chinese Medical Students ◽  
Self Harm

Objective The purpose of this cross-sectional survey is to explore the current state of Internet addiction (IA) in Chinese medical students and its connection with medical students’ sleep quality and self-injury behavior.Methods Respondents were came from Wannan Medical College, China. The Young’s Internet Addiction Test, Pittsburgh Sleep Quality Index (PSQI), Self-Harm Questionnaire were used in this cross-sectional survey. A total of 3,738 medical students were investigated, 1,552 (41.52%) males, 2,186 (58.48%) females. T-test, chi-square test and MANOVA were used for data analysis.Results Of the 3,738 medical students, 1,054 (28.2%) reported having IA, 1,126 (30.1%) reported having poor sleep quality, 563 (15.1%) having self-harm behaviors. IA tends to be more female, upper grade students. The sleep quality of IA was worse than that of non-IA (χ<sup>2</sup>=54.882, p<0.001), and the possibility of self-injury was higher than non-IA (χ<sup>2</sup>=107.990, p<0.001).Conclusion This survey shows that the IA detection rate of medical students was 28.2%. Females, higher grade students had a higher IA detection rate. The low sleep quality and self-injury behavior of medical students are associated with IA.

Abstract 037: History Of Weight Cycling Is Prospectively Associated With Shorter And Poorer Quality Sleep, And Higher Sleep Apnea Risk In Diverse Us Women: Results From The AHA Go Red For Women Strategically Focused Research Network

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Vivian Cao ◽  
Nour Makarem ◽  
Moorea Maguire ◽  
Ivan Samayoa ◽  
Huaqing Xi ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Onset ◽  
Research Network ◽  
Poor Sleep ◽  
Sleep Onset Latency ◽  
Weight Cycling ◽  
Onset Latency ◽  
Cross Sectional ◽  
History Of ◽  
Insomnia Severity

Introduction: Poor sleep and history of weight cycling (HWC) are associated with worse cardiovascular health, yet limited research has evaluated the association between HWC and poor sleep patterns. Hypothesis: We hypothesized that HWC would be associated with poor sleep in US women. Methods: The AHA Go Red for Women Strategically Focused Research Network cohort at Columbia University (n=506, mean age 37 ± 15.7y, 61% racial/ethnic minority) was used to evaluate cross-sectional associations of HWC and sleep characteristics at baseline, and prospective associations of HWC from baseline with sleep measures at 1-yr. HWC, defined as losing and gaining ≥ 10 lbs at least once (excluding pregnancy), and number of WC episodes were self-reported. Sleep duration, measures of sleep quality, insomnia severity, and obstructive sleep apnea (OSA) risk were assessed using the validated Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Berlin questionnaire. Linear and logistic regression models, adjusted for age, race/ethnicity, education, health insurance status, pregnancy history, and menopausal status, were used to evaluate the relation of HWC with sleep. Results: Most women reported ≥1episode of weight cycling (72%). In linear models of cross-sectional and prospective data, each additional weight cycling episode was related to shorter sleep duration, poorer sleep quality, longer sleep onset latency, greater insomnia severity, more sleep disturbances and daytime dysfunction, lower sleep efficiency, and higher sleep medication use frequency. In logistic models, HWC (≥1 vs. 0 episodes) was associated with greater odds for short sleep, poor sleep quality, long sleep onset latency ≥26 min, high OSA risk, and sleep efficiency<85% ( Table ). Conclusion: HWC predicted poor sleep among women, suggesting that weight maintenance may represent an important strategy to promote sleep health. Long-term studies are needed to disentangle the complex relations between weight fluctuations and sleep across the life course.

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