Indian Journal of Palliative Care最新文献

{"title":"Prolonged Indwelling Percutaneous Nephrostomy Leading to Purple Urinary Bag Syndrome in Palliative Care Setting: A Case Report.","authors":"Divya Sai Vanumu,&nbsp;Shyam Prasad Mantha,&nbsp;Praneeth Suvvari,&nbsp;Praveen Kumar Kodisharapu","doi":"10.25259/IJPC_162_2022","DOIUrl":"10.25259/IJPC_162_2022","url":null,"abstract":"<p><p>Purple urine bag syndrome (PUBS) is a complication and a rare phenomenon associated with bacterial colonisation in bladder catheters in which urine turns purple in the tubing and the catheter bag. This condition can be distressing and panicking for the patients and their families as well as the medical staff caring for them. It is an interesting and unusual presentation that affects people with long-term indwelling catheters and chronic constipation. We report one such case in our hospital, a 73-year-old woman with stage 4 cancer of the vaginal vault, post-bilateral percutaneous nephrostomy (PCN) 4 months ago, currently on best supportive care, presented to the emergency room with symptoms of urosepsis, while a purple urine bag may appear innocuous and not need any particular care beyond replacing the catheter and giving the patient the proper antibiotics, it may indicate an occult urinary tract infection (UTI), which can have catastrophic effects in a patient using a urinary catheter for an extended period of time. Only a few examples of PUBS with an underlying nephrostomy have been documented in the literature. This is a case of a palliative care patient who had a poor prognosis despite receiving the right antibiotic treatment for an upper UTI that caused purple staining of the PCN catheter bag. Using this case report as a guide, we could manage a complex UTI in a palliative care context.</p>","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":"29 3","pages":"324-327"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/28/IJPC-29-324.PMC10493687.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Science to Spirituality in Paediatric Palliative Care: A Commentary.","authors":"R R Pravin","doi":"10.25259/IJPC_48_2023","DOIUrl":"10.25259/IJPC_48_2023","url":null,"abstract":"<p><p>Spirituality in paediatric palliative care remains an enigma across both the Eastern and Western worlds. There is no absolute science to it, and it can be a barrier to effective palliative care to be delivered. This article aims to discuss the barriers to and recommendations for discussing this sensitive topic with children and their families to enhance the quality of palliative care rendered, with the aid of case studies to illustrate the underestimated importance of spirituality in paediatric palliative care.</p>","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":"29 3","pages":"336-339"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/9d/IJPC-29-336.PMC10493681.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Care Pathway for Assessment and Treatment of Fatigue in Palliative Care.","authors":"Mochamat Mochamat,&nbsp;Marta Przyborek,&nbsp;Birgit Jaspers,&nbsp;Henning Cuhls,&nbsp;Rupert Conrad,&nbsp;Martin Mücke,&nbsp;Lukas Radbruch","doi":"10.25259/IJPC_194_2022","DOIUrl":"10.25259/IJPC_194_2022","url":null,"abstract":"<p><strong>Objectives: </strong>Fatigue is a frequent and burdensome symptom in patients with advanced disease in palliative care. However, it is under-assessed and undertreated in clinical practice, even though many treatment options have been identified in systematic reviews. Care pathways with defined and standardised steps have been recommended for effective management in the clinical setting. This paper describes a care pathway for managing fatigue in palliative care patients. This study aims to develop a care pathway with detailed guidance for screening, assessment, diagnosis, and treatment of fatigue in palliative care patients.</p><p><strong>Material and methods: </strong>A collaborative effort of multidisciplinary clinicians participated in constructing the care pathway. The care pathway was developed using the following steps: (a) Developing an intervention; (b) piloting and feasibility; (c) evaluating the intervention; (d) reporting; and (e) implementation. This paper covers the first step, which includes the evidence base identification, theory identification/development, and process/outcomes modeling. A literature search was conducted to understand the extent of the fatigue problem in the palliative care setting and identify existing guidelines and strategies for managing fatigue. Consistent recommendations emanating from the included papers were then contributed to a care pathway. Patient representatives and palliative care professionals provided feedback on the draft.</p><p><strong>Results: </strong>The care pathway address the following care processes: (1) Screening for the presence of fatigue; (2) assessment to evaluate the severity of fatigue; (3) diagnostic procedure, including history, physical examination, and laboratory finding; (4) therapeutic management pathway for clinical decision-making; and (5) valuation of treatment effect, using questionnaires, diaries and physical activity monitoring with body-worn sensors.</p><p><strong>Conclusion: </strong>The development of a care pathway will help to implement regular and structured assessment, diagnosis, and treatment of fatigue for healthcare professionals treating palliative care patients. Reviewing the pathway with a multidisciplinary expert group and field testing the pathway will be the next steps toward implementation.</p>","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":"29 3","pages":"256-265"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/f1/IJPC-29-256.PMC10493685.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10244005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing the Role of Higher Education Institutions to Support Palliative Care Education in Primary Care and Humanitarian Settings within Low- and Middle-Income Countries: Online Workshop Report.","authors":"Teguh Kristian Perdamaian,&nbsp;Michelle McGannan,&nbsp;Liz Grant,&nbsp;David Fearon","doi":"10.25259/IJPC_45_2023","DOIUrl":"10.25259/IJPC_45_2023","url":null,"abstract":"<p><p>The need for palliative care is increasing, especially in low- and middle-income countries (LMICs). Higher education institutions (HEIs) have a role to play in developing a skilled palliative care workforce in LMICs. A workshop was held to discuss this issue, and it was attended by experts from around the world. The workshop highlighted the challenges and opportunities for palliative care education in HEIs for LMIC settings. The participants discussed the importance of a collaborative interprofessional approach and advocacy for the inclusion of palliative care into a wide range of curricula. They also expressed the hope to explore possibilities of networks to continue this discussion and incorporate the wider perspectives from primary care and humanitarian practitioners.</p>","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":"29 3","pages":"332-333"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/b6/IJPC-29-332.PMC10493692.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bleeding Control in Advanced Gastric Cancer; Role of Radiotherapy.","authors":"Asifa Andleeb,&nbsp;Kaneez Fatima,&nbsp;Shahida Nasreen,&nbsp;Mushtaq Ahmad Sofi,&nbsp;Arshad Manzoor Najmi,&nbsp;Sumaira Qadri,&nbsp;Farhana Siraj","doi":"10.25259/IJPC_1_2023","DOIUrl":"10.25259/IJPC_1_2023","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of our study is to see the efficacy of palliative radiotherapy (RT) for bleeding control in patients with advanced gastric cancer (AGC).</p><p><strong>Materials and methods: </strong>It is a retrospective review based on observations of 74 AGC patients with a median age of 60 years (range 50-82 years) who had active tumour bleeding and were treated with palliative RT. Treatment response was assessed by both subjective symptom relief and objective change in parameters. Objective response to RT was defined by an increase in the median haemoglobin (Hb) level of patients and a decrease in number of packed red blood cell (RBC) units needed by patients after RT.</p><p><strong>Results: </strong>Response to haemostatic RT was observed in 52 patients out of 74 patients (70.27%). We observed a significant increase in mean Hb level after palliative RT. Pre-RT mean Hb was 6.14 ± 1.01 and post-RT mean Hb was 7.19 ± 1.75 (<i>P</i> < 0.05). Response to RT was also evident in a significant decrease in the number of packed RBC units post-haemostatic RT. The mean number of pre-RT transfused packed RBC units was 8.28 ± 3.76 and post-RT, it was 4.34 ± 2.91 (P < 0.05). The median overall survival was 90 days and the median transfusion-free survival was 40 days.</p><p><strong>Conclusion: </strong>RT may be an effective treatment option for bleeding control in AGC. In our study, we observed fair and reasonably durable haemostasis. A success rate of 70.24% was documented with clinical palliation, a higher Hb level and fewer transfusions after RT. This modality for bleeding control is more important and reliable in situations where alternative modalities are not feasible.</p>","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":"29 3","pages":"279-284"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/54/f1/IJPC-29-279.PMC10493693.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Multimodal Properties of Quercetin in Chronic Pain Syndromes.","authors":"Abhijit Nair","doi":"10.25259/IJPC_151_2022","DOIUrl":"10.25259/IJPC_151_2022","url":null,"abstract":"To the Editor, Bioflavonoids are a family of polyphenolic molecules found in a variety of plants and reportedly have significant antioxidant and anti-inflammatory properties. Based on their chemical structure, flavonoids are broadly classified as flavones, isoflavones, flavanones, flavonols, flavan-3-ols (flavanols), and anthocyanins. Despite the difference in their chemical structure, the members of the flavonoid family share the same flavan nucleus. The recent interest in flavonoids for exploring their role in various chronic ailments is probably their antiinflammatory and anti-oxidative properties mediated through various target molecules. Various flavonoid-containing products are available and marketed for topical and oral use. Flavonoids available in natural sources are subject to variable bioavailability when taken orally. To increase its oral bioavailability and water solubility, companies have introduced these formulations as microcapsules, nanoparticles, liposomes, cyclodextrin, and phospholipid inclusion complexes.[1] Quercetin (3,3′,4′,5,7-pentahydroxyflavone) is a flavonol that is the most common flavonoid which has been investigated in various pathologies in human and animal studies [Figure 1]. Quercetin is a member of bioflavonoids and is found in red wine, green tea and onions. It possesses potent free oxygen scavenging, antioxidant and anti-inflammatory properties. As an antioxidant, quercetin scavenges free radicals directly, chelates metal ions and inhibits lipid peroxidation. The antioxidant property demonstrated an increase if the concentration of quercetin used is more. Research has also demonstrated the anti-tumour properties of quercetin by preventing the cell cycle, promoting cell apoptosis and inhibiting angiogenesis.[2-4] Chemotherapy-induced peripheral neuropathy is a distressing condition that is difficult to manage. The use of quercetin provided favourable results in patients with platinum compounds and taxon-induced peripheral neuropathy in induced models and animal studies.[5] Several human and animal studies investigated the role of quercetin supplements in painful arthritis such as osteoarthritis and rheumatoid arthritis successfully. The plausible mechanisms responsible are cyclo-oxygenase 2 inhibition, reduction of tumour necrosis factor α, interleukin 1β and17, and monocyte chemoattractant protein-1 levels.[6] The neuropathic pain associated with diabetic neuropathy is difficult to treat even with a combination of medications. Flavonoid compounds could be the next possible agent which could relieve the suffering of these patients incessantly suffering from excruciating pain. The regular use of flavonoids has been shown to decrease the reactive oxygen species level by increasing the level of antioxidative enzymes such as glutathione peroxidase, reduced glutathione peroxidase and superoxide dismutase, glutathione reductase and catalase in various tissues such as the liver, sciatic nerve and brain of experimental ","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":"29 3","pages":"334-335"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/cd/IJPC-29-334.PMC10493683.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10244002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Addendum: Looking Ahead: Assured of a Vibrant Indian Association of Palliative Care to Lead the World of Palliative Care.","authors":"","doi":"10.25259/IJPC_149_2022_ER","DOIUrl":"10.25259/IJPC_149_2022_ER","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.25259/IJPC_149_2022.].</p>","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":"29 3","pages":"341"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/30/67/IJPC-29-341.PMC10493688.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dentists Role in Psychological Screening and Management of Head-and-neck Cancer Patients Undergoing Radiotherapy - Narrative Review.","authors":"A Srividya,&nbsp;Astha Chaudhry","doi":"10.25259/IJPC_47_2023","DOIUrl":"10.25259/IJPC_47_2023","url":null,"abstract":"<p><strong>Objectives: </strong>Head-and-neck cancer management primarily involves surgery and chemoradiotherapy. Recurrent radiotherapy (RT) sessions are often linked to social, physical, and psychological burdens. Oral physicians are part of the palliative care team and play a pivotal role in decimating the physical side effects associated with disease and its treatment. There is a need to familiarise dentists with the psychological aspect of the treatment.</p><p><strong>Material and methods: </strong>Various libraries were searched from the year 2012 to 2022. A total of nine studies that had head-and-neck RT patients exclusively were included in the study.</p><p><strong>Results: </strong>Anxiety and depression are patients' most prevalent psychological problems during and after the RT regimen. A few most used psychological screening tools were identified.</p><p><strong>Conclusion: </strong>Dental professionals are uneducated about the holistic approach to managing RT patients. The current narrative review details the various psychological screening tools and care measures that can be incorporated into the dental setup to help these patients.</p>","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":"29 3","pages":"250-255"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/89/IJPC-29-250.PMC10493684.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mapping of Influencing Factors in the Decision-Making of End-of-Life Care Patients: A Systematic Scoping Review.","authors":"Mauricio de Almeida Pereira da Silva,&nbsp;Carla Corradi-Perini","doi":"10.25259/IJPC_292_2022","DOIUrl":"10.25259/IJPC_292_2022","url":null,"abstract":"<p><p>Decisions in end-of-life care are influenced by several factors, many of which are not identified by the decision maker. These influencing factors modify important decisions in this scenario, such as in decisions to adapt to therapeutic support. This presented scoping review aims to map the factors that influence end-of-life care decisions for adult and older adult patients, by a scoping review. The review was carried out in 19 databases, with the keyword 'clinical decision-making' AND 'terminal care' OR 'end-of-life care' and its analogues, including publications from 2017 to 2022. The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. The search resulted in 3474 publications, where the presence of influencing factors in end-of-life decision-making for adults and the elderly was applied as a selection criterion. Fifty-four (54) of them were selected, which means 1.5% of all the results. Among the selected publications, 89 influencing factors were found, distributed in 54 (60.6%) factors related to the health team, 18 (20.2%) to patients, 10 (11.2%) related to family or surrogates and 7 (7.8%) factors related to the decision environment. In conclusion, we note that the decision-making in end-of-life care is complex, mainly because there is an interaction of different characters (health team, patient, family, or surrogates) with a plurality of influencing factors, associated with an environment of uncertainty and that result in a critical outcome, with a great repercussion for the end of life, making it imperative the recognition of these factors for more competent and safe decision-making.</p>","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":"29 3","pages":"234-242"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/65/6c/IJPC-29-234.PMC10493695.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10244000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Literature Review of Nurses Challenges and Barriers in Assisting Patients and Families Facing Breaking Bad News.","authors":"Surya Wahyuni,&nbsp;Made Satya Nugraha Gautama,&nbsp;Tiur Yulianta Simamora","doi":"10.25259/IJPC_128_2023","DOIUrl":"10.25259/IJPC_128_2023","url":null,"abstract":"<p><strong>Objectives: </strong>Breaking bad news (BBN) is a challenging task for healthcare professionals, including nurses. The manner in which bad news is delivered can have a significant impact on patients and their families, either positive or negative. Understanding the roles, methods, obstacles, and challenges that nurses face in the process of delivering bad news is crucial for improving the quality of the delivery process.</p><p><strong>Material and methods: </strong>This narrative review synthesises related studies. The search was conducted through PubMed, Scopus, ScienceDirect and Sage, with no restriction on publication year. The main keywords were 'nurse's challenge', 'nurse's barrier', 'bad news', 'breaking bad news', and 'communicating bad news.' A total of 12 articles were selected from 1075 articles.</p><p><strong>Results: </strong>Nurses play a key role in BBN before, during and after the process. Their activities include preparing patients to receive bad news, supporting patients and families when doctors deliver bad news and clarifying information obtained by patients and families regarding the prognosis of their illness. Nurses should possess skills such as building interpersonal relationships, therapeutic communication and providing emotional care for patients and their families. The main challenges and barriers for nurses in implementing BBN are due to a lack of skills and unpreparedness for patient and family reactions. After BBN, the most reported roles of nurses were supporting patients and families and helping them understand the information received from doctors. It is essential for nurses to have the necessary skills and preparedness to effectively deliver bad news to patients and their families.</p><p><strong>Conclusion: </strong>Nurses play a crucial role in delivering bad news to patients and their families. They should be equipped with the necessary skills to effectively communicate with patients and their families during this difficult time. Further training for nurses in therapeutic communication, emotional care for patients and their families, and building interpersonal relationships could help to improve the quality of the delivery process.</p>","PeriodicalId":13319,"journal":{"name":"Indian Journal of Palliative Care","volume":"29 3","pages":"243-249"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/26/IJPC-29-243.PMC10493690.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10240638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}