Palliative Medicine in Practice最新文献

{"title":"Chronic pain evaluation in breast cancer patients using the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS): a single center cross-sectional retrospective study","authors":"Dhiraj Daga, N. S. Shah, Sanchit Jain, Gaurav Sharma, Harsh Goel, Sooyun Tavolacci, Boski Gupta, Kiran Gulia, Tabish H Khan, Darksha Usmani, Akash Gujral, Naoshad Muhammad, Sandeep Mittan, Poonam Banthia","doi":"10.5603/pmpi.a2023.0027","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0027","url":null,"abstract":"Background: Breast cancer is the most common cancer in India, and the number of survivors has increased over the last few years. Pain is one of the most common symptoms during cancer treatment due to either the disease itself or adverse effects of treatment. The available data suggests that breast cancer patients have a high prevalence of neuropathic pain. Patients and methods: A cross sectional observational study was done at the Department of Radiation Oncology, between November 2021 to June 2022. The patients were admitted and screened for participation, non-metastatic post operative breast cancer on regular follow up for 2 years after their last chemotherapy or radiotherapy and not having any chronic neuropathy disease and the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale was used to assess the neuropathy pain status of patients. Patients’ demographics, clinical characteristics, and treatment of surgery, radiation therapy, and chemotherapy were collected and the comparison of the pain score between the patients was analysed. Results: Total of 149 patients were included in the study. S-LANSS score was calculated in the study population and more than 61% of participants reported a score equal or greater than 12, suggesting a predominant neuropathic pain component. Autonomic dysfunction, thermal pain, and allodynia were more prevalent in patients who underwent mastectomies compared to breast-conserving surgery. Whereas the dysesthesia and autonomic dysfunction score was higher in only the anthracycline group. Conclusions: The most important index for quality of life in cancer patients is the presence of persistent chronic pain and it is important to classify it accordingly in order to provide the best management. Using the S-LANSS score, the pattern of neuropathic pain can be determined early which leads to early intervention.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139359999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of hippocampal sparing during prophylactic cranial irradiation on the preservation of neurocognitive functions in patients with small cell lung cancer: a preliminary study","authors":"Karolina Loga, Bartosz Wójcik, Anna Stanisławek, A. Papis-Ubych, Jacek Fijuth, L. Gottwald","doi":"10.5603/pmpi.a2023.0021","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0021","url":null,"abstract":"Background: Prophylactic cerebral irradiation (PCI) is the standard of care for patients with limited small cell lung cancer (SCLC). Cerebral irradiation is associated with the deterioration of the quality of life in terms of cognitive function, in which the hippocampus plays a critical role. Protection of the hippocampus during PCI aims to reduce the adverse effects of ionizing radiation on neurocognitive function, which may be important for optimal quality of life. To date, subjective psychological tests have been used as a methodical assessment of cognitive function in patients after PCI","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-pharmacological methods of treating depression in elderly are effective and not toxic: a minireview","authors":"Mateusz Kalita, Zbigniew Żylicz","doi":"10.5603/pmpi.a2023.0026","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0026","url":null,"abstract":"Psychological depression is a frequent disorder still underdiagnosed and untreated in elderly. It is treated like something that belongs to the last phase of life. Depression is known to compromise quality of life near death. Pharmacological therapy is not always possible in this group because of frequent adverse effects and interactions with other drugs used and limited time until death. Beside pharmacological therapy there are many non-toxic non pharmacological therapies, more suitable for this population. These therapies, like cognitive behavioral therapy or mindfulness meditation therapy as well as many other are confirmed to be effective and safe in this population. Some of these therapies are suitable for the patients who are cognitively impaired.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons learned from self-efficacy of healthcare professionals for advance care planning","authors":"V. Tripodoro, María Stella Di Gennaro, Julia Fila, Verónica Inés Veloso, Celeste Quiroga, Cristina Lasmarías Martínez","doi":"10.5603/pmpi.a2023.0024","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0024","url":null,"abstract":"Background: Advance care planning (ACP) is a reflective, deliberative, and structured process based on dialogue and free agreement between the person concerned and healthcare professionals. Argentina has no national ACP program or systematic approach for patients diagnosed with advanced chronic disease. Healthcare providers who treat these patients highlight some main obstacles in initiating the ACP process. Perceived self-efficacy is one of the main predictors of success in learning processes and promotes the acquisition of new behaviours and positive results in implementing ACP. We aimed to sensitise professionals and explore their self-efficacy for ACP before specific training. Participants and methods: This exploratory, prospective, descriptive study used the self-efficacy ACP-SEs scale already validated in Argentina. We surveyed 236 healthcare professionals (n 125 physicians/n 111 non-physicians) before specific training courses (2019–2021). Results: Participants’ experience, training needs, and practices. Most respondents were females (43 years old). Non-physicians (n 111) were 40 nurses, 32 psychologists, 16 social workers, 15 physiotherapists, and 8 other health backgrounds. Over 50% had 5–20 years of professional and primary care experience. When comparing professions, half of the physicians increased by up to 5.23 points higher on the self-efficacy scale than non-physicians. Most participants had no personal advance directives and neither helped a relative nor a patient sign a document. Half of the participants had previously undergone training. Half of the professionals who had done ACP significantly increased their value on the scale by up to 7.5 points more than those who did not. Differences between physicians and non-physicians revealed areas of improvement involving communication skills, roles and tasks, and legal issues. Conclusions: Healthcare providers' skills improve with experience and require training to increase self-efficacy. Our findings should encourage tailor-made training programs in the future. One of the goals of this study was to spark discussions before specific training courses and develop appropriate teaching methods based on perceived self-efficacy in Argentina.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiology and management of opioid-induced constipation: a narrative review","authors":"Jakub Kobiałka, Bartłomiej Ludwig, Anna Dziekiewicz, Joanna Bystron","doi":"10.5603/pmpi.a2023.0025","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0025","url":null,"abstract":"","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139362120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood transfusions in palliative care: a method to improve quality of life or a double-edged sword? A mini-review","authors":"Martyna Bukała, Zbigniew Żylicz","doi":"10.5603/pmpi.a2023.0023","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0023","url":null,"abstract":"Blood transfusions are uncommon in the palliative care setting. There are no guidelines to make decisions about blood transfusions in palliative care. Certainly, these decisions cannot be made basing on the hemoglobin level only. Occasionally the issue of blood transfusion is being discussed with the family. Instead of being a bridge to recovery and self-sufficiency of the bone marrow, like non-palliative medicine, blood transfusions are appreciated as buying some quality time for the patient. However, this issue is questionable in the light of available data and experience. Blood transfusion can boost the patient’s energy for days or a week, but it can also have more adverse effects including re-bleeding and unexplained death. Controlled data on this subject are absent. In the discussions on blood transfusions with the patients and their families these aspects should not be forgotten. Blood transfusions remain, not without reason a rare but possible procedure in palliative care.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"167 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139362379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative, supportive, and hospice care: current challenges in medical education","authors":"Wojciech Leppert","doi":"10.5603/pmpi.2023.0016","DOIUrl":"https://doi.org/10.5603/pmpi.2023.0016","url":null,"abstract":"","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"242 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136365951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessibility and challenges of perinatal palliative care in Poland","authors":"Urszula Tataj-Puzyna, Beata Szlendak, Izabela Kaptacz, Dorota Sys, Maria Węgrzynowska, Barbara Baranowska","doi":"10.5603/pmpi.a2023.0015","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0015","url":null,"abstract":"Introduction: This article examines the legal status and level of accessibility to perinatal palliative care (PPC) in Poland, with a focus on the number of services provided and the number of parents receiving PPC services. Material and methods: The desk research was based on information obtained from the National Health Fund regarding the number of units that signed a contract for the provision of guaranteed PPC services from 2018 to the first half (January–June) of 2022; the number of parents receiving the service from 2018 to 2022; and the number of services provided by a doctor, a psychologist and by primary care midwives (PCMs). In addition, the Map of Health Needs and National Transformation Plan data were used to prepare the data. Results: In Poland, since 2018, PPC services have been provided with public funds under contracts signed with the National Health Fund. Since 2022, these type of services has been provided by 17 centres. Care was provided to 1,860 pregnant women diagnosed with lethal foetal anomaly and to four fathers. There are still voivodeships in which there is a lack of provision of PPC services that are financed from the state budget. Conclusions: In Poland, there is no full accessibility to publicly funded PPC in every voivodeship. The lack of a sufficient number of PPC centres and the lack of a uniform national standard of practice for this type of care — provided in hospices, hospitals and home settings — prevents women from having continuity of professional perinatal care. There is a need to ensure the quality of the services provided and make progress towards the employment of midwives in PPC facilities by service providers to ensure that women receive obstetric care from the moment of an adverse diagnosis, professional preparation for childbirth and the postnatal period.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136365954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual care competence and caring abilities among Polish nurses: a correlation descriptive study","authors":"Michał Machul, Beata Dobrowolska","doi":"10.5603/pmpi.a2023.0022","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0022","url":null,"abstract":"Background: Spiritual care is an obligatory aspect of nursing care for a patient at the end of life and play an important role in providing quality nursing care. The aim of this study was to describe level of spiritual care competence and caring abilities of Polish nurses, and to examine the relationship between them. Participants and methods: In the study based on the Caring Ability Inventory (CAI) and the Spiritual Care Competence Scale (SCCS) questionnaires descriptive, correlational, cross-sectional design was adopted. The study involved 451 clinical nurses. Results: Respondents’ overall score of SCCS was high (median = 101.22; mean = 103.00; SD = 17.14) and low in the overall score of CAI (median = 185.44; mean = 185.00; SD = 21.05). The respondents who believe that nurses should assess the patient’s spiritual needs obtained statistically higher scores in all subscales and the overall score of SCCS and CAI. The total score of spiritual care competence was also positively correlated with the level of caring abilities (p < 0.01). The caring abilities and competences to provide spiritual care of Polish nurses correlate, among others, with their age, professional experience, level of education and job satisfaction. Conclusions: The implementation by academic teachers and nursing managers of strategies promoting patient-centred nursing care and humanistic values will contribute to strengthening the caring abilities of nurses and the skills to provide spiritual care to patients especially in the most basic human experience of dying.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135154777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visitation policies at palliative care units and stationary hospices during COVID-19 pandemic: a literature review","authors":"Filip Lebiedziński, Kacper Wilczkowski, Jan Getek, Leszek Pawłowski","doi":"10.5603/pmpi.a2023.0019","DOIUrl":"https://doi.org/10.5603/pmpi.a2023.0019","url":null,"abstract":"Background: The COVID-19 pandemic has significantly affected the ability of relatives and friends to accompany patients. Medical facilities have taken measures to limit or prohibit direct contact in proportion to the epidemic risk while respecting the integral healthcare component of relatives’ participation in the therapeutic process. New challenges have also arisen in specialized palliative care units, where the family plays a key role in providing support and comfort to patients with advanced illness, especially at the end of life. This review aims to explore visitation policies in palliative care settings during the COVID-19 pandemic. Patients and methods: PubMed, SCOPUS and Web of Science (WoS) were reviewed using iteratively selected keywords (visiting policy AND palliative care AND COVID-19) to identify visiting policies in specialist palliative care settings. Results: The presence of relatives and their direct participation in inpatient palliative care have been significantly reduced or completely excluded. Several units have established specific visiting policies designed to prevent patients, staff and visiting relatives from acquiring the infection. The rules included obligatory personal protective equipment, limiting the duration of visits and the number of permitted guests, as well as allowing only visitors that had been vaccinated against COVID-19. To mitigate the harm caused by the restrictions, new means of remote contact such as video calls through teleconferencing platforms have been introduced or expanded. Conclusions: Delving into solutions facilitating contact between relatives and patients, implemented in inpatient palliative care units during the COVID-19 pandemic may serve to identify and establish model solutions for managing similar scenarios in the future.","PeriodicalId":19965,"journal":{"name":"Palliative Medicine in Practice","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135916603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}