Current Opinion in Supportive and Palliative Care最新文献

Early palliative care and its impact on end of life care. 早期姑息关怀及其对生命末期关怀的影响。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000729

Dan Monnery, Joanne Droney

{"title":"Early palliative care and its impact on end of life care.","authors":"Dan Monnery, Joanne Droney","doi":"10.1097/SPC.0000000000000729","DOIUrl":"10.1097/SPC.0000000000000729","url":null,"abstract":"Purpose of review: The impacts of early palliative care for patients with advanced cancer are well described. This has led to endorsement of early palliative care, alongside cancer treatment, by leading cancer organisations. The aim of this review is to consider how best to adopt and integrate the learning from studies of early palliative care into an effective, sustainable service that is offered as part of routine cancer care.Recent findings: 'Timely', 'targeted' and 'precision' approaches have been proposed to ensure that limited palliative care resources are available to those who are most likely to benefit. Triage and referral based on individual patients' needs has been shown to be both efficient and effective. Standardised referral criteria and the use of tools to assess complexity may support equitable service development. A specialist multidisciplinary approach is a common factor underpinning successful integration between palliative care and oncology but does not negate the importance patient-centred considerations such as advance care planning, which can be facilitated by non-specialist teams.Summary: The challenge is no longer whether early palliative care should be provided, but how. Evidence-based strategies about how best to implement early palliative care are needed to inform appropriate resourcing, funding, and delivery.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to evaluate exertional breathlessness using normative reference equations in research. 如何在研究中使用常模参考方程评估用力呼吸困难。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000721

Magnus Ekström, Hayley Lewthwaite, Dennis Jensen

{"title":"How to evaluate exertional breathlessness using normative reference equations in research.","authors":"Magnus Ekström, Hayley Lewthwaite, Dennis Jensen","doi":"10.1097/SPC.0000000000000721","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000721","url":null,"abstract":"Purpose of review: Breathlessness is a common, distressing and limiting symptom in people with advanced disease, but is challenging to assess as the symptom intensity depends on the level of exertion (symptom stimulus) during the assessment. This review outlines how to use recently developed normative reference equations to evaluate breathlessness responses, accounting for level of exertion, for valid assessment in symptom research.Recent findings: Published normative reference equations are freely available to predict the breathlessness intensity response (on a 0-10 Borg scale) among healthy people after a 6-minute walking test (6MWT) or an incremental cycle cardiopulmonary exercise test (iCPET). The predicted normal values account for individual characteristics (including age, sex, height, and body mass) and level of exertion (walk distance for 6MWT; power output, oxygen uptake, or minute ventilation at any point during the iCPET). The equations can be used to (1) construct a matched healthy control dataset for a study; (2) determine how abnormal an individual's exertional breathlessness is compared with healthy controls; (3) identify abnormal exertional breathlessness (rating > upper limit of normal); and (4) validly compare exertional breathlessness levels across individuals and groups.Summary: Methods for standardized and valid assessment of exertional breathlessness have emerged for improved symptoms research.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bridging the care gap: radiation therapy in elderly and frail cancer patients. 缩小护理差距：年老体弱癌症患者的放射治疗。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000727

Caroline Hircock, Shing Fung Lee, Srinivas Raman, Elizabeth Chuk, Adrian W Chan, Edward Chow, Henry C Y Wong

{"title":"Bridging the care gap: radiation therapy in elderly and frail cancer patients.","authors":"Caroline Hircock, Shing Fung Lee, Srinivas Raman, Elizabeth Chuk, Adrian W Chan, Edward Chow, Henry C Y Wong","doi":"10.1097/SPC.0000000000000727","DOIUrl":"10.1097/SPC.0000000000000727","url":null,"abstract":"Purpose of review: This review aims to address the gap in radiation therapy (RT) care for elderly cancer patients. It will discuss the barriers to implementing effective RT in elderly and frail patients with a focus on breast cancer and metastatic settings.Recent findings: Recent studies indicate that SBRT provides better pain control for bone metastases compared to cEBRT, but elderly patients are underrepresented in these trials. Evidence on the effectiveness of geriatric assessment tools in predicting RT tolerance and toxicity is mixed, with some studies showing a correlation while others do not. Comprehensive geriatric assessments, though promising, are often impractical due to time and resource constraints.Summary: There is a critical need for more inclusive research to better understand the risks and benefits of RT in elderly patients. Developing streamlined geriatric assessment tools and integrating them into clinical practice can enhance treatment personalization. Future studies should prioritize elderly populations to generate robust data, thereby improving RT outcomes and quality of life for this growing patient group.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of caregivers being trained in assisting in end of life care - Latin American perspective. 接受培训的护理人员在协助临终关怀中的作用--拉丁美洲视角。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000730

Esther de Vries, José A Calvache, Sandra M Hernández Zambrano

{"title":"Role of caregivers being trained in assisting in end of life care - Latin American perspective.","authors":"Esther de Vries, José A Calvache, Sandra M Hernández Zambrano","doi":"10.1097/SPC.0000000000000730","DOIUrl":"10.1097/SPC.0000000000000730","url":null,"abstract":"Purpose of review: Palliative care in Latin America is evolving, but training for informal caregivers remains underexplored. This review summarizes recent interventions to educate or train caregivers in end-of-life care.Recent findings: The literature search identified three interventions published by 2023, two with reception evaluations, all with small sample sizes and no control groups. Needs of caregivers have been more frequently described and include training on aspects of the disease, nursing skills, how to handle patients´ and own emotions; help in navigating the complex healthcare systems in Latin America; help in conversations about the end of life and dying, still taboos in the region; help in finding additional caregivers or other types of support to make the caregiving role sustainable over time for the caregiver. Interventions mainly focused on emotional support and identifying additional caregivers without guilt; two included nursing skills training.Summary: There are very few formal interventions described and evaluated to assist caregivers in end-of-life care in Latin America described in the literature. This illustrates the rather invisible but very important role of these important stakeholders in the care for patients. Multidimensional interventions should be developed and evaluated to support caregivers.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of digital health interventions in supporting family caregivers for people with dementia to improve quality of life. 数字健康干预在支持痴呆症患者家庭护理人员提高生活质量方面的作用。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000734

Annabel Farnood, Bridget Johnston, Catherine Evans

{"title":"The role of digital health interventions in supporting family caregivers for people with dementia to improve quality of life.","authors":"Annabel Farnood, Bridget Johnston, Catherine Evans","doi":"10.1097/SPC.0000000000000734","DOIUrl":"10.1097/SPC.0000000000000734","url":null,"abstract":"Purpose of review: Dementia is a chronic progressive terminal condition. Most care is provided by family caregivers (including close friends); their wellbeing is a public health priority. Caregivers manage increasingly complex needs with disease progression, and declining cognitive and physical function. This can impact the well-being of caregivers, and meaningful support is essential. This review article aims to understand what the benefits and challenges of digital health interventions are and provide considerations for future development of digital health interventions for family caregivers for people with dementia, to improve quality of life.Recent findings: Benefits include the valuable source of support from connective platforms; 24/7 accessibility; and opportunity for remote monitoring. However, this needs to balance with challenges, including the privacy of data concerns; and the digital divide driving inequalities in care provision for family caregivers with no access to internet devices.Summary: Digital health interventions can positively impact the overall well-being of family caregivers for people with dementia. If challenges are addressed and digital health interventions are designed to meet priorities for family caregivers, this can help improve the quality of life for family caregivers of people with dementia.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Symptom management for people with advanced dementia who are receiving end of life care. 对接受临终关怀的晚期痴呆症患者进行症状管理。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000733

Maria Drummond, Bridget Johnston

{"title":"Symptom management for people with advanced dementia who are receiving end of life care.","authors":"Maria Drummond, Bridget Johnston","doi":"10.1097/SPC.0000000000000733","DOIUrl":"10.1097/SPC.0000000000000733","url":null,"abstract":"Purpose of review: This review aims to synthesise contemporary research on symptom management for people with advanced dementia who are thought to be in the final year of life. It highlights the unique challenges faced by palliative care and dementia care specialists, offering insights into the clinical decision-making required to support those with advanced dementia in various care settings.Recent findings: Recent studies indicate that people with advanced dementia often experience significant unmet palliative care needs, particularly regarding symptom management. Pain, breathlessness, and psychological distress are frequently mismanaged, which contributes to suboptimal care. Moreover, the unpredictable trajectory of dementia complicates the identification of end-of-life needs, which can result in fragmented care. Caregivers, both professional and family, struggle with managing complex symptoms, while family caregivers in home settings face added burdens in providing care without sufficient support.Summary: Palliative care for people with advanced dementia is currently inadequate due to a lack of tailored interventions, poor symptom management, and disjointed care systems. Enhancing training for caregivers, fostering interdisciplinary collaboration, and focusing on integrated care approaches across home and institutional settings are crucial to improving quality of life and symptom control for people with advanced dementia.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in breathlessness support services for people with serious illness. 为重症患者提供的呼吸困难支持服务取得进展。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000723

Naomi Takemura, Matthew Maddocks, Lisa Jane Brighton

{"title":"Advances in breathlessness support services for people with serious illness.","authors":"Naomi Takemura, Matthew Maddocks, Lisa Jane Brighton","doi":"10.1097/SPC.0000000000000723","DOIUrl":"10.1097/SPC.0000000000000723","url":null,"abstract":"Purpose of review: Breathlessness remains a common and distressing symptom among people with serious illness, particularly in advanced disease. This review synthesises recent advances in the development, characteristics, and outcomes of breathlessness support services.Recent findings: The expanding body of evidence regarding breathlessness support services has broadened and strengthened our understanding of clinical and cost-effectiveness. The expansion of these services, into diverse settings and including digital delivery, has augmented their reach and accessibility to a wider population. Additionally, there is increasing attention to the psychological aspects of breathlessness and its management, including the challenges of optimising breathlessness support services for long-term benefit.Summary: Recent studies have made substantial progress in enhancing our knowledge of breathlessness support services and their impact on people with serious illness. Innovations extending services into new countries and settings, including use of digital platforms for intervention delivery, plus increased recognition of psychological mechanisms, have the potential to support more people with serious illness to live as best as possible with breathlessness.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The gut microbiome and the brain. 肠道微生物群与大脑

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000717

Nadiia Rykalo, Lydia Riehl, Michaela Kress

{"title":"The gut microbiome and the brain.","authors":"Nadiia Rykalo, Lydia Riehl, Michaela Kress","doi":"10.1097/SPC.0000000000000717","DOIUrl":"10.1097/SPC.0000000000000717","url":null,"abstract":"Purpose of review: The importance of the gut microbiome for human health and well-being is generally accepted, and elucidating the signaling pathways between the gut microbiome and the host offers novel mechanistic insight into the (patho)physiology and multifaceted aspects of healthy aging and human brain functions.Recent findings: The gut microbiome is tightly linked with the nervous system, and gut microbiota are increasingly emerging as important regulators of emotional and cognitive performance. They send and receive signals for the bidirectional communication between gut and brain via immunological, neuroanatomical, and humoral pathways. The composition of the gut microbiota and the spectrum of metabolites and neurotransmitters that they release changes with increasing age, nutrition, hypoxia, and other pathological conditions. Changes in gut microbiota (dysbiosis) are associated with critical illnesses such as cancer, cardiovascular, and chronic kidney disease but also neurological, mental, and pain disorders, as well as chemotherapies and antibiotics affecting brain development and function.Summary: Dysbiosis and a concomitant imbalance of mediators are increasingly emerging both as causes and consequences of diseases affecting the brain. Understanding the microbiota's role in the pathogenesis of these disorders will have major clinical implications and offer new opportunities for therapeutic interventions.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Existential aspects of breathlessness in serious disease. 重症患者呼吸困难的生存问题。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000736

David Baglow, Kylie Johnston, Marie Williams

{"title":"Existential aspects of breathlessness in serious disease.","authors":"David Baglow, Kylie Johnston, Marie Williams","doi":"10.1097/SPC.0000000000000736","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000736","url":null,"abstract":"Purpose of the review: Breathlessness may evoke existential threat but may also affect the person with serious illness or their caregiver/s in other important ways which can be considered 'existential'. This review explores existential aspects of breathlessness in people with serious illness and presents recent studies of assessment and management of associated distress and suffering.Recent findings: Both existential distress and breathlessness are multidimensional and include a range of constructs, many of which have behavioural consequences. Existential distress tracks closely with distressing breathing potentially due to shared underlying neurobiological processing. Paradoxically 'contagious' and isolating effects of breathlessness and related distress have been recently highlighted. Approaches to screening and assessment vary. Preliminary studies have investigated novel approaches to breathing-related anxiety and existential distress.Summary: Studies with existential constructs as outcome measures in people with breathlessness are scarce. Interventions for existential distress developed for those with malignant disease may be beneficial for those with non-malignant conditions, but adaptations may be required. Recently proposed taxonomies of existential distress/concerns may guide assessment and direct novel therapeutic interventions in people living with serious illness and breathlessness-related distress. Neglecting existential aspects of breathlessness represents a missed opportunity to support holistic well-being in people with serious illness.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Palliative care for people with respiratory illness: challenges, new developments, and future perspectives. 呼吸系统疾病患者的姑息治疗：挑战、新发展和未来展望。

IF 1.9 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1097/SPC.0000000000000720

Daisy J A Janssen, Magnus Ekström

引用次数: 0