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Physicians' understandings and experience of advance care planning in Norwegian nursing homes: a qualitative study. 挪威养老院中医生对预先护理计划的理解和经验:一项定性研究。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2024-06-24 DOI: 10.1186/s12904-024-01481-9
Liv Ødbehr, Reidun Hov, Harald Sanaker, Åsa Serholt Jensen, Aina Korup, Tuva Sandsdalen
{"title":"Physicians' understandings and experience of advance care planning in Norwegian nursing homes: a qualitative study.","authors":"Liv Ødbehr, Reidun Hov, Harald Sanaker, Åsa Serholt Jensen, Aina Korup, Tuva Sandsdalen","doi":"10.1186/s12904-024-01481-9","DOIUrl":"10.1186/s12904-024-01481-9","url":null,"abstract":"<p><strong>Background: </strong>Advance care planning is a way of facilitating conversations with patients about future health care, values, and preferences at end of life. Nursing home physicians have the medical responsibility and the main obligation to facilitate planned meetings with patients. Although there has been a great deal of focus on establishing advance care planning in Norwegian nursing homes, it has yet to be widely implemented. Stated reasons are that the work routines in a nursing home do not include such meetings or that implementation seems complex due to frail patients. The aim of this study is thus to explore how physicians understand and experience advance care planning and follow-up of care plans in Norwegian nursing homes.</p><p><strong>Methods: </strong>The study has a qualitative research design with a phenomenological-hermeneutic approach based on interviews of twelve nursing home physicians working in community care. Interviews were conducted in February 2023 to May 2023, using a semi-structured interview guide. All interviews were recorded on audio files, transcribed, and analyzed using structural text analysis.</p><p><strong>Results: </strong>The findings are presented based on the following themes: (1) advance care planning is a dialog and a process, (2) advance care planning implies clarifying mutual expectations, and (3) advance care planning that brings relief and hope to patients is a medical art.</p><p><strong>Conclusions: </strong>Advance care planning is a complex and dynamic process that implies medical treatment, decisions on treatment level, pain relief, and formulation of care plans where the patient's self-determination and personal values are respected. It implies an ongoing dialogue between physicians, patients, and their relatives about values such as dignity, self-understanding, social relations, and existential questions at end of life. Advance care planning requires a holistic approach that meets patients' psychological and existential needs such as comfort, trust, hope, and respect as well as their preferences and concerns.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
End-of-life care needs in cancer patients: a qualitative study of patient and family experiences. 癌症患者的临终关怀需求:对患者和家属经历的定性研究。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2024-06-21 DOI: 10.1186/s12904-024-01489-1
Mario López-Salas, Antonio Yanes-Roldán, Ana Fernández, Ainhoa Marín, Ana I Martínez, Ana Monroy, José M Navarro, Marta Pino, Raquel Gómez, Saray Rodríguez, Sergio Garrido, Sonia Cousillas, Tatiana Navas, Víctor Lapeña, Belén Fernández
{"title":"End-of-life care needs in cancer patients: a qualitative study of patient and family experiences.","authors":"Mario López-Salas, Antonio Yanes-Roldán, Ana Fernández, Ainhoa Marín, Ana I Martínez, Ana Monroy, José M Navarro, Marta Pino, Raquel Gómez, Saray Rodríguez, Sergio Garrido, Sonia Cousillas, Tatiana Navas, Víctor Lapeña, Belén Fernández","doi":"10.1186/s12904-024-01489-1","DOIUrl":"10.1186/s12904-024-01489-1","url":null,"abstract":"<p><strong>Background: </strong>Cancer is a disease that transcends what is purely medical, profoundly affecting the day-to-day life of both patients and family members. Previous research has shown that the consequences of cancer are greatly aggravated in patients at the end of life, at a time when they must also grapple with numerous unmet needs. The main objective of this study was to obtain more in-depth insight into these needs, primarily in patients with end-stage cancer nearing death.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted in Spain with cancer patients at the end of life (n = 3) and their family members (n = 12). The findings from the interviews were analyzed using qualitative thematic analysis and a grounded theory approach.</p><p><strong>Results: </strong>Four major themes emerged from the interviews that explored the needs and concerns of patients with cancer at the end of life: (1) physical well-being (2) emotional well-being (3) social well-being and (4), needs relating to information and autonomous decision-making. The interviews also shed light on the specific needs of family members during this period, namely the difficulties of managing increased caregiver burden and maintaining a healthy work-life balance.</p><p><strong>Conclusions: </strong>A lack of support, information and transparency during a period of immense vulnerability makes the end-of-life experience even more difficult for patients with cancer. Our findings highlight the importance of developing a more in-depth understanding of the needs of this population, so that informed efforts can be made to improve palliative healthcare and implement more comprehensive care and support at the end of life.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility of an exercise-nutrition-psychology integrated rehabilitation model based on mobile health and virtual reality for cancer patients: a single-center, single-arm, prospective phase II study. 基于移动医疗和虚拟现实技术的癌症患者运动-营养-心理综合康复模式的可行性:单中心、单臂、前瞻性 II 期研究。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2024-06-20 DOI: 10.1186/s12904-024-01487-3
Yuan Qi, Mengjie Wang, Ya Xue, Jingyan Yue, Chunjian Qi, Weihu Shang, Weifen Meng, Wenyu Zhu, Xiaolin Pu, Dongqing Li, Hua Jiang
{"title":"Feasibility of an exercise-nutrition-psychology integrated rehabilitation model based on mobile health and virtual reality for cancer patients: a single-center, single-arm, prospective phase II study.","authors":"Yuan Qi, Mengjie Wang, Ya Xue, Jingyan Yue, Chunjian Qi, Weihu Shang, Weifen Meng, Wenyu Zhu, Xiaolin Pu, Dongqing Li, Hua Jiang","doi":"10.1186/s12904-024-01487-3","DOIUrl":"10.1186/s12904-024-01487-3","url":null,"abstract":"<p><strong>Objective: </strong>Explore the feasibility of a mobile health(mHealth) and virtual reality (VR) based nutrition-exercise-psychology integrated rehabilitation model in Chinese cancer patients.</p><p><strong>Methods: </strong>We recruited cancer patients in the Oncology department of the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from October 2022 to April 2023. The rehabilitation program was provided by a team of medical oncologists, dietitians, psychotherapists, and oncology specialist nurses. Participants received standard anti-cancer therapy and integrated intervention including hospitalized group-based exercise classes, at-home physical activity prescription, behavior change education, oral nutrition supplements, and psychological counseling. An effective intervention course includes two consecutive hospitalization and two periods of home-based rehabilitation (8 weeks). Access the feasibility as well as changes in aspects of physical, nutritional, and psychological status.</p><p><strong>Results: </strong>At the cutoff date of April 2023, the recruitment rate was 75% (123/165). 11.4%patients were lost to follow-up, and 3.25% withdrew halfway. Respectively, the completion rate of nutrition, exercise, and psychology were 85%,55%, and 63%. Nutrition interventions show the highest compliance. The parameters in nutrition, psychology, muscle mass, and quality of life after the rehabilitation showed significant improvements (P < .05). There was no significant statistical difference (P > .05) in handgrip strength and 6-minute walking speed.</p><p><strong>Conclusion: </strong>It is feasible to conduct mHealth and VR-based nutrition-exercise-psychology integrated rehabilitation model in Chinese cancer patients. A larger multi-center trial is warranted in the future.</p><p><strong>Trial registration: </strong>ChiCTR2200065748 Registered 14 November 2022.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving patients', carers' and primary care healthcare professionals' experiences of discharge communication from specialist palliative care to community settings: a protocol for a qualitative interview study. 改善患者、照护者和初级医疗保健专业人员从专科姑息关怀到社区环境的出院沟通体验:定性访谈研究协议。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2024-06-20 DOI: 10.1186/s12904-024-01451-1
Katharine Weetman, John I MacArtney, Catherine Grimley, Cara Bailey, Jeremy Dale
{"title":"Improving patients', carers' and primary care healthcare professionals' experiences of discharge communication from specialist palliative care to community settings: a protocol for a qualitative interview study.","authors":"Katharine Weetman, John I MacArtney, Catherine Grimley, Cara Bailey, Jeremy Dale","doi":"10.1186/s12904-024-01451-1","DOIUrl":"10.1186/s12904-024-01451-1","url":null,"abstract":"<p><strong>Background: </strong>Patients who have benefited from specialist intervention during periods of acute/complex palliative care needs often transition from specialist-to-primary care once such needs have been controlled. Effective communication between services is central to co-ordination of care to avoid the potential consequences of unmet needs, fragmented care, and poor patient and family experience. Discharge communications are a key component of care transitions. However, little is known about the experiences of those primarily receiving these communications, to include patients', carers' and primary care healthcare professionals. This study aims to have a better understanding of how the discharge communications from specialist palliative care services to primary care are experienced by patients, carers, and healthcare professionals, and how these communications might be improved to support effective patient-centred care.</p><p><strong>Methods: </strong>This is a 15-month qualitative study. We will interview 30 adult patients and carers and 15 healthcare professionals (n = 45). We will seek a range of experiences of discharge communication by using a maximum variation approach to sampling, including purposively recruiting people from a range of demographic backgrounds from 4-6 specialist palliative care services (hospitals and hospices) as well as 5-7 general practices. Interview data will be analysed using a reflexive thematic approach and will involve input from the research and advisory team. Working with clinicians, commissioners, and PPI representatives we will co-produce a list of recommendations for discharge communication from specialist palliative care.</p><p><strong>Discussion: </strong>Data collection may be limited by the need to be sensitive to participants' wellbeing needs. Study findings will be shared through academic publications and presentations. We will draft principles for how specialist palliative care clinicians can best communicate discharge with patients, carers, and primary care clinicians. These will be shared with clinicians, policy makers, commissioners, and PPI representatives and key stakeholders and organisations (e.g. Hospice UK) and on social media. Key outputs will be recommendations for a specialist palliative care discharge proforma.</p><p><strong>Trial registration: </strong>Registered in ISRCTN Registry on 29.12.2023 ref: ISRCTN18098027.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Report on palliative sedation medication usage: a survey of palliative care experts in Eight European countries. 关于姑息镇静药物使用情况的报告:对八个欧洲国家姑息关怀专家的调查。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2024-06-20 DOI: 10.1186/s12904-024-01484-6
Éva Pozsgai, Eduardo Garralda, Csilla Busa, Sheila Payne, Jeroen Hasselaar, Daniela Mosoiu, Séverine M Surges, Michaël Van der Elst, Sebastiano Mercadante, Carlos Centeno, Ágnes Csikós
{"title":"Report on palliative sedation medication usage: a survey of palliative care experts in Eight European countries.","authors":"Éva Pozsgai, Eduardo Garralda, Csilla Busa, Sheila Payne, Jeroen Hasselaar, Daniela Mosoiu, Séverine M Surges, Michaël Van der Elst, Sebastiano Mercadante, Carlos Centeno, Ágnes Csikós","doi":"10.1186/s12904-024-01484-6","DOIUrl":"10.1186/s12904-024-01484-6","url":null,"abstract":"<p><strong>Background: </strong>The practice of palliative sedation continues to raise ethical questions among people, which in turn leads to its varied acceptance and practice across regions. As part of the Palliative Sedation European Union (EU) project, the aim of the present study was to determine the perceptions of palliative care experts regarding the practice of palliative sedation in eight European countries (The Netherlands, Belgium, Germany, UK, Italy, Spain, Hungary, and Romania).</p><p><strong>Methods: </strong>A specifically designed survey, including questions on the most frequently used medications for palliative sedation, their availability per countries and settings, and the barriers and facilitators to the appropriate practice of palliative sedation was sent to expert clinicians involved and knowledgeable in palliative care in the indicated countries. A purposive sampling strategy was used to select at least 18 participating clinicians per consortium country. Descriptive statistical analysis was conducted on the survey data.</p><p><strong>Results: </strong>Of the 208 expert clinicians invited to participate, 124 participants completed the survey. Midazolam was perceived to be the most frequently used benzodiazepine in all eight countries. 86% and 89% of expert clinicians in Germany and Italy, respectively, perceived midazolam was used \"almost always\", while in Hungary and Romania only about 50% or less of the respondents perceived this. Levomepromazine was the neuroleptic most frequently perceived to be used for palliative sedation in the Netherlands, Spain, Germany, and the United Kingdom. Between 38- 86% of all eight countries´ expert clinicians believed that opioid medications were \"almost always\" used during palliative sedation. The perceived use of IV hydration and artificial nutrition \"almost always\" was generally low, while the country where both IV hydration and artificial nutrition were considered to be \"very often\" given by a third of the expert clinicians, was in Hungary, with 36% and 27%, respectively.</p><p><strong>Conclusions: </strong>Our study provides insight about the differences in the perceived practice of medication during palliative sedation between eight European countries. In countries where palliative care services have been established longer perceptions regarding medication use during palliative sedation were more in line with the recommended European guidelines than in Central and Eastern European countries like Romania and Hungary.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11188245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adapting the serious illness conversation guide for unhoused older adults: a rapid qualitative study. 为无住房的老年人改编重病谈话指南:一项快速定性研究。
IF 3.1 2区 医学
BMC Palliative Care Pub Date : 2024-06-17 DOI: 10.1186/s12904-024-01485-5
Abigail Latimer, Natalie D Pope, Chin-Yen Lin, JungHee Kang, Olivia Sasdi, Jia-Rong Wu, Debra K Moser, Terry Lennie
{"title":"Adapting the serious illness conversation guide for unhoused older adults: a rapid qualitative study.","authors":"Abigail Latimer, Natalie D Pope, Chin-Yen Lin, JungHee Kang, Olivia Sasdi, Jia-Rong Wu, Debra K Moser, Terry Lennie","doi":"10.1186/s12904-024-01485-5","DOIUrl":"10.1186/s12904-024-01485-5","url":null,"abstract":"<p><strong>Background: </strong>Older adults experiencing homelessness (OAEH) age quickly and die earlier than their housed counterparts. Illness-related decisions are best guided by patients' values, but healthcare and homelessness service providers need support in facilitating these discussions. The Serious Illness Conversation Guide (SICG) is a communication tool to guide discussions but has not yet been adapted for OAEH.</p><p><strong>Methods: </strong>We aimed to adapt the SICG for use with OAEH by nurses, social workers, and other homelessness service providers. We conducted semi-structured interviews with homelessness service providers and cognitive interviews with OAEH using the SICG. Service providers included nurses, social workers, or others working in homeless settings. OAEH were at least 50 years old and diagnosed with a serious illness. Interviews were conducted and audio recorded in shelters, transitional housing, a hospital, public spaces, and over Zoom. The research team reviewed transcripts, identifying common themes across transcripts and applying analytic notetaking. We summarized transcripts from each participant group, applying rapid qualitative analysis. For OAEH, data that referenced proposed adaptations or feedback about the SICG tool were grouped into two domains: \"SICG interpretation\" and \"SICG feedback\". For providers, we used domains from the Toolkit of Adaptation Approaches: \"collaborative working\", \"team\", \"endorsement\", \"materials\", \"messages\", and \"delivery\". Summaries were grouped into matrices to help visualize themes to inform adaptations. The adapted guide was then reviewed by expert palliative care clinicians for further refinement.</p><p><strong>Results: </strong>The final sample included 11 OAEH (45% Black, 61 ± 7 years old) and 10 providers (80% White, 8.9 ± years practice). Adaptation themes included changing words and phrases to (1) increase transparency about the purpose of the conversation, (2) promote OAEH autonomy and empowerment, (3) align with nurses' and social workers' scope of practice regarding facilitating diagnostic and prognostic awareness, and (4) be sensitive to the realities of fragmented healthcare. Responses also revealed training and implementation considerations.</p><p><strong>Conclusions: </strong>The adapted SICG is a promising clinical tool to aid in the delivery of serious illness conversations with OAEH. Future research should use this updated guide for implementation planning. Additional adaptations may be dependent on specific settings where the SICG will be delivered.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Health care providers' perspectives on the need for palliative care in Upper Egypt: a descriptive exploratory study including children and adult patients. 医疗服务提供者对上埃及姑息关怀需求的看法:一项包括儿童和成年患者在内的描述性探索研究。
IF 3.1 2区 医学
BMC Palliative Care Pub Date : 2024-06-15 DOI: 10.1186/s12904-024-01469-5
Atiat Osman, Savannah Gail Horvick, Nancy Dias
{"title":"Health care providers' perspectives on the need for palliative care in Upper Egypt: a descriptive exploratory study including children and adult patients.","authors":"Atiat Osman, Savannah Gail Horvick, Nancy Dias","doi":"10.1186/s12904-024-01469-5","DOIUrl":"10.1186/s12904-024-01469-5","url":null,"abstract":"<p><strong>Background: </strong>Only four centers in Egypt provide Palliative Care (PC) for adult cancer patients and one provides care for pediatric cancer patients. While PC is not widely utilized in Egypt, this study aims to assess patients' need for PC from the providers' perspective. The primary objectives were to assess providers' knowledge about PC, understand patients' needs, and compare children's and adults' needs for PC.</p><p><strong>Methods: </strong>A descriptive exploratory design was utilized. Patients were recruited from a cancer center in Qena Governorate, Egypt. All 108 nurses and physicians in the cancer center were interviewed to assess their perspectives about PC and patients' need for it.</p><p><strong>Results: </strong>Of the 108 care providers, more than 60% of the providers were not familiar with the concept of PC and did not participate in related activities, and more than 77% did not receive any training on the topic. All the providers reported there is no specific policy for end-of-life care. More than 60% of the providers responded that their patients do not need PC as the providers believe that PC provided only for end-stage patients. 50% of the providers see that PC has benefits such as pain relief and symptom management. No major differences were noted between pediatric and adult PC needs.</p><p><strong>Conclusion: </strong>The results of this study provide foundational evidence of providers' lack of experience with and understanding of palliative care. This deficit is creating a barrier to providing palliative care in Egypt.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141328010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of fentanyl buccal soluble film in cancer patients with inadequate breakthrough pain control. 芬太尼口腔可溶性膜对突破性疼痛控制不足的癌症患者的疗效。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2024-06-14 DOI: 10.1186/s12904-024-01483-7
Yi-Hao Chiang, Ching-Ting Lien, Wen-Hao Su, Tsung-Yu Yen, Yu-Jen Chen, Yuen-Liang Lai, Ken-Hong Lim, Kun-Yao Dai, Hsin-Pei Chung, Chia-Yen Hung, Yi-Shing Leu
{"title":"Effectiveness of fentanyl buccal soluble film in cancer patients with inadequate breakthrough pain control.","authors":"Yi-Hao Chiang, Ching-Ting Lien, Wen-Hao Su, Tsung-Yu Yen, Yu-Jen Chen, Yuen-Liang Lai, Ken-Hong Lim, Kun-Yao Dai, Hsin-Pei Chung, Chia-Yen Hung, Yi-Shing Leu","doi":"10.1186/s12904-024-01483-7","DOIUrl":"10.1186/s12904-024-01483-7","url":null,"abstract":"<p><strong>Background: </strong>Clinical evidence for the rapidity and effectiveness of fentanyl buccal soluble film (FBSF) in reducing pain intensity of breakthrough cancer pain (BTcP) remains inadequate. This study aimed to evaluate the efficacy of FBSF proportional to the around-the-clock (ATC) opioid regimens in rapidly relieving the intensity of BTcP episodes by determining the percentage of patients requiring further dose titration.</p><p><strong>Methods: </strong>The study procedure included a dose-finding period followed by a 14-day observation period. Pain intensity was recorded with a Numeric Rating Scale (NRS) at onset and 5, 10, 15, and 30 min after FBSF self-administration. Meaningful pain relief was defined as the final NRS score ≤ 3. Satisfaction survey was conducted for each patient after treatment using the Global Satisfaction Scale.</p><p><strong>Results: </strong>A total of 63 BTcP episodes occurred in 30 cancer patients. Only one patient required rescue medication at first BTcP episode and then achieved meaningful pain relief after titrating FBSF by 200 µg. Most BTcP episodes relieved within 10 min. Of 63 BTcP episodes, 30 (47.6%), 46 (73.0%), and 53 (84.1%) relieved within 5, 10, and 15 min after FBSF administration. Only grade 1/2 adverse events were reported, including somnolence, malaise, and dizziness. Of the 63 BTcP episodes, 82.6% were rated as excellent/good satisfaction with FBSF.</p><p><strong>Conclusion: </strong>FBSF can be administrated \"on demand\" by cancer patients at the onset of BTcP, providing rapid analgesia by achieving meaningful pain relief within 10 min.</p><p><strong>Trial registration: </strong>This study was retrospectively registered 24 December, 2021 at Clinicaltrial.gov (NCT05209906): https://clinicaltrials.gov/study/NCT05209906 .</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11177451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Small Steps, Big Vision: using multi-stage qualitative research to develop a grab-and-go guide to support utilisation of the Ambitions for Palliative and End of Life Care framework. 小步骤,大视野:利用多阶段定性研究,制定一份随手可得的指南,以支持姑息关怀和生命末期关怀目标框架的使用。
IF 3.1 2区 医学
BMC Palliative Care Pub Date : 2024-06-14 DOI: 10.1186/s12904-024-01466-8
Erica Borgstrom, Joanne Jordan, Una St Ledger, Claire Henry
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引用次数: 0
Palliative care education in undergraduate medical and nursing programs in Colombia: a cross-sectional analysis. 哥伦比亚医学和护理本科课程中的姑息关怀教育:横断面分析。
IF 3.1 2区 医学
BMC Palliative Care Pub Date : 2024-06-13 DOI: 10.1186/s12904-024-01477-5
Miguel Antonio Sánchez-Cárdenas, Camila Andrea Navarro Tibaquirá, Nidia Mantilla-Manosalva, David Andrade Fonseca, Alexandra Marin Morales, Martha Ximena León Delgado
{"title":"Palliative care education in undergraduate medical and nursing programs in Colombia: a cross-sectional analysis.","authors":"Miguel Antonio Sánchez-Cárdenas, Camila Andrea Navarro Tibaquirá, Nidia Mantilla-Manosalva, David Andrade Fonseca, Alexandra Marin Morales, Martha Ximena León Delgado","doi":"10.1186/s12904-024-01477-5","DOIUrl":"10.1186/s12904-024-01477-5","url":null,"abstract":"<p><strong>Background: </strong>The number of people suffering from chronic diseases requiring palliative care (PC) is increasing rapidly. Therefore, PC teaching in undergraduate health science programs is necessary to improve primary PC based on international recommendations and available scientific evidence.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted. Active undergraduate medical and nursing programs that were approved by the Colombian Ministry of Education and integrated PC teaching into their curricula were included in the study. The total sample consisted of 48 programs: 31 nursing and 17 medical programs.</p><p><strong>Results: </strong>PC competencies are distributed throughout the curriculum in 41.67% of programs, in elective courses in 31.25%, and in mandatory courses in 27.08% of the programs. The average PC teaching hours is 81 for nursing and 57.6 for medicine. PC clinical rotations are not offered in 75% of the programs. For undergraduate nursing programs, the most frequent competencies taught are the definition and history of PC and identifying common symptoms associated with advanced disease. In undergraduate medicine, the most common competencies are pharmacological and non-pharmacological pain management and identification of PC needs.</p><p><strong>Conclusions: </strong>PC teaching in undergraduate health science programs mainly addresses the conceptual and theoretical aspects of PC, which are part of the competencies present throughout the programs' curricula. Low availability of PC clinical rotations was identified. Future studies should assess whether the low availability of clinical rotations in PC limits the ability of students to develop the practical competencies necessary to provide quality PC.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11170879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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