Journal of Palliative Care最新文献_第5页

Initiating Prognostic Talk During Hospice Multidisciplinary Team Meetings: A Conversation Analytic Study. 在安宁疗护多学科团队会议期间启动预后谈话：对话分析研究。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-04-01 Epub Date: 2024-11-14 DOI: 10.1177/08258597241286347

Andrea Bruun, Nicola White, Linda Oostendorp, Patrick Stone, Steven Bloch

{"title":"Initiating Prognostic Talk During Hospice Multidisciplinary Team Meetings: A Conversation Analytic Study.","authors":"Andrea Bruun, Nicola White, Linda Oostendorp, Patrick Stone, Steven Bloch","doi":"10.1177/08258597241286347","DOIUrl":"10.1177/08258597241286347","url":null,"abstract":"Objective: Guidelines recommend that patients' prognoses should be discussed by the palliative care multidisciplinary team. However, there is a lack of evidence on how multidisciplinary teams carry out prognostic discussions, and especially how prognostic talk is initiated during team meetings. This study explored how prognostic talk is initiated and responded to during meetings of a hospice multidisciplinary team. Methods: Video-recordings of 24 inpatient multidisciplinary team meetings in a UK hospice were collected from May to December 2021. A total of 65 multidisciplinary team members participated in the meetings. Recordings were transcribed and analysed using Conversation Analysis. Results: Prognostic talk was initiated during multidisciplinary team members' patient case presentations. Case presentations followed a certain template, and prognoses could be initiated as responses to template items such as the patient's Phase of Illness and Karnofsky's Performance Status score and the patient's main diagnosis and issues. Prognoses also occurred as accounts for a lack of template item responses. Beyond the patient case presentation, prognostic talk was initiated in relation to discharge planning. Prognoses appeared with sequences of assessments that accounted for them. When a prognosis was provided, it received confirming minimal responses from other team members. Conclusions: Patients' prognoses were embedded into other care discussions during meetings of a hospice multidisciplinary team. These findings can be used to inform the development of clinical guidelines and interventions aiming at improving multidisciplinary team discussions around prognosis in the future.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"183-189"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Adherence to Patients' Preferences for Levels of Life-Sustaining Treatment: A 2-Year Follow-Up Study. 坚持患者对维持生命治疗水平的偏好：一项2年随访研究。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-03-28 DOI: 10.1177/08258597251329842

Mette A Smith, Anne C Brøchner, Helene K Nedergaard, Hanne I Jensen

{"title":"Adherence to Patients' Preferences for Levels of Life-Sustaining Treatment: A 2-Year Follow-Up Study.","authors":"Mette A Smith, Anne C Brøchner, Helene K Nedergaard, Hanne I Jensen","doi":"10.1177/08258597251329842","DOIUrl":"https://doi.org/10.1177/08258597251329842","url":null,"abstract":"ObjectiveThere is increasing interest in advance care planning (ACP) and the implementation of various forms of ACP. The purpose of ACP is to define patients' goals and preferences for future medical treatment and care for patients nearing the end of life (EOL). The aim of this study was to investigate adherence to patients' preferences for levels of life-sustaining treatment in emergency situations, as documented in a Danish POLST (Physician Orders for Life-Sustaining Treatment) form.MethodsA retrospective journal review was conducted 2 years after the conversation with the patients about their wishes for treatment and care at EOL. Medical records included electronic hospital records, nursing home records, and general practice records. Patients were assessed nearing EOL and included in the study based on a negative response to the \"surprise.\"ResultsA total of 120 patients and nursing home residents were included in the study. Overall, there were 2148 contacts with the healthcare system, of which 31 were emergency situations, where the patients were not capable of expressing their own wishes. In 4 contacts (12%), the patients (4) received treatment discordant with their wishes, as documented in the POLST form (and medical record).ConclusionsOur study shows that patients assessed nearing EOL are a patient group with many contacts with the healthcare system, and the results indicate that having had an ACP conversation and the wishes documented is useful to avoid unwanted treatment in emergency situations.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251329842"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732911","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

Intrinsic Gratitude's Impact on Professional Trajectory: A Qualitative Interview Study With Palliative Care Team Members. 内在感恩对职业轨迹的影响：对缓和疗护团队成员的质性访谈研究。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-03-18 DOI: 10.1177/08258597251326760

Hui-Ching Weng, Wei-Shu Lai, Duan-Rung Chen

{"title":"Intrinsic Gratitude's Impact on Professional Trajectory: A Qualitative Interview Study With Palliative Care Team Members.","authors":"Hui-Ching Weng, Wei-Shu Lai, Duan-Rung Chen","doi":"10.1177/08258597251326760","DOIUrl":"https://doi.org/10.1177/08258597251326760","url":null,"abstract":"ObjectivesPalliative care is emotionally demanding, yet extrinsic gratitude can improve job satisfaction. While intrinsic gratitude is effective in preventing burnout, the focus of existing research is mainly on extrinsic gratitude received by clinicians. This study aims to examine the role of intrinsic gratitude in clinicians within the emotionally demanding field of palliative care, assessing its impact on professional development and potential for broader community benefit.MethodsUtilizing purposive sampling, we recruited a diverse group of palliative care professionals from 10 hospitals, focusing on full-time staff with at least two years of experience in palliative care. Of the 23 clinicians, 12 (five physicians, six nurses, and one social worker) were recruited because they spontaneously expressed profound gratitude toward others.ResultsTwelve of twenty-three clinicians maintained a positive outlook despite the inherent challenges of their field. Intrinsic gratitude, especially toward team members like nurses, emerged as a pivotal support mechanism. Through its transformative dimensions of empathic engagement, self-elevation, and humility, this gratitude strengthened their professional resilience and trajectory and had a ripple effect on their personal lives, influencing familial relationships and broader societal interactions.ConclusionsThis is the first research focusing on clinicians' spontaneous expressions of gratitude. This study provides new insights into understanding the clinicians' intrinsic gratitude, its impact on their professional trajectory, and harnessing its potential benefits for broader community outreach. Through a reflective process incorporating gratitude, clinicians may be empowered to develop their self-coping mechanisms and nurture inner resilience while caring.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251326760"},"PeriodicalIF":1.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659728","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

Electronic Health Records and Family Satisfaction in the ICU: Communication, Care Processes, and Decision-Making. ICU的电子健康记录和家庭满意度：沟通、护理过程和决策。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-02-24 DOI: 10.1177/08258597251320713

Vivian Wuerges de Aquino, Kawoana Trautman Vianna, Marcio Manozzo Boniatti, Mellina da Silva Terres

{"title":"Electronic Health Records and Family Satisfaction in the ICU: Communication, Care Processes, and Decision-Making.","authors":"Vivian Wuerges de Aquino, Kawoana Trautman Vianna, Marcio Manozzo Boniatti, Mellina da Silva Terres","doi":"10.1177/08258597251320713","DOIUrl":"https://doi.org/10.1177/08258597251320713","url":null,"abstract":"Objectives: To evaluate electronic health records and explore associations with the satisfaction of families of critically ill patients. Methods: Exploratory cohort study. Included 94 patients with severe chronic illnesses or chronic critical illness who were admitted to the ICU and their family members. Family satisfaction was assessed using the Family Satisfaction ICU (FS-ICU 24) questionnaire, through the FS-ICU Care score (perception of care itself), FS-ICU Decision Making score (perception of decision-making), and FS-ICU Total score, and queried about the use of a room suitable for communication. Electronic health records were analyzed for elements of communication with family members, care processes, and decision-making. Results: The scores were FS-ICU Care 91.1 (76.8-98.0), FS-ICU DM 90.0 (77.5-97.5), and FS-ICU total 90.7 (78.0-97.0). In 17 (18.1%) of the medical records, there was a documented family meeting within the first 72 hours, and in 9.6%, there was documentation of communication about functionality, wishes and values, and consultation for palliative care. The use of a suitable room for communication was reported as \"never\" or \"rarely\" by 45 (47.8%) of the family members. There was a trend towards greater satisfaction with social support and lower satisfaction among family members of deceased patients, with 9 (25.8%) of these family members feeling that the patient was uncomfortable before death, and the records of meetings and communication of poor prognosis were associated with a lower perception of discomfort (P < .05). Conclusions: The satisfaction of family members of critically ill patients was high and was not significantly associated with the documentation deficiencies found. Deficiencies in communication appear to have influenced the perception of family members. Various perspectives are necessary for analyzing the care provided to patients and families in the ICU.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251320713"},"PeriodicalIF":1.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494694","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 Effect of Life Activity Levels of Palliative Care Patients on the Caregivers' Perception of Caregivers Burden. 姑息治疗患者生活活动水平对照顾者负担感知的影响。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-01-15 DOI: 10.1177/08258597241309728

Elif Tuğba Uygun, Aylin Özakgül

{"title":"The Effect of Life Activity Levels of Palliative Care Patients on the Caregivers' Perception of Caregivers Burden.","authors":"Elif Tuğba Uygun, Aylin Özakgül","doi":"10.1177/08258597241309728","DOIUrl":"https://doi.org/10.1177/08258597241309728","url":null,"abstract":"Objective(s): Studies show the effects of dependent patients' caregivers on the caregiving burden. Knowing the effects of maintenance of movement, especially in life activities, on the factors affecting the caregiving burden is important for the quality of care, ensuring that the caregiver's capacity is preserved. Methods: This descriptive and cross-sectional study research was carried out to determine the effect of life activity levels of palliative care patients on the care burden of caregivers. The number of individuals to be sampled was calculated according to the sample formula with a known population. The sample of the consisted of 108 patients and their caregivers in a district state hospital between June and December 2022. Data were collected using the Barthel Index of Patient Activities of Daily Living (ADL) and Caregiver Burden Scale. Descriptive statistical methods, quantitative data analyses, and correlation analyses were used in the analysis of the data. Results: The average age for patient was 78.13 ± 10.25 and for caregivers was 54.64 ± 13.22 years. Barthel ADL Index score of the patients was 35.05, and 38% of the patients were completely dependent. Caregiver Burden Scale scores was 50.80, and 76.8% of the caregivers had moderate caregiver burden. Patients with increasing age, with diabetes mellitus and dementia diagnosis, not using glasses, or having urinary catheters and gastrostomy tubes had lower activity levels. The caregiver burden of caregivers was higher in those who spent 3 to 4 h for daily patient care, who had sleep problems, who thought that their health deteriorated compared to those who did not. It was determined that as the patients' ability to perform their daily activities decreased, the caregiver burden increased (r = -0.417; P < .01). Conclusions: It might be recommended that nurses can implement the nursing interventions completely and severely dependent patients' caregivers psychological and social support.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597241309728"},"PeriodicalIF":1.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015458","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 Consultation in the Intensive Care Unit Reduces Hospital Costs: A Cost-Analysis. 重症监护室的姑息治疗咨询降低了医院成本：成本分析。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-01-01 Epub Date: 2022-04-26 DOI: 10.1177/08258597221095986

Tong Han Chung, Linh K Nguyen, Lincy S Lal, J Michael Swint, Yen-Chi L Le, Kathleen R Hanley, Efrain Siller, Cheryl M Chanaud

{"title":"Palliative Care Consultation in the Intensive Care Unit Reduces Hospital Costs: A Cost-Analysis.","authors":"Tong Han Chung, Linh K Nguyen, Lincy S Lal, J Michael Swint, Yen-Chi L Le, Kathleen R Hanley, Efrain Siller, Cheryl M Chanaud","doi":"10.1177/08258597221095986","DOIUrl":"10.1177/08258597221095986","url":null,"abstract":"Background: Palliative care aims to improve or maintain quality of life for patients with life-limiting or life-threatening diseases. Limited research shows that palliative care is associated with reduced intensive care unit length of stay and use of high-cost resources.Methods: This was an observational, non-experimental comparison group study on all patients 18 years or older admitted to any intensive care unit (ICU) at Memorial Hermann - Texas Medical Center for 7 to 30 days from August 2013 to December 2015. Length of stay (LOS) and hospital costs were compared between the treatment group of patients with palliative care in the ICU and the control group of patients with usual care in the ICU. To adjust for confounding of the palliative care consultation on LOS and hospital cost, an inverse probability of treatment weighted method was conducted. Generalized linear models using gamma distribution and log link were estimated. All costs were converted to 2015 US dollars.Results: Mean LOS was 13 days and mean total hospital costs were USD 58,378. In adjusted and weighted analysis, LOS for the treatment group was 8% longer compared to the control group. The mean total hospital cost was estimated to decrease by 21% for the treatment group versus the control group. We found a reduction of USD 33,783 in hospital costs per patient who died in the hospital and reduction of USD 9113 per patient discharged alive.Conclusion: Palliative care consultation was associated with a reduction in the total cost of hospital care for patients with life-limiting or life-threatening diseases.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":"1 1","pages":"3-7"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45777617","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

Continuous Sedation in Palliative Care in Portugal: A Prospective Multicentric Study. 葡萄牙姑息治疗中的持续镇静：前瞻性多中心研究

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-01-01 Epub Date: 2024-05-25 DOI: 10.1177/08258597241256874

José António Ferraz-Gonçalves, Alice Flores, Ana Abreu Silva, Ana Simões, Carmen Pais, Clarisse Melo, Diana Pirra, Dora Coelho, Lília Conde, Lorena Real, Madalena Feio, Manuel Barbosa, Maria de Lurdes Martins, Marlene Areias, Rafael Muñoz-Romero, Rita Cunha Ferreira, Susete Freitas

{"title":"Continuous Sedation in Palliative Care in Portugal: A Prospective Multicentric Study.","authors":"José António Ferraz-Gonçalves, Alice Flores, Ana Abreu Silva, Ana Simões, Carmen Pais, Clarisse Melo, Diana Pirra, Dora Coelho, Lília Conde, Lorena Real, Madalena Feio, Manuel Barbosa, Maria de Lurdes Martins, Marlene Areias, Rafael Muñoz-Romero, Rita Cunha Ferreira, Susete Freitas","doi":"10.1177/08258597241256874","DOIUrl":"10.1177/08258597241256874","url":null,"abstract":"Objective: This study aimed to survey the practice of palliative sedation in Portugal, where data on this subject were lacking. Methods: This was a prospective multicentric study that included all patients admitted to each team that agreed to participate. Patients were followed until death, discharge, or after 3 months of follow-up. Results: The study included 8 teams: 4 as palliative care units (PCU), 1 as a hospital palliative care team (HPCT), 2 as home care (HC), and 1 as HPCT and HC. Of the 361 patients enrolled, 52% were male, the median age was 76 years, and 285 (79%) had cancer. Continuous sedation was undergone by 49 (14%) patients: 26 (53%) were male, and the median age was 76. Most patients, 46 (94%), had an oncological diagnosis. Only in a minority of cases, the family, 16 (33%), or the patient, 5 (10%), participated in the decision to sedate. Delirium was the most frequent symptom leading to sedation. The medication most used was midazolam (65%). In the multivariable analysis, only age and the combined score were independently associated with sedation; patients <76 years and those with higher levels of suffering had a higher probability of being sedated. Conclusions: The practice of continuous palliative sedation in Portugal is within the range reported in other studies. One particularly relevant point was the low participation of patients and their families in the decision-making process. Each team must have a deep discussion on this aspect.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"72-78"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Clinical Practice Guidelines on Palliative Sedation Around the World: A Systematic Review. 全球姑息镇静临床实践指南：系统回顾。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-01-01 Epub Date: 2022-11-28 DOI: 10.1177/08258597221138674

Martyna Tomczyk, Cécile Jaques, Ralf J Jox

{"title":"Clinical Practice Guidelines on Palliative Sedation Around the World: A Systematic Review.","authors":"Martyna Tomczyk, Cécile Jaques, Ralf J Jox","doi":"10.1177/08258597221138674","DOIUrl":"10.1177/08258597221138674","url":null,"abstract":"Objective: The principal aim of this study was to identify, systematically and transparently, clinical practice guidelines (CPGs) on palliative sedation from around the world. Methods: A systematic search was performed using 5 databases, grey literature search tools, citation tracking, and contact with palliative care experts across the world. Current CPGs accredited by an international, national, or regional authority, published in English, German, French, or Italian, were subjected to content analysis. Results: In total, 35 CPGs from 14 countries and 1 international CPG were included in the analysis. The CPGs had diverse formal characteristics. Their thematic scope was difficult to analyze and compare because of differences in the terms and definitions of palliative sedation in those texts. We identified 3 main situations: (1) CPGs with a fully explicit thematic scope; (2) CPGs with a partially explicit thematic scope; and (3) CPGs without an explicit thematic scope. Several CPGs explicitly stated what forms of sedation were excluded from the text. However, this presentation was often confusing. Conclusion: Our review provides several pieces of information that could guide international reflections in this field, and be used to develop or update CPGs at all levels. Efforts should be made to clarify the thematic scope of each CPG on palliative sedation, in order to generate an understanding of the forms of this therapy addressed in the text.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"58-71"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

The Impact of Palliative Care Consultation on Aggressive Medical Interventions in End-of-life Among Patients with Metastatic Breast Cancer: Insights from the U.S. National Patient Sample. 姑息治疗咨询对转移性乳腺癌患者临终前积极医疗干预的影响：来自美国全国患者样本的启示。

IF 16.4 4区医学

Journal of Palliative Care Pub Date : 2025-01-01 Epub Date: 2024-05-15 DOI: 10.1177/08258597241253933

Zidong Zhang, Alexandria Lovell, Divya S Subramaniam, Leslie Hinyard

{"title":"The Impact of Palliative Care Consultation on Aggressive Medical Interventions in End-of-life Among Patients with Metastatic Breast Cancer: Insights from the U.S. National Patient Sample.","authors":"Zidong Zhang, Alexandria Lovell, Divya S Subramaniam, Leslie Hinyard","doi":"10.1177/08258597241253933","DOIUrl":"10.1177/08258597241253933","url":null,"abstract":"Background: Advancement in treatment has led to prolonged survival and a rising number of women living with metastatic breast cancer (MBC) in the United States. Due to its high symptom burden, it is recommended that palliative care be integrated into the standard care to help improve quality of life. However, little is known about the use of palliative care among MBC patients in the nation.Objectives: To determine utilization of palliative care consult (PCC) after metastasis and the influence of PCC on healthcare utilization in the end of life among women living with MBC in the US.Methods: This retrospective cohort study examined a national electronic health record database to quantify the PCC use after metastasis diagnosis until death and the associations of PCC with Emergency Department (ED), Intensive Care Unit (ICU), and chemotherapies in the end-of-life women (age ≥ 18 years) living with MBC.Results: From a cohort of 2615 deceased MBC patients, 37% received PCC in the last 6 months of life. Patients who had received PCC in the end-of-life were more likely to be hospitalized, admitted to ED and ICU, and receive chemotherapies in the last 60 days before death. However, patients who had received end-of-life PCC had less hospital and ED visits and received less chemotherapies after PCC initiated.Conclusion: While PCC can reduce end-of-life aggressive interventions, it was underutilized among patients with MBC in the end-of-life. A myriad of clinical and patient factors may still challenge timely consultation. We urge for future endeavors in developing strategies to remove barriers in the implementation, especially earlier in the disease course, to assure timely PC treatments and reduce discomfort amid aggressive interventions for MBC.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8-17"},"PeriodicalIF":16.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946494","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

Relatives' Unmet Needs in the Last Year of Life of Patients With Advanced Cancer: Results of a Dutch Prospective, Longitudinal Study (eQuiPe). 晚期癌症患者最后一年生活中亲属未满足的需求：荷兰前瞻性纵向研究（eQuiPe）的结果。

IF 1.3 4区医学

Journal of Palliative Care Pub Date : 2025-01-01 Epub Date: 2024-03-22 DOI: 10.1177/08258597241239614

Laurien Ham, Heidi P Fransen, Alexander de Graeff, Mathijs P Hendriks, Wouter K de Jong, Jeroen Kloover, Evelien Kuip, Caroline Mandigers, Dirkje Sommeijer, Lonneke van de Poll, Natasja Raijmakers, Lia van Zuylen

{"title":"Relatives' Unmet Needs in the Last Year of Life of Patients With Advanced Cancer: Results of a Dutch Prospective, Longitudinal Study (eQuiPe).","authors":"Laurien Ham, Heidi P Fransen, Alexander de Graeff, Mathijs P Hendriks, Wouter K de Jong, Jeroen Kloover, Evelien Kuip, Caroline Mandigers, Dirkje Sommeijer, Lonneke van de Poll, Natasja Raijmakers, Lia van Zuylen","doi":"10.1177/08258597241239614","DOIUrl":"10.1177/08258597241239614","url":null,"abstract":"Objective(s): Unmet needs of relatives of patients with advanced cancer not only reduce their own health-related quality of life, but may also negatively affect patients' health outcomes. The aim of this study was to assess changes in relatives' unmet needs of patients with advanced cancer in the last year of life and to identify differences in unmet needs by gender and type of relationship. Methods: Relatives of patients with advanced cancer in the Netherlands were included in a prospective, longitudinal, observational study. Relatives' unmet needs were measured every 3 months with an adapted version of the Problems and Needs in Palliative Care (PNPC) questionnaire Caregiver form (44 items, 12 domains). Questionnaires completed in the patients' last year of life were analyzed. Change of unmet needs in the last year, and differences in unmet needs by gender and type of relationship were analyzed. Results: A total of 409 relatives were included with a median of 4 unmet needs in the patient's last year. Unmet needs were most prevalent at all time points during the last year in the domains \"caring for the patient\" (highest need = 35%) and \"psychological issues\" (highest need = 40%). The number of unmet needs of relatives did not change significantly during the last year of life (P=.807). There were no significant differences in the number of unmet needs between male and female partners and between partners and other relatives. Conclusion: The most unmet needs for relatives were in the domains \"caring for the patient\" and \"psychological issues.\" Professional support should focus on these items. Within these domains, it seems especially important that relatives get more knowledge and support about what scenarios to expect and how to deal with them.","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"41-50"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186251","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