Journal of Palliative Care最新文献

{"title":"Setting Regional Priorities for Palliative and End-of-Life Care Research Using a Delphi Technique Approach.","authors":"Nikolaos Efstathiou, Ping Guo, Wendy Walker, John I MacArtney, Cara Bailey","doi":"10.1177/08258597241264455","DOIUrl":"https://doi.org/10.1177/08258597241264455","url":null,"abstract":"<p><strong>Objective: </strong>Identifying research priorities is very important for palliative and end-of-life care to ensure research is focused on evidence gaps. This project aimed to identify and prioritise palliative and end-of-life care research areas within the West Midlands region in United Kingdom (UK).</p><p><strong>Methods: </strong>A modified Delphi technique approach was used with palliative care stakeholders. The first round was item generation via rapid interviews. Data were analysed using content analysis and all the items were grouped into main categories. For round two, an online survey was conducted to present all the items from round one, and stakeholders were asked to rate the priority of items on a Likert-type scale (1 = not a priority to 7 = essential priority). Items that achieved consensus in round two were presented to the third round, where stakeholders ranked them in descending order.</p><p><strong>Results: </strong>We completed and analysed 56 rapid interviews which resulted in 158 research items under 15 categories. The research items were rated by 30 stakeholders and seven items which reached consensus were subsequently ranked in order by 45 stakeholders. The highest ranked item was 'Integrated care systems to prevent crisis', followed by three research items related to 'equity' in palliative care.</p><p><strong>Conclusions: </strong>Our research priorities, although unique for our region, mirror previously research priorities from other regions and countries. This suggests issues of integration and equity in palliative and end-of-life care remain unresolved, despite ongoing initiatives and research to address these issues.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597241264455"},"PeriodicalIF":1.3,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762412","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}

{"title":"Factors Associated With Long Survival in Patients With Cancer Admitted to Palliative Care: An Exploratory Study.","authors":"José António Ferraz-Gonçalves, Adelaide Alves, Álvaro José Silva, Ana Carmo Valente, Ana Pina, Áurea Lima, Daniela Antunes, Francisco Cubal, Isabel Costa, Jorge Rodrigues, Mariana Costa, Mariana Ramos, Michael Luis, Sofia Garcês Soares, Sofia Sousa, Teresa Dias Moreira, Vânia Sá-Araújo, Maria José Bento","doi":"10.1177/08258597241231005","DOIUrl":"10.1177/08258597241231005","url":null,"abstract":"<p><p><b>Objective:</b> Some patients with cancer admitted to palliative care have relatively long survivals of 1 year or more. The objective of this study was to find out factors associated with prolonged survival. <b>Methods:</b> Retrospective case-control study comparing the available data of patients with cancer who survived more than 1 year after admission in a palliative care service with patients with cancer who survived 6 months or less. The intended proportion was 4 controls for each case. Patients were identified through electronic records from 2012 until 2018. <b>Results:</b> And 1721 patients were identified. Of those patients, 111 (6.4%) survived for at least 1 year, and 363 (21.1%) were included as controls according to the established criteria. The intended proportion could not be reached; the proportion was only 3.3:1. The median survival of cases was 581 days (range: 371-2763), and the median survival of controls was 57 days (range: 1-182). In the multivariable analysis, patients with a hemoglobin ≥ 10.6 g/dL and a creatinine level >95 µmol/L had a higher probability of living more than 1 year. In contrast, patients with abnormal cognition, pain, anorexia, liver metastases, an Eastern Cooperative Oncology Group performance status >1, and a neutrophil/lymphocyte ratio ≥ 3.43 had a low probability of living more than 1 year. <b>Conclusion:</b> Several factors were statistically associated positively or negatively with prolonged survival. However, the data of this study should be confirmed in other studies.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"244-252"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906864","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}

{"title":"Comparison of Simplified Palliative Prognostic Index and Palliative Performance Scale in Patients with Advanced Cancer in a Home Palliative Care Setting.","authors":"Yusuke Hiratsuka, Sang-Yeon Suh, Seok Joon Yoon","doi":"10.1177/08258597231214896","DOIUrl":"10.1177/08258597231214896","url":null,"abstract":"<p><p><b>Objective:</b> The Palliative Performance Scale (PPS) has been reported to be as accurate as Palliative Prognostic Index (PPI). PPS is a component of the simplified PPI (sPPI). It is unknown whether PPS is as accurate as sPPI. This study aimed to compare the prognostic performance of the PPS and sPPI in patients with advanced cancer in a home palliative care setting in South Korea. <b>Methods:</b> This was a secondary analysis of a prospective cohort study that included Korean patients with advanced cancer who received home-based palliative care. We used the medical records maintained by specialized palliative care nurses. We computed the prognostic performance of PPS and sPPI using the area under the receiver operating characteristic curve (AUROC) and calibration plots for the 3- and 6-week survival. <b>Results:</b> A total of 80 patients were included, with a median overall survival of 47.0 days. The AUROCs of PPS were 0.71 and 0.69 at the 3- and 6-week survival predictions, respectively. The AUROCs of sPPI were 0.87 and 0.73 at the 3- and 6-week survival predictions, respectively. The calibration plot demonstrated satisfactory agreement across all score ranges for both the PPS and sPPI. <b>Conclusions:</b> This study showed that the sPPI assessed by nurses was more accurate than the PPS in a home palliative care setting in predicting the 3-week survival in patients with advanced cancer. The PPS can be used for a quick assessment.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"194-201"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803155","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}

{"title":"Cancer Patients: Forgiveness, Discomfort Intolerance and Psychiatric Symptoms.","authors":"Hilal Merve Belen, Gamze Sarikoç","doi":"10.1177/08258597231172838","DOIUrl":"10.1177/08258597231172838","url":null,"abstract":"<p><p><b>Objectives:</b> Cancer patients try to find answers in the light of their individual experiences and if they cannot adapt in line with the answers, various psychiatric symptoms may occur. There are studies supporting that \"forgiveness\" helps reduce the emotional burden of patients with cancer in their ability to discomfort intolerance of the disease, find meaning in the life. The aim of this study is to evaluate forgiveness, discomfort intolerance, and psychiatric symptoms in cancer patients. <b>Methods:</b> The data of this study, which was conducted with 208 cancer patients receiving outpatient chemotherapy treatment, Personal Information Form was collected with Heartland Forgiveness Scale, Brief Symptom Inventory, and Discomfort Intolerance Scale. <b>Result:</b> It has been determined that cancer patients have a high level of forgiveness, a moderate tolerance to tolerate discomfort, and enable low level of occurrence of psychiatric symptoms. As the level of self-forgiveness and forgiveness of patients increases, the incidence of psychiatric symptoms decreases. <b>Conclusion:</b> In line with the findings, it can be thought that the high level of forgiveness of cancer patients towards their illness allows them to experience less psychiatric symptoms and increase their tolerance to the disorder. Awareness of both patients and healthcare personnel can be increased by preparing training programs that address forgiveness in individuals diagnosed with cancer in healthcare institutions.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"227-237"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9617716","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}

{"title":"Post-graduate Course in Palliative Medicine: Experiences from an E-Learning-Based Pilot Program, a Mixed Methods Study.","authors":"Annamarja Lamminmäki, Minna Hökkä, Outi Hirvonen, Eeva Rahko, Tiina Saarto, Juho T Lehto","doi":"10.1177/08258597231171823","DOIUrl":"10.1177/08258597231171823","url":null,"abstract":"<p><p><b>Objective:</b> To study whether E-learning methods are feasible in the post-graduate education of palliative medicine. <b>Methods:</b> A mixed-methods study. Evaluations from pilot course attendees were analyzed numerically and answers to open-ended questions about E-learning were analyzed using inductive content analysis. A national pilot E-learning-based post-graduate course in palliative medicine with 24 participating physicians in Finland. The evaluation of teaching modules and different aspects of the course was achieved from the participants through numerical statements and open-ended questions. <b>Results:</b> The feedback on most aspects of the course was good. For example, issues of pain and symptom control, lectures, pre-exams, and group discussions were deemed suitable for E-learning, while studying communication and existential issues through E-learning was considered more challenging. The benefits of E-learning included efficacy, better accessibility, and the possibility to go back to the teaching material. Reduced networking and face-to-face interactions were stated as challenges of E-learning. <b>Conclusions:</b> E-learning is feasible in the post-graduate education of palliative medicine and can be 'surprisingly rewarding'. It allows easy access to learn many important topics, while social networking may fall short. Further studies are needed to assess the increase in competence by different learning methods.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"209-216"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9844977","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}

{"title":"Relationship Between Corticosteroid Administration and Survival Period in Terminal Cancer Patients.","authors":"Hideki Katayama, Masahiro Tabata, Haruhito Kamei, Yusuke Mimura, Yoshinobu Maeda","doi":"10.1177/08258597231221924","DOIUrl":"10.1177/08258597231221924","url":null,"abstract":"<p><p><b>Objective:</b> Corticosteroids are commonly used for symptom relief in patients with terminal cancer, but their use may have an impact on patient survival. We compared the survival of patients with terminal cancer who did and did not receive corticosteroid treatment for symptom relief, stratified by their predicted prognosis. <b>Methods:</b> We retrospectively reviewed consecutive patients with cancer who received corticosteroid treatment for symptom relief in a single palliative care unit. We stratified the patients according to their predicted prognosis using the palliative prognostic (PaP) score either before starting the corticosteroid treatment or at admission for control patients who did not receive a corticosteroid treatment. The 2 groups were compared for survival based on the PaP Scores. <b>Results:</b> We analyzed 204 patients treated with a corticosteroid during the study period and 139 control patients who did not receive corticosteroids during their treatment. No difference was observed in the survival between the treatment and control groups. <b>Conclusion:</b> Corticosteroid treatment for symptom relief in patients with terminal cancer did not affect survival time.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"238-243"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803159","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}

{"title":"Place of Death for Adults Receiving Specialist Palliative Care in Their Last 3 Months of Life: Factors Associated With Preferred Place, Actual Place, and Place of Death Congruence.","authors":"Samantha Smith, Aoife Brick, Bridget Johnston, Karen Ryan, Regina McQuillan, Sinead O'Hara, Peter May, Elsa Droog, Barbara Daveson, R Sean Morrison, Irene J Higginson, Charles Normand","doi":"10.1177/08258597241231042","DOIUrl":"10.1177/08258597241231042","url":null,"abstract":"<p><p><b>Objectives:</b> Congruence between the preferred and actual place of death is recognised as an important quality indicator in end-of-life care. However, there may be complexities about preferences that are ignored in summary congruence measures. This article examined factors associated with preferred place of death, actual place of death, and congruence for a sample of patients who had received specialist palliative care in the last three months of life in Ireland. <b>Methods:</b> This article analysed merged data from two previously published mortality follow-back surveys: Economic Evaluation of Palliative Care in Ireland (EEPCI); Irish component of International Access, Rights and Empowerment (IARE I). Logistic regression models examined factors associated with (a) preferences for home death versus institutional setting, (b) home death versus hospital death, and (c) congruent versus non-congruent death. <b>Setting:</b> Four regions with differing levels of specialist palliative care development in Ireland. <b>Participants:</b> Mean age 77, 50% female/male, 19% living alone, 64% main diagnosis cancer. Data collected 2011-2015, regression model sample sizes: n = 342-351. <b>Results:</b> Congruence between preferred and actual place of death in the raw merged dataset was 51%. Patients living alone were significantly less likely to prefer home versus institution death (OR 0.389, 95%CI 0.157-0.961), less likely to die at home (OR 0.383, 95%CI 0.274-0.536), but had no significant association with congruence. <b>Conclusions:</b> The findings highlight the value in examining place of death preferences as well as congruence, because preferences may be influenced by what is feasible rather than what patients would like. The analyses also underline the importance of well-resourced community-based supports, including homecare, facilitating hospital discharge, and management of complex (eg, non-cancer) conditions, to facilitate patients to die in their preferred place.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"184-193"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974417","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}

{"title":"Exploring Specialist Palliative Care Practitioner Perspectives on the Face Validity of the Attitude to Health Change Scales in Assessing the Impact of Life-limiting Illness on Patients and Carers.","authors":"Linda Machin, Catherine Walshe, Lesley Dunleavy","doi":"10.1177/08258597211064016","DOIUrl":"10.1177/08258597211064016","url":null,"abstract":"<p><p><b>Background:</b> Identifying and assessing vulnerability and resilience through reflexive reactions and conscious coping responses to life-limiting illness is an important, but rarely assessed, component of care. The novel Attitude to Health Change scales can contribute to this, but require fuller development and testing. <b>Objectives:</b> Exploring face validity of the Attitude to Health Change Scales (patient and carer versions) from the perspective of specialist palliative care professionals. <b>Design:</b> A two-stage study: (i) focus groups to explore experiences of scale use and wording, (ii) online survey to gather preferences on possible scale modifications. Focus group data were analysed using framework analysis. A hermeneutic approach was used to modify the wording of the scales, ensuring adherence to the underpinning concepts used in the design of the scale, congruence with the palliative care context, and simplicity of language. <b>Setting/Subjects:</b> Specialist palliative care practitioners in UK hospice settings who had been involved in pilot use of the scales in clinical practice. <b>Results:</b> 21 practitioners participated in 3 focus groups across 3 UK hospice sites, 9 of those participants responded to the survey. Four themes are presented: the importance and distinctiveness of the scales; maintaining conceptual integrity; ensuring a palliative care focus; and ensuring linguistic clarity. New iterations of the patient and carer versions of the Attitude to Health Change scales were developed. <b>Conclusion:</b> The scales appear to reflect the intended theoretical constructs, and are worded in a way which is congruent with the experience of specialist palliative care practitioners.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"175-183"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39577814","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}

{"title":"Do People Prefer Home Palliative Care? A Survey Study and Assessment of Associated Factors in China.","authors":"Juncheng Tong, Shuaiyan Wang, Jiawei Cao","doi":"10.1177/08258597241235449","DOIUrl":"10.1177/08258597241235449","url":null,"abstract":"<p><p><b>Objectives:</b> This study examined people's preference for the location to receive palliative care services and determined the associated factors. <b>Methods:</b> A questionnaire with reference to the Chinese version of the Hospice Attitude Scale and the Death Correspondence Scale was designed, piloted, revised, and distributed online and in person to collect data (N = 762). Binary logistic regression was used to analyze the effects of relevant factors. <b>Results:</b> The average age of the participants was 38.1, with a relatively even gender distribution. Over 90% of the participants were either single/never married (44.9%) or married with children (46.0%). 58.1% of the respondents (N = 428) indicated that they would like to receive palliative care at home, compared to 41.9% who preferred receiving such care in institutions or other places (N = 309). Each time people's attitudes toward death became one point more positive, they were 10.2% more likely to choose to receive palliative care services at home. People with a neutral attitude toward palliative care, single/never married or divorced with children, and having/had an occupation in health and social work had higher odds of preferring receiving palliative care at home. Those who had poor self-rated health or with an educational background of primary school or lower or some college had lower odds of preferring receiving palliative care at home. <b>Conclusions:</b> The research showed that attitudes toward death and other factors were associated with people's preferences for palliative care locations. More accessible and affordable community-based and home-based palliative care services should be further explored and provided.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"202-208"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984468","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}

{"title":"Thirst Distress in Palliative Care Patients.","authors":"Gülşah Çamcı, Sıdıka Oğuz, Eyyüp Özdemir","doi":"10.1177/08258597241253930","DOIUrl":"https://doi.org/10.1177/08258597241253930","url":null,"abstract":"<p><p><b>Objective:</b> It has been reported that chronically critical patients and patients at high risk of death have moderate to high levels of thirst distress. It was planned as a descriptive and cross-sectional study to determine thirst distress in palliative care patients. <b>Methods:</b> A Patient Information Form, the Thirst Severity Form, and the Thirst Distress Scale were used for data collection. The research was carried out between March 2023 and July 2023 with 157 patients hospitalized in the palliative care services of a state hospital and a training and research hospital in Istanbul, Turkey. <b>Results:</b> Of the patients, 51.6% were female. The mean thirst distress score of the patients was 23.96 ± 5.096. Of the patients, 0.6% had no thirst distress; 7.6% had mild, 48.4% had moderate, 38.9% had high, and 4.5% had severe thirst distress. Thirst scores of patients who were illiterate and did not smoke or drink alcohol were high (<i>P</i> < .05). The thirst distress score of patients fed with percutaneous endoscopic gastrostomy was higher than that of patients fed with total parenteral nutrition. There was a positive weak correlation between age and thirst distress score, a negative very weak correlation between fluid balance and thirst distress score, and a positive moderate correlation between Visual Analog Scale and thirst distress. <b>Conclusion:</b> Thirst distress was found to be at moderate and high levels in palliative care patients. In patients, thirst should be routinely assessed, and necessary interventions should be planned.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597241253930"},"PeriodicalIF":1.7,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891887","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}