Palliative medicine reports最新文献

{"title":"Accuracy of the \"Surprise Question\" in Predicting Long-Term Mortality Among Older Patients Admitted to the Emergency Department: Comparison Between Emergency Physicians and Nurses in a Multicenter Longitudinal Study.","authors":"Alexandra Coulon, Delphine Bourmorck, Françoise Steenebruggen, Laurent Knoops, Isabelle De Brauwer","doi":"10.1089/pmr.2024.0010","DOIUrl":"10.1089/pmr.2024.0010","url":null,"abstract":"<p><strong>Background: </strong>The \"surprise question\" (SQ) (\"Would you be surprised if this patient died in the next 12 months?\") is the most frequently used screening tool in emergency departments (EDs) to identify patients with poor prognosis and potential unmet palliative needs.</p><p><strong>Objective: </strong>To test and compare the accuracy of the SQ between emergency nurses (ENs) and emergency physicians (EPs) in predicting long-term mortality among older patients (OP) in the ED.</p><p><strong>Design and setting/subjects: </strong>A prospective cohort study of OPs (≥75 years) conducted in two Belgian EDs. EPs and ENs answered the SQ for the patients they cared for. Positive SQ (SQ+) was defined as a \"no\" answer. One-year mortality was assessed by phone call.</p><p><strong>Results: </strong>EPs and ENs both answered the SQ for 291 OPs (mean age 83.2 ± 5.4, males 42.6%). The SQ was positive in 43% and 40.6%, respectively. Predictive values were similar in both groups: sensitivity, specificity, c-statistics, negative predictive value, and positive predictive value were 0.79 (0.66-0.88), 0.68 (0.62-0.76), 0.69 (0.63-0.75), 0.92 (0.86-0.96), and 0.4 (0.31-0.50), respectively, for EPs and 0.71 (0.57-0.82), 0.69 (0.62-0.75), 0.69 (0.63-0.75), 0.89 (0.83-0.93), and 0.41 (0.31-0.51), respectively, for ENs. SQ + was associated with a higher mortality risk in both group (EPs hazard ratio: 3.2 [1.6-6.7], <i>p</i> = 0.002; ENs hazard ratio: 2.5 [1.3-4.8], <i>p</i> = 0.006). The survival probability was lower when both EPs and ENs agreed on the SQ+ (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The SQ is a simple tool to identify older ED patients at high mortality risk. Concordant responses from EPs and ENs are more predictive than either alone.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"387-395"},"PeriodicalIF":1.1,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Safety of Food Containing <i>Acanthopanax</i> <i>senticosus</i> for Treating Patients with Cancer-Related Fatigue.","authors":"Yutaka Kawano, Nanae Watanabe, Masahiko Nishiyama, Tousei Ohmura, Hiroyoshi Mihara, Kaoru Ono, Maki Tanaka, Yasushi Sato, Tetsu Tomonari, Hidekatsu Takeda, Tetsuji Takayama","doi":"10.1089/pmr.2024.0041","DOIUrl":"10.1089/pmr.2024.0041","url":null,"abstract":"<p><strong>Background: </strong>Cancer-related fatigue (CRF) is a major obstacle to quality of life. <i>Acanthopanax senticosus</i> Harms (ASH) is available as a botanical adaptogen food worldwide.</p><p><strong>Objective: </strong>This study aimed to assess the feasibility and safety of ASH in patients with CRF.</p><p><strong>Methods: </strong>Fifteen patients with CRF consumed ASH drink for 28 days. The primary endpoint was the completion rate of the study, and the secondary endpoints were changes in brief fatigue inventory (BFI), oxidative stress markers, and adverse events.</p><p><strong>Results: </strong>Seven patients successfully completed the study. Four patients who had BFI <5.5 at enrollment revealed a decrease in BFI. The biological antioxidant potential/diacron-reactive oxygen metabolites ratio, potential antioxidant capacity, was increased but not significant (<i>p</i> = 0.063). No adverse events attributable to ASH were observed.</p><p><strong>Conclusions: </strong>Approximately 50% patients were successful in consuming ASH for 28 days. Patients with mild CRF showed improvement by using ASH. However, further investigations are needed to validate these findings.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"381-386"},"PeriodicalIF":1.1,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoglycemia in Terminally Ill Patients with Cancer with a History of Diabetes Mellitus Admitted to a General Ward: A Retrospective Observational Study.","authors":"Ryota Yanaizumi, Yusuke Nagamine, Shinsuke Harada, Takahisa Goto","doi":"10.1089/pmr.2024.0008","DOIUrl":"10.1089/pmr.2024.0008","url":null,"abstract":"<p><strong>Background: </strong>Poor glycemic control may be a risk factor for hypoglycemia in terminally ill patients with cancer with a history of diabetes mellitus (DM). However, no guidelines have been established for achieving glycemic control in this patient population, and epidemiological information remains lacking.</p><p><strong>Objectives: </strong>We aimed to investigate the prevalence of hypoglycemic episodes and provide epidemiological information on hypoglycemia in terminally ill patients with cancer with a history of DM admitted to a general ward.</p><p><strong>Design: </strong>This was a single-center, retrospective, observational study.</p><p><strong>Setting/subjects: </strong>This study enrolled terminally ill patients with cancer with a history of DM, receiving palliative care at a hospital in Japan between January 2017 and July 2022.</p><p><strong>Measurements: </strong>Data extracted from the patients' medical records were age, sex, body mass index, primary cancer, liver metastases, dialysis status, Eastern Cooperative Oncology Group performance status score, type and duration of DM, HbA1c level, and use of diabetes medications (antihyperglycemic agents and types and insulin) at the time of initial visit within 180 days of death.</p><p><strong>Results: </strong>Among the 104 patients included in the analysis, hypoglycemic episodes occurred in 36 patients (34.6%). The total number of hypoglycemic episodes was 132, and the median number of hypoglycemic episodes for each patient during hospitalization was 2.5 (interquartile range, 1-6).</p><p><strong>Conclusions: </strong>The prevalence of hypoglycemia in terminally ill patients with cancer with a history of DM who were admitted to a Japanese general ward was 34.6%. Further studies are needed to determine the frequency of hypoglycemia because of overtreatment in this patient population.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"373-380"},"PeriodicalIF":1.1,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End-of-Life Practices in an Intensive Care Unit of a Private Hospital in Mexico.","authors":"Roberto Carlos Miranda-Ackerman, Paulina Ruiz-Ochoa, Daniela López-Ramírez, Juan Fernando Quevedo-Barrientos, Mariana Plascencia-Rendón, José Luis Landeros-Torres, Karen Fernanda Astorga-Cervantes, Alejandra González-Uribe, Ana Olivia Cortes-Flores, Carlos José Zuloaga-Fernández- Del-Valle, Gilberto Morgan-Villela, Francisco José Barbosa-Camacho, Clotilde Fuentes-Orozco, Irma Valeria Brancaccio-Pérez, Alejandro González-Ojeda","doi":"10.1089/pmr.2024.0023","DOIUrl":"10.1089/pmr.2024.0023","url":null,"abstract":"<p><strong>Background: </strong>Many factors, such as religion, geography, and customs, influence end-of-life practices. This variability exists even between different physicians.</p><p><strong>Objective: </strong>To observe and describe the end-of-life actions of patients in the intensive care unit (ICU) and document the variables that might influence decision-making at the end of life.</p><p><strong>Materials and methods: </strong>This is a cross-sectional study performed in the ICU patients of a private hospital from March 2017 to March 2022. We used the Philips Tasy Electronic Medical Record database of clinical records; 298 patients were included in the study during these five years (2017-2022). The data analysis was done with the statistical package SPSS version 23 for Windows.</p><p><strong>Results: </strong>A total of 297 patients were included in this study, of which more than half were men. About 60% of our sample had private health insurance, whereas the remaining paid out of pocket. Most patients had withholding treatment, followed by failed cardiopulmonary resuscitation, withdrawal treatment, and brain death, and none of the patients had acceleration of the dying process. The main cause of admission to the ICU in our center was respiratory complications. Most of our samples were Catholics.</p><p><strong>Conclusions: </strong>Decision-making at the end of life is a complex process. Active participation of the patient, when possible, the patient's family, doctors, and nurses, can give different perspectives and a more compassionate and individualized approach to end-of-life care.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"359-364"},"PeriodicalIF":1.1,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicians' Prediction of Survival Is Most Useful for Palliative Care Referral.","authors":"Eun Hee Jung, Yusuke Hiratsuka, Sang-Yeon Suh, Seok-Joon Yoon, Beodeul Kang, Si Won Lee, Koung Jin Suh, Ji-Won Kim, Se Hyun Kim, Jin Won Kim, Keun-Wook Lee, Yu Jung Kim","doi":"10.1089/pmr.2024.0013","DOIUrl":"10.1089/pmr.2024.0013","url":null,"abstract":"<p><strong>Background: </strong>Timely palliative transition in patients with advanced cancer is essential for their improved quality of life and overall survival (OS). Most prognostic models have been developed focusing on weeks' survival. The current study aimed to compare the accuracies of several indicators, such as the Karnofsky Performance Scale (KPS), Clinicians' Prediction of Survival (CPS), and Edmonton Symptom Assessment System (ESAS), for predicting the survival of patients.</p><p><strong>Methods: </strong>Two hundred patients were enrolled at a single tertiary cancer center in South Korea between 2016 and 2019. We compared the discrimination of CPS versus KPS and ESAS total scores using the area under the receiver operating characteristic curve (AUROC) in 3-month and 6-month survival predictions.</p><p><strong>Results: </strong>The median age of patients was 66.0 years, and 128 (64%) were male. Two-thirds (66%) of the patients had an Eastern Cooperative Oncology Group performance status of 0 or 1, and 55.5% had a KPS of 80% or higher. The values of AUROC of CPS, KPS, and ESAS total score in 3-month survival prediction were 0.80 (95% confidence interval [CI]: 0.73-0.88), 0.71 (95% CI: 0.62-0.79), and 0.71 (95% CI: 0.62-0.81), respectively, whereas those in 6-month survival were 0.82 (95% CI: 0.76-0.88), 0.70 (95% CI: 0.63-0.78), and 0.63 (95% CI: 0.55-0.71), respectively.</p><p><strong>Conclusion: </strong>CPS showed the highest accuracy in predicting 3- and 6-month survival, whereas KPS had an acceptable accuracy. Experienced clinicians can rely on CPS to predict survival in months. We recommend the use of KPS with CPS to assist inexperienced clinicians.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"365-372"},"PeriodicalIF":1.1,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of the ID-PALL Assessment Tool for Palliative Care Needs: A Feasibility and Prevalence Study in a Tertiary Hospital.","authors":"F Teike Lüthi, M Bernard, G Behaghel, S Burgniard, P Larkin, G D Borasio","doi":"10.1089/pmr.2023.0080","DOIUrl":"10.1089/pmr.2023.0080","url":null,"abstract":"<p><strong>Background: </strong>Identifying patients who require palliative care is a major public health concern. ID-PALL is the first screening instrument developed and validated to differentiate between patients in need of general versus specialized palliative care.</p><p><strong>Objectives: </strong>This study aimed to (1) evaluate user satisfaction and the facilitators and barriers for ID-PALL use and (2) assess the prevalence of patients who require palliative care.</p><p><strong>Design: </strong>A mixed methods study with an explanatory sequential design.</p><p><strong>Setting/subjects: </strong>Over a six-month period, patients admitted to two internal medicine wards of a Swiss tertiary hospital were screened by nurses and physicians with ID-PALL, two to three days after hospitalization. Nurses and physicians completed a questionnaire and participated in focus groups.</p><p><strong>Results: </strong>Out of 969 patients, ID-PALL was completed for 420 (43.3%). Sixty percent of patients assessed needed general palliative care and 26.7% specialized palliative care. From the questionnaire and focus groups, five subthemes were identified concerning facilitators and barriers: organization, knowledge, collaboration, meaning, and characteristics of the instrument. ID-PALL was recognized as an easy-to-use and helpful instrument that facilitates discussion between health care professionals about palliative care. The difficulties in using ID-PALL in nurse-physician collaboration and the paucity of referrals to the palliative care team were highlighted.</p><p><strong>Conclusions: </strong>ID-PALL helped to identify a very high prevalence of palliative care needs among internal medicine patients in a tertiary hospital setting. Although regarded as helpful and easy to use, challenges remain concerning interprofessional implementation and inclusion of palliative care specialists, which may be met by automatic referrals in case of specialist needs.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"350-358"},"PeriodicalIF":1.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Do Not Resuscitate Status and Palliative Care in Hospitalized Patients: A National Inpatient Sample Analysis.","authors":"Jean-Sebastien Rachoin, Nicole Debski, Krystal Hunter, Elizabeth Cerceo","doi":"10.1089/pmr.2024.0030","DOIUrl":"10.1089/pmr.2024.0030","url":null,"abstract":"<p><strong>Introduction: </strong>Patients from diverse sociocultural backgrounds and with differing medical conditions may have varying levels of acceptance of advanced care planning and palliative care.</p><p><strong>Methods: </strong>We performed a retrospective analysis of the National Inpatient Sample for patients discharged from January 1, 2016, to December 31, 2019, with conditions associated with frequently terminal conditions. We recorded demographic variables, do not resuscitate (DNR) status, and palliative care (PC) status and analyzed the associations between outcomes, mortality, and length of stay (LOS).</p><p><strong>Results: </strong>A total of 23,402,637 patient records were included in the study, of which 2% were DNR and PC, 5% were DNR only, and 1% was PC only. From 2016 to 2019, the percentage of patients with PC increased from 2.55% to 3.27% and DNR from 6.31% to 7.7%. Black patients were less likely to have DNR status (odds ratio [OR] 0.72 [0.71-0.72]) but had similar PC rates. Male patients were less likely to have a DNR order in place (OR 0.89 [0.89-0.89]) but more likely to be in PC (OR 1.05 [1.04-1.05]). The diagnoses with the highest association with DNR status were lung cancer (OR 4.1 [4.0-4.5]), pancreatic cancer (OR 4.6 [4.5-4.7]), and sepsis (OR 2.9 [2.9-2.9]) The diagnoses most associated with PC were lung cancer (OR 6.3 [6.2-6.4]), pancreatic cancer (OR 8.1 [7.1-8.3]), colon cancer (OR 4.9 [4.8-5.1]), and senile brain degeneration of the brain OR 6.5 [5.3-7.9]). Mortality and LOS decreased between 2016 and 2019, but hospital charges increased (<i>p</i> < 0.001). Black race and male gender were associated with higher inpatient mortality (OR 1.12 [1.12-1.14]), LOS, and hospital charges.</p><p><strong>Conclusion: </strong>In the United States, the proportion of hospitalized patients with DNR, PC, and DNR with PC increased from 2016 to 2019. Overall, inpatient mortality and LOS fell, but hospital charges per patient increased. Significant gender and ethnic differences emerged. Black patients and males were less likely to have DNR status and had higher inpatient mortality, LOS, and hospital charges.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"331-339"},"PeriodicalIF":1.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Combined Injection of Pure-μ-Opioid Agonist with Tramadol as an Opioid Induction Agent for Opioid-Naïve Cancer Patients.","authors":"Tetsumi Sato, Shigeki Ono, Tetsu Sato, Rei Tanaka, Yoshiko Kamo, Tomomi Suzuki","doi":"10.1089/pmr.2023.0061","DOIUrl":"10.1089/pmr.2023.0061","url":null,"abstract":"<p><strong>Background: </strong>Tramadol is known to provide synergistic analgesia when used in combination with morphine.</p><p><strong>Objectives: </strong>The aims of this study were: (1) to introduce an opioid combination therapy using pure-μ-opioid receptor agonist (OPI) + tramadol injections (OPI + tramadol) and (2) to elucidate safety and efficacy of this combination therapy for opioid-naïve cancer pain patients.</p><p><strong>Methods: </strong>Opioid-naïve patients referred to our palliative care team (in Japan) who were unable to take oral medications and received OPI + tramadol as opioid induction agents were retrospectively investigated on the electric medical chart. OPI + tramadol dosage was adjusted to achieve the patient's pain as Numerical Rating Scale ≤4/10 or Support Team Assessment Schedule-Japanese ≤1. Patients' demography, doses of OPI and tramadol administered, and adverse events were analyzed.</p><p><strong>Results: </strong>A total of 44 patients were included. The primary organs of malignancy were pancreas (11), stomach (5), lung (4), breast (4), liver (4), and others (13). OPI injections administered were hydromorphone (39), morphine (6), oxycodone (1), and fentanyl (1). The starting doses of OPI (morphine equivalent) and tramadol were 6.05 ± 1.63 and 67.8 ± 13.6 mg/day, respectively, and the final doses of OPI (morphine equivalent) and tramadol were 8.14 ± 3.85 and 80.0 ± 28.5 mg/day, respectively. Treatment goals were achieved in all patients. There were three patients in whom OPI was switched owing to inadequate analgesia and no new side effects other than those known to occur when OPI or tramadol is administered appeared.</p><p><strong>Conclusion: </strong>The results suggest that this innovative and unique opioid therapy can be safely and effectively introduced to opioid-naïve cancer patients who are relatively close to the end of life.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"340-349"},"PeriodicalIF":1.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Refractory Cancer Pain with Intrathecal Drug Delivery and Spinal Cord Stimulation.","authors":"Evgeny Bulat, Jason E Crowther, Vikram Chakravarthy, Ilya Laufer, Ori Barzilai, Amitabh Gulati","doi":"10.1089/pmr.2023.0089","DOIUrl":"10.1089/pmr.2023.0089","url":null,"abstract":"<p><strong>Background: </strong>Intrathecal pumps (ITPs) are indicated for refractory cancer pain and decrease systemic opioid requirements. While not yet indicated for cancer pain, spinal cord stimulators (SCSs) are used off-label for cancer pain, with increasing evidence of their efficacy.</p><p><strong>Materials and methods: </strong>A retrospective chart review was conducted of patients who underwent both ITP and at least SCS trial for cancer pain. Primary outcomes were pain numeric rating scale (NRS) and daily morphine equivalents (MEQs).</p><p><strong>Results: </strong>Seventeen patients were identified. Both ITP and SCS were associated with significant decreases in pain ratings at the 3-month follow-up, but this decrease became nonsignificant subsequently. ITP, but not SCS, was associated with a significant decrease in MEQ.</p><p><strong>Conclusions: </strong>ITP and SCS may both provide efficacy for cancer pain, but the opioid-sparing effects of SCS may be limited. ITP and SCS may potentially be complementary in their ability to provide relief from cancer-related pain.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"301-305"},"PeriodicalIF":1.1,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Infections in Palliative Care Patients at the End-of-Life and Active Process of Death: A Brazilian Retrospective Study.","authors":"Isabela Fernandes de Aguiar Tonetto, Angelita Maria Stabile, Dieyeni Yuki Kobayasi, Rita de Cássia Quaglio, Ana Carolina de Souza, Fabiana Bolela","doi":"10.1089/pmr.2024.0005","DOIUrl":"10.1089/pmr.2024.0005","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of specific studies on the management of infections in patients receiving palliative care (PC) in the final stages of life and during the active process of death, related to specific nursing care. There is clinical and social importance as patients in PC represent a vulnerable population, and adequate management of infections is crucial to improve quality of life and the experience of comfort.</p><p><strong>Objective: </strong>This study analyzed how infections are managed in patients undergoing PC at the end-of-life and in the active process of death in two hospital health services.</p><p><strong>Design: </strong>This is an observational, analytical, and retrospective study.</p><p><strong>Settings: </strong>Data collection took place in two hospitals that assist individuals who are hospitalized under PC, located in Brazil, in a city in the interior of the state of São Paulo.</p><p><strong>Measurements and results: </strong>The sample consisted of 113 medical records, in which the oncological diagnosis was the most prevalent. There was a predominance of infection diagnoses based on the patient's clinical symptoms, the main focus being the pulmonary, in individuals at the end-of-life. The management of infection in the study sample occurred through care and procedures that generate physical discomfort, however aiming at relieving symptoms. Such findings must be documented, as they invite us to reflect on our practical attitudes and what it means to be comfortable for these people, making it possible to incorporate this information into the design of interventions focused on enhancing the experience of comfort.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"324-330"},"PeriodicalIF":1.1,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}