Annals of palliative medicine最新文献

{"title":"Oncology nursing in the Eastern Mediterranean Region: listening to the workforce.","authors":"Myrna Doumit, Manochehr Samadi, Hassan Khadar Mohamoud, Amal Farah Adan, Gebrekirstos Hagos, Shirin Ahmadnia, Margaret I Fitch, Annie M Young","doi":"10.21037/apm-23-511","DOIUrl":"10.21037/apm-23-511","url":null,"abstract":"<p><strong>Background: </strong>Over half the countries in the World Health Organization (WHO) Eastern Mediterranean Region (EMR) are experiencing conflict or are socially fragile, compromising cancer care. Nonetheless, throughout the EMR, competent nurses are major players in the cancer care team. The aim of this paper is to portray the challenges and opportunities for oncology nursing in the EMR.</p><p><strong>Methods: </strong>This paper draws upon the relevant literature on oncology nursing across EMR with a focus on Afghanistan, Lebanon, Somaliland, and Iran. To enhance the scant nursing literature and obtain real-life experiences, short interviews were undertaken with nine nurses and two doctors, personal contacts of the authors, working in cancer care in those countries.</p><p><strong>Results: </strong>Against the general background of vast economic constraints in health services, the lack of recognition of oncology nursing as a speciality and high rates of nurse migration, many oncology nurses in EMR are fighting for professional recognition and some are working under unsafe conditions. Undeterred by these circumstances, nurses are making every effort to care compassionately for people with cancer.</p><p><strong>Conclusions: </strong>The perspectives of the cancer workforce in EMR both foster an appreciation of cultural diversity and provide the evidence and motivation for oncology nurses worldwide to further collaborate via global nursing organisations to strive for country-specific recognition and change in nursing practice.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":"1210-1228"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016164","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":"Palliative therapies in hepatocellular carcinoma, palliative care in geriatric clinics, and the introduction of narrative medicine.","authors":"Charles B Simone","doi":"10.21037/apm-24-141","DOIUrl":"10.21037/apm-24-141","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"13 5","pages":"1309-1311"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399185","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":"Cross-cultural serious neurological illness communication: qualitative analysis of multidisciplinary perspectives.","authors":"Adela Wu, Karleen F Giannitrapani, Gabriela D Ruiz Colón, Alyce S Adams, Gordon Li, Karl A Lorenz","doi":"10.21037/apm-24-37","DOIUrl":"10.21037/apm-24-37","url":null,"abstract":"<p><strong>Background: </strong>Cultural competence is important in approaching serious illness communication with diverse patients about goals of care. Culture colors patients' perspectives on many healthcare issues, including end-of-life care, and impacts how clinicians make decisions with patients. Communication about serious neurological illnesses can be additionally challenging due to disease impact on patients' cognition and decision-making abilities. We aim to understand provider experiences regarding cross-cultural serious neurological illness communication with diverse patients and families.</p><p><strong>Methods: </strong>Using non-stratified purposive and snowball sampling, we conducted semi-structured interviews with 17 multidisciplinary participants, including neurosurgeons, neurologists, and social workers, who provide care for patients diagnosed with serious neurological disorders, at three hospital settings between 2021 and 2022. We used standard qualitative content analysis methods with dual review.</p><p><strong>Results: </strong>Five themes reflected provider perspectives about serious neurological illness communication with diverse patients and families. Theme 1: providers recognize that patients' personal biases and lived experiences impact attitudes about healthcare and communication. Theme 2: challenges in communication can arise when providers miss chances to identify important cultural values. Theme 3: understanding how to engage with family members is important for effective communication about serious neurological illness. Theme 4: providers want to accommodate patients. Theme 5: cultivating trust builds a strong patient-provider partnership, even when racial or cultural discordance is present.</p><p><strong>Conclusions: </strong>Our study highlights elements of cross-cultural communication and opportunities for providers to approach diverse patients and families within a racial or culturally discordant context. Effective communication, fostered through respecting individual experiences and variation, eliciting cultural perspectives, engaging family, and cultivating trust reflects processes and learned skills required of high-quality teams caring for patients with serious neurological conditions.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":"1172-1182"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915966","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":"The challenge of opioids in cancer care: balancing equity, safety, and access.","authors":"Rebecca A Rodin, Cardinale B Smith","doi":"10.21037/apm-24-61","DOIUrl":"10.21037/apm-24-61","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":"1301-1306"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279564","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":"Cervical gastric decompression tube: safety and efficacy outcomes for inoperable malignant bowel obstruction.","authors":"Sujay S Shankar, Min P Kim, Edward Y Chan, Ray K Chihara","doi":"10.21037/apm-24-21","DOIUrl":"10.21037/apm-24-21","url":null,"abstract":"<p><strong>Background: </strong>Inoperable malignant bowel obstruction, which results in chronic nausea, vomiting and abdominal pain, often requires nasogastric tube decompression. However, these tubes are often uncomfortable for patients and require hospitalization during the end-of-life care. Cervical esophago-gastric (CEG) decompression tubes are a potential palliative solution. The objective of this study is to present the outcomes of CEG tubes in 11 patients with malignant bowel obstruction.</p><p><strong>Methods: </strong>We performed a retrospective review of patients requiring nasogastric tube decompression who received CEG decompression tubes for inoperable malignant bowel obstructions between 2016-2022. CEG tube placement was performed percutaneously through the left neck using a guidewire and an endoscopic technique.</p><p><strong>Results: </strong>The average age of patients was 58 years (31-72 years), with metastatic colorectal cancer (36.4%) and ovarian cancer (27.3%) being the most common causes of malignant bowel obstruction. All procedures were completed percutaneously, without requiring conversion to open procedures. The morbidity of the procedure was 27%, which included tube dislodgement, local cellulitis, or bleeding at the insertion site. None of the patients required reoperation, with most of the patients successfully treated conservatively. Most patients were discharged home after the procedure (82%); however, 45% were readmitted (mostly due to abdominal pain). Most patients (73%) were able to continue additional chemotherapy after tube placement. The average survival from cancer diagnosis was approximately six months, whereas the average survival after the procedure was about four months. No mortalities occurred due to CEG tube placement.</p><p><strong>Conclusions: </strong>A CEG decompression tube is safe for patients with malignant bowel obstruction. The procedure allows patients to undergo additional chemotherapy and be discharged home with a more comfortable tube.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":"1183-1188"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279560","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":"Updates on the preventions and management of post-mastectomy pain syndrome beyond medical treatment: a comprehensive narrative review.","authors":"Eriko Narusawa, Sarina Sadeghi, Kaori Tane, Muna Alkhaifi, Yuichiro Kikawa","doi":"10.21037/apm-24-73","DOIUrl":"10.21037/apm-24-73","url":null,"abstract":"<p><strong>Background and objective: </strong>With the significant advances in breast cancer treatment, the survival rates have improved. Consequently, improving the quality of life for breast cancer survivors has emerged an important issue. In this study, we examined the management of post-mastectomy pain syndrome (PMPS) in breast cancer patients thorough a comprehensive literature review. We introduce the preventive measures and pharmacotherapy for PMPS in breast cancer patients and discuss the effectiveness of psychosocial interventions.</p><p><strong>Methods: </strong>We conducted a literature search for relevant articles in Medline ALL, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, Embase, and nine other databases from October 2023 to January 2024. Chronic pain was defined as pain persisting for more than 3 months after breast cancer surgery. The search included terms related to PMPS, psychological interventions, and breast cancer. Data extraction was done independently by two reviewers, and any discrepancies will be discussed to ensure consensus or by a third reviewer.</p><p><strong>Key content and findings: </strong>Studies have investigated surgical anesthetics, postoperative medications, and surgical procedures for PMPS prevention, but few have focused on treatment. Our literature search about the usefulness of psychosocial interventions yielded two articles, one was about the usefulness of mindfulness and the other was about the efficacy of yoga.</p><p><strong>Conclusions: </strong>Mindfulness and yoga show potential efficacy for PMPS treatment, but the evidence is limited. More research is needed to confirm these findings and to explore other psychosocial interventions.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":"1258-1264"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016126","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":"Breast cancer survivorship among younger patients: challenges and opportunities-narrative review.","authors":"Sandy Vuong, Ellen Warner","doi":"10.21037/apm-24-64","DOIUrl":"10.21037/apm-24-64","url":null,"abstract":"<p><strong>Background and objective: </strong>Young women with breast cancer (YWBC) face unique survivorship challenges due to being diagnosed at a more vulnerable stage in life and receiving gonadotoxic and/or antiestrogen therapy during their reproductive years. The purpose of this article is to elaborate on these challenges and demonstrate how specialized supportive care programs tailored specifically for YWBC, can greatly facilitate the provision of interventions to address these challenges.</p><p><strong>Methods: </strong>The databases used were PubMed and Medline. Articles included those that involve young women with breast cancer and survivorship care needs.</p><p><strong>Key content and findings: </strong>Compared to older breast cancer patients, YWBC generally require more aggressive treatments and are more likely to have a hereditary basis for their disease. Common challenges include childbearing concerns, premature menopause, body image issues, excessive fear of cancer recurrence, difficulties with intimate relationships, and financial toxicity. A possible solution to addressing these needs are longitudinal care in a specialized supportive care program, such as the PYNK Program for Young Women with Breast Cancer in Toronto, Ontario, Canada. Examples of such interventions include fast-tracking fertility preservation, aggressive management of symptoms of iatrogenic menopause, peer support groups, as well as individualized psycho-social support for the patient and her family.</p><p><strong>Conclusions: </strong>By addressing the unique needs of this population, supportive care programs can play a crucial role in empowering young women with breast cancer to cope with the physical, emotional, and practical challenges they may face during and after treatment. The limitation lies in resource availability and funding for sustainability. Ongoing research is required to better understand the needs of YWBC patients in survivorship and ensure the sustainability of programs designed to address these challenges.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":"1246-1257"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016161","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":"Prospective surveillance of patients after palliative radiation for painful bone metastases: a feasibility study.","authors":"Lorna McLean-Thomas, Kareem Fakhoury, Richard Blake Ross, Rhonda Mahoney, Nicholas Gortmaker, Junxiao Hu, Sana D Karam","doi":"10.21037/apm-24-10","DOIUrl":"10.21037/apm-24-10","url":null,"abstract":"<p><strong>Background: </strong>Bone metastasis is the most common cause of cancer-related pain. Radiation therapy (RT) can provide successful palliation but there is currently no consensus for surveillance after palliative radiation. This study aimed to assess the feasibility of surveillance after RT for painful bone metastases.</p><p><strong>Methods: </strong>The study took place in an academic cancer center. Patient feasibility measures included % of calls answered, ease of recruitment and study retention. Clinician measures included % of calls made within 3 days, call time and qualitative feedback. Patients were identified with a painful bone metastasis treated with RT. The bone metastasis had a worst pain score of at least 4 (0-10 scale), with pain localized to a radiographically confirmed lesion. Patients were called at weeks 1, 4 and 8 following RT. Pain response and opioid use were assessed. Quality of life was assessed using a validated questionnaire. Descriptive statistics were used to assess if these metrics were met for patients and clinicians over 8 weeks post-RT.</p><p><strong>Results: </strong>Twenty patients were consented: 14 participants completed treatment and were not hospitalized or deceased prior to week 1. The patients were 50% male and 50% female. Recruitment was completed quickly, with no patients withdrawing. Response rate was week 1: 85% week 4: 83% and week 8: 83%. Six patients were referred back to their provider for pain management. Calls were made to patients within 3 days a median of 63% of the time (range, 40-82%), with a median call time of 16 (range, 8-42) minutes. Call lengths were longer for patients who required interpretation. Nurse feedback highlighted length of call and nursing time available as limitations.</p><p><strong>Conclusions: </strong>All patient feasibility measures were met. Six patients required further pain management, highlighting a need for improved follow up post-RT for bone metastases. Staffing challenges for this intervention must be overcome.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":"1202-1209"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279563","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":"Examining stigma in experiences of male breast cancer patients and its impact as a barrier to care: a narrative review.","authors":"Shayan Raeisi Dehkordi, Samantha K F Kennedy, Malika Peera, Henry C Y Wong, Shing Fung Lee, Muna Alkhaifi, Carlos Amir Carmona Gonzalez","doi":"10.21037/apm-24-67","DOIUrl":"https://doi.org/10.21037/apm-24-67","url":null,"abstract":"<p><strong>Background and objective: </strong>Male breast cancer (MBC) accounts for nearly one percent of all diagnosed breast cancer (BC). In the United States alone, there were 2,670 MBC reported cases and 500 fatalities in 2019. In addition to the general challenges faced by patients to diagnose and treat cancer, MBC patients experience stigma from the medical community and their own feelings of embarrassment. The presence of stigma has a negative impact on the quality of life and psychological outcomes of MBC patients. This narrative review investigates current research on the presence of stigma in the diagnosis and care of MBC patients, and the role of stigma as a barrier to care.</p><p><strong>Methods: </strong>Current literature on MBC and stigma was found through a search of PubMed and Google Scholar. The search strategy consisted of keywords related to \"male breast cancer, stigma, awareness, experiences, and social support\". Studies published from January 2005 to April 2024, that were retrievable and written in English, were included in this review.</p><p><strong>Key content and findings: </strong>Several studies have supported that MBC patients experience stigma due to the lack of awareness in the medical community, and feelings of embarrassment felt by the patients. This stigma is seen through insufficient guidelines on MBC diagnosis and treatment and a lack of male-specific information for BC. These topics of stigma act as barriers to care, as they lead to psychological distress (e.g., anxiety and depression) and delayed diagnoses. Current studies suggest addressing the lack of information and awareness of MBC and implementing screening procedures to mitigate the negative impact of stigma.</p><p><strong>Conclusions: </strong>This review highlights the presence of stigma in the care of MBC patients and its distressing effects on patients. There is a need for increased awareness among the medical community to improve diagnosis and treatment of MBC patients, to allow for more equitable care. Future therapies should focus on the viability of routine screening programs for male patients and addressing the gap of male-specific information.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"13 5","pages":"1291-1300"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399184","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":"The effects of mandatory drug monitoring on opioid use during oropharynx cancer radiotherapy.","authors":"Saim Mahmood Khan, Jawairya Muhammad Hussain","doi":"10.21037/apm-24-94","DOIUrl":"10.21037/apm-24-94","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":"1307-1308"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915968","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}