Journal of palliative care & medicine最新文献_第3页

Predictors of Seven-Day Mortality in Patients with Advanced Oncologic Liver Disease Admitted to a Palliative Care Unit 姑息治疗病房住院的晚期肿瘤性肝病患者7天死亡率的预测因素

Journal of palliative care & medicine Pub Date : 2018-01-01 DOI: 10.4172/2165-7386.1000339

N. Rahm, Audrey Calmant, C. Combescure

{"title":"Predictors of Seven-Day Mortality in Patients with Advanced Oncologic Liver Disease Admitted to a Palliative Care Unit","authors":"N. Rahm, Audrey Calmant, C. Combescure","doi":"10.4172/2165-7386.1000339","DOIUrl":"https://doi.org/10.4172/2165-7386.1000339","url":null,"abstract":"Context and objectives: A specific prognostic tool is lacking for end-stage oncological liver diseases. In addition to various factors, bilirubin, which reflects the severity of liver dysfunction, may be associated with mortality in this population. We aimed to assess how bilirubin influence survival in patients admitted in palliative care units with advanced oncologic liver diseases and to develop a prognostic model combining bilirubin with other factors. Methods: Data were collected retrospectively from 652 patients with oncologic liver diseases, accounting for 25% of all admissions in our palliative care units from 2011 to 2016. Age, gender, chronic liver diseases, infections including spontaneous bacterial peritonitis, gastrointestinal bleeding, encephalopathy, Eastern Cooperative Oncology Group score (ECOG), oral intake, jaundice, dyspnea, bilirubin, albumin and urea variables collected within 24 hours before or after admission were analyzed. Univariate and multivariate survival analyses were performed to identify the predictive value of bilirubin and other variables for 7-day survival. Results: Bilirubin value was collected in 398 patients. Univariate analysis showed that male sex, chronic liver diseases, encephalopathy, ECOG, oral intake, jaundice, bilirubin and urea blood levels, were associated with 7-day survival. Multivariate analysis showed that bilirubin>25 μ mol/L, urea>15 mmol/L, ECOG=4 and reduced oral intake, were independently correlated with survival. Accuracy of the model based on these factors to predict 7-day mortality is high (AUC=0.90). Conclusion: Bilirubin is an independent prognostic factor for 7 day-survival among patients with end-stage oncologic liver disease. Combining bilirubin, urea, ECOG and oral intake increases short term prognostication accuracy in this subgroup of patients.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenging Pain Management in Widespread Metastatic Neuroendocrine Tumour 广泛转移性神经内分泌肿瘤疼痛管理的挑战

Journal of palliative care & medicine Pub Date : 2018-01-01 DOI: 10.4172/2165-7386.1000341

S. Majeed, N. Rodwell

引用次数: 0

“Do-Not-Resuscitate” Orders in Children with Cancer at the End of Life: A Retrospective Review “不复苏”命令的儿童癌症在生命的尽头:回顾性审查

Journal of palliative care & medicine Pub Date : 2018-01-01 DOI: 10.4172/2165-7386.1000340

Chun-Chu Chang, M. Lee, Yu‐Chuan Wen, Tingting Yu, Shih-Hsiang Chen, T. Jaing

{"title":"“Do-Not-Resuscitate” Orders in Children with Cancer at the End of Life: A Retrospective Review","authors":"Chun-Chu Chang, M. Lee, Yu‐Chuan Wen, Tingting Yu, Shih-Hsiang Chen, T. Jaing","doi":"10.4172/2165-7386.1000340","DOIUrl":"https://doi.org/10.4172/2165-7386.1000340","url":null,"abstract":"‘‘Do-not-resuscitate’’ (DNR) orders constitute a vital part of End-of-Life (EOL) care for patients with terminal cancer. In this retrospective study, we reviewed the medical records of patients treated at a tertiary referral pediatric oncology unit between May 2006 and May 2017. We gathered data about days from signing the DNR to death, age at death, gender, disease and its status, place of death, and survival and performed t-test and χ2 test as appropriate. Of the 225 patients [127 males, 98 females; median age: 10.0 years (range, 0.4-23.4) years] enrolled, 130 (57.8%) provided DNR orders signed by their surrogates. In addition, 29.3%, 44.8%, and 25.8% of deaths occurred in the pediatric oncology ward, the intensive care unit, and at home or another hospital, respectively. We observed an annual increase in the signing rate of DNR orders. The median duration between signing a DNR order and death was 2 (range: 0-88) days. Furthermore, DNR orders tended to be committed by patients with slowly deteriorating disease and those with extended overall survival. This study deduces that an explicit DNR order is now a rule rather than an exception, with more DNR orders being signed for patients aged>10 years hospitalized for EOL cancer care. Hence, the early implementation of a DNR order could be underutilized in younger patients with cancer.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"08 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70685090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Access to Palliative Care Services: A Qualitative Study of Experiences of Children and Families Attending University Teaching Hospital in Lusaka 缓和疗护服务的可及性:卢萨卡大学教学医院儿童及家庭住院经验的质性研究

Journal of palliative care & medicine Pub Date : 2018-01-01 DOI: 10.4172/2165-7386.1000328

W. Mutale, F. Goma, L. Gwyther

{"title":"Access to Palliative Care Services: A Qualitative Study of Experiences of Children and Families Attending University Teaching Hospital in Lusaka","authors":"W. Mutale, F. Goma, L. Gwyther","doi":"10.4172/2165-7386.1000328","DOIUrl":"https://doi.org/10.4172/2165-7386.1000328","url":null,"abstract":"Introduction: WHO recommends provision of palliative care for all who need it according to needs and context. However, in Sub-Saharan Africa coverage of palliative care services remain low especially children. This study reports experiences of palliative care services for children and their families attending the University Teaching hospital in Lusaka, Zambia. Methodology: The was a cross-sectional qualitative study conducted at University teaching hospital in Lusaka, Zambia. Results: The major challenges faced by families included lack of economic/financial and bereavement support. Most families were referred to the UTH from very far places without any form of support. One major barrier identified to provision of palliative care was poor coordination of services with most patients missing out on services which were already available. While social workers were available, poor funding negatively affected this service. There were very few trained health workers in palliative care. Pain management remained poor with many clinicians still not comfortable to prescribe stronger analgesia such as morphine for severe pain. Conclusion: The study revealed significant gaps for children’s palliative care services in at the University teaching hospital in Zambia. One major barrier identified to provision of palliative care was poor coordination of services. Families reported lack of economic and bereavement support in addition to lack of information.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physician Assisted Suicide for Terminally Ill Patients: An Argumentative Essay 医生协助临终病人自杀:一篇议论文

Journal of palliative care & medicine Pub Date : 2018-01-01 DOI: 10.4172/2165-7386.1000337

A. Ababneh

引用次数: 0

Knowledge and Attitude of ER and ICU Physicians towards DNR in a Tertiary Care Center in Saudi Arabia: A Survey Study 沙特阿拉伯三级医疗中心急诊室和ICU医生对DNR的知识和态度:一项调查研究

Journal of palliative care & medicine Pub Date : 2018-01-01 DOI: 10.4172/2165-7386.1000327

Alaa M. Gouda, N. Alrasheed, Alaa Ali, Ahmad Allaf, Najd Almudaiheem, Youssuf Ali, A. Alghabban, Sami Alsalolami

{"title":"Knowledge and Attitude of ER and ICU Physicians towards DNR in a Tertiary Care Center in Saudi Arabia: A Survey Study","authors":"Alaa M. Gouda, N. Alrasheed, Alaa Ali, Ahmad Allaf, Najd Almudaiheem, Youssuf Ali, A. Alghabban, Sami Alsalolami","doi":"10.4172/2165-7386.1000327","DOIUrl":"https://doi.org/10.4172/2165-7386.1000327","url":null,"abstract":"Introduction: Only a few studies from Arab Muslim countries address DNR practice. Our institute has a clear DNR policy. The knowledge of the existing policy and the attitude towards DNR of emergency room (ER) and intensive care unit (ICU) physicians were studied through this survey. Objective: To identify the knowledge of the participants of the local DNR policy and guidelines and to summarize the possible barriers of addressing DNR including religious background. Method: A questionnaire has been distributed to ER and ICU physicians. The answers to the questions were tabulated and analyzed using frequencies and percentage. Results: Total of 112 physicians with majority (97.3%) are from a Muslim religion. Among the participants 108 (96.4%) were aware about the existence of DNR policy in our institute. 107 (95.5%) stated that DNR is not against Islamic rules. Only (13.4%) of the physicians have advance directives and (90.2%) answered they will request to be placed as DNR if they have terminal illness. Lack of patients and families understanding (51.8%) and inadequate training (35.7%) were the 2 most important barriers for effective DNR discussion. Patients and Families level of education (58.0%) and cultural factors (52.7%) were the main obstacles in initiating a DNR order. Only (1.8%) of the participants stated that DNR is against their religious belief. Conclusions: There is a lack of knowledge about DNR policy which make the optimization of DNR process difficult. Most physicians wish DNR for themselves and their patients at end of life but only a few of them have advance directives. The most important barriers for initializing and discussing DNR were lack of patient understanding, level of education, and the culture of patients. Most of the Muslim physicians believe that DNR is not against Islamic rules. We suggest that the DNR concept should be part of any training program.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Existential Analysis and Logo Therapy on a Good Way to Die “好死”的存在分析与标志疗法

Journal of palliative care & medicine Pub Date : 2018-01-01 DOI: 10.4172/2165-7386.1000330

M. Ulrichová

引用次数: 0

Blood Pressure Levels and Urinary Frequency in Hypertensive Patients: A Cross-sectional Analysis 高血压患者血压水平和尿频:一项横断面分析

Journal of palliative care & medicine Pub Date : 2018-01-01 DOI: 10.4172/2165-7386.1000345

M. Sarfraz, Sana Shaikh, S. A. Zaidi, A. Raees, Ahsan Ali Siddiqui, N. Jamil, A. Anwar

引用次数: 0

Palliative Care is a Useful Means to Overcome Intercultural Barriers Faced by Refugees in their New Host Countries 姑息治疗是难民在新东道国克服跨文化障碍的有效手段

Journal of palliative care & medicine Pub Date : 2018-01-01 DOI: 10.4172/2165-7386.1000334

M. Silbermann, L. Baider, D. Respini, P. Tralongo, M. Daher, Rana F. Obeidat, N. Gafer, S. Fadhil, M. Rassouli, S. Cheli, A. Eniu, L. Balducci

{"title":"Palliative Care is a Useful Means to Overcome Intercultural Barriers Faced by Refugees in their New Host Countries","authors":"M. Silbermann, L. Baider, D. Respini, P. Tralongo, M. Daher, Rana F. Obeidat, N. Gafer, S. Fadhil, M. Rassouli, S. Cheli, A. Eniu, L. Balducci","doi":"10.4172/2165-7386.1000334","DOIUrl":"https://doi.org/10.4172/2165-7386.1000334","url":null,"abstract":"The unprecedented wave of refugee migration from Africa and the Middle East to Europe presents major challenges to European health professionals and to society at large. A recent workshop which took place in Syracuse, Sicily, brought together physicians, nurses and psychologists and managers of governmental agencies from Italy, Lebanon, Israel, Iraq, Iran, Sudan, Tunisia, Jordan, and the European Society of Medical Oncology, aimed to create a training program to formulate a dialogue between professionals in their regions and refugees in Italy. A major barrier refugees face is a lack of communication (verbal and cultural) which hinders their smooth absorption into society. Cultural mediators who speak Arabic and Italian and understand the refugees’ faith, tradition and beliefs, are paramount to successfully building bridges between such diversities. Predictably, most asylum seekers undergo anxiety, fear, and depression after arriving in Europe. Following intensive deliberations, all workshop participants agreed that applying palliative care methodologies, as practiced in cancer patients, would be therapeutically advantageous in overcoming the psychological suffering that refugees experience during their initial stay in Europe. Accordingly, all agreed to start with training courses, both in refugees’ countries of origin and in Europe, for representatives or mediators (preferably with some clinical background and experience); whereby tremendous efforts would be made to create a working palliative care model that includes bio-psycho-social elements. This model or paradigm will employ a culturally sensitive approach that takes refugees’ spiritual needs into consideration, relying on core ethical principles.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Overview of Breast Cancer Epidemiology, Incidence and Trends from 2008-2016 in Dubai Hospital, Dubai Health Authority, Hospital-Based Cancer Registry 2018 迪拜医院2008-2016年乳腺癌流行病学、发病率和趋势综述，迪拜卫生局，2018年医院癌症登记处

Journal of palliative care & medicine Pub Date : 2018-01-01 DOI: 10.4172/2165-7386.1000346

N. Salim, H. Hussain, M. Tuffaha, Raja Kathamuthu, A. Tamimi, Amna Abunawas Al Mehairi

引用次数: 0