BMJ Supportive & Palliative Care最新文献_第10页

Hospice care and the value of a statistical life year (VSLY). 安宁疗护和统计生命年的价值 (VSLY)。

IF 2.7 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-05-22 DOI: 10.1136/spcare-2024-004938

Nadia J Sweis

引用次数: 0

Palliative care needs in medical intensive care: improved identification-retrospective cohort study. 内科重症监护中的姑息关怀需求：改进识别--回顾性队列研究。

IF 2.7 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-05-22 DOI: 10.1136/spcare-2022-004128

Olivia Rossnan, Abby Hanson, Aaron Spaulding, Parthkumar Satashia, Shivang Bhakta, Maisha Robinson, Scott A Helgeson, Pablo Moreno-Franco, Devang Sanghavi

引用次数: 0

Palliative care inpatients in Switzerland (2012-2021): characteristics, in-hospital mortality and avoidable admissions. 瑞士姑息关怀住院病人（2012-2021 年）：特征、院内死亡率和可避免的入院治疗。

IF 2.7 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-05-20 DOI: 10.1136/spcare-2023-004717

Benjamin Hurni, Beat Müller, Balthasar L Hug, Patrick E Beeler

{"title":"Palliative care inpatients in Switzerland (2012-2021): characteristics, in-hospital mortality and avoidable admissions.","authors":"Benjamin Hurni, Beat Müller, Balthasar L Hug, Patrick E Beeler","doi":"10.1136/spcare-2023-004717","DOIUrl":"https://doi.org/10.1136/spcare-2023-004717","url":null,"abstract":"Objectives: Palliative patients generally prefer to be cared for and die at home. Overly aggressive treatments place additional strain on already burdened patients and healthcare services, contributing to decreased quality of life and increased healthcare costs. This study characterises palliative inpatients, quantifies in-hospital mortality and potentially avoidable hospitalisations.Methods: We conducted a multicentre retrospective analysis using the national inpatient cohort. The extracted data encompassed all inpatients for palliative care spanning the years 2012-2021. The dataset comprised information on demographics, diagnoses, comorbidities, treatments and clinical outcomes. Content experts reviewed a list of treatments for which no hospitalisation was required.Results: 120 396 hospitalisation records indicated palliative patients. Almost half were women (n=59 297, 49%). Most patients were ≥65 years old. 66% had an oncologic primary diagnosis. The majority were admitted from home (82 443; 69%). The patients stayed a median of 12 days (6-20). All treatments for 25 188 patients (21%) could have been performed at home. In-hospital deaths ended 64 739 stays (54%); of note, 10% (n=6357/64 739) of in-hospital deaths occurred within 24 hours.Conclusions: In this nationwide study of palliative inpatients, two-thirds were 65 years old and older. Regarding the performed treatments alone, a fifth of these hospitalisations can be considered as avoidable. More than half of the patients died during their hospital stay, and 1 in 10 of those within 24 hours.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141069875","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

Frailty and prognosis in lung cancer: systematic review and meta-analysis. “肺癌的虚弱和预后:系统回顾和荟萃分析”。

IF 2.7 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-05-17 DOI: 10.1136/spcare-2023-004577

Tianzi Liu, Xintong Peng, Yan Geng, Chen Song, Ziwen Zhou, Yan Huang

{"title":"Frailty and prognosis in lung cancer: systematic review and meta-analysis.","authors":"Tianzi Liu, Xintong Peng, Yan Geng, Chen Song, Ziwen Zhou, Yan Huang","doi":"10.1136/spcare-2023-004577","DOIUrl":"10.1136/spcare-2023-004577","url":null,"abstract":"Lung cancer is one of the most common malignant tumours. Patients are frequently at risk of frailty as lung cancer progresses. The meta-analysis aims to explore the impact of frailty on the long-term prognosis and the incidence of short-term chemotherapy toxicity in patients with lung cancer. This study was designed adhered to the criteria of Cochrane Handbook for Systematic Reviews. Systematic searches were performed on PubMed, Embase, Web of Science and Cochrane Library databases for relevant studies until December 2022. The outcome measures were overall survival, progression-free survival, chemotherapy toxicity and all-cause mortality. We then performed sensitivity analyses, subgroup analyses and evidence quality. This meta-analysis was performed using Review Manager V.5.4 software. Of the included studies, six were retrospective and five were prospective. There was a statistically significant difference between the frail and non-frail groups in overall survival (HR 2.27, 95% CI 1.24 to 4.15, p=0.008), all-cause mortality (HR 1.63, 95% CI 1.00 to 2.65, p=0.05) and chemotherapy toxicity (OR 3.73, 95% CI 1.99 to 7.00, p<0.0001). We conducted a sensitivity analysis, and the result was stable. The study revealed frail group had shorter survival and experienced more severe adverse effects than the non-frail group. Frailty affects the long-term prognosis and the incidence of short-term chemotherapy toxicity of patients with lung cancer. Consequently, medical professionals should focus on frailty screening in patients with lung cancer and implement active intervention measures. PROSPERO registration number is CRD42023398606.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138481923","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

Early palliative care in haematological malignancies. 血液恶性肿瘤的早期姑息治疗。

IF 2.7 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-05-17 DOI: 10.1136/spcare-2024-004812

Leonardo Potenza, Mario Luppi, Camilla Zimmermann, Elena Bandieri

引用次数: 0

Integrative oncology for palliative care nurses: pre-post training evaluation. 针对姑息治疗护士的整合肿瘤学：培训前后评估。

IF 2.7 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-05-17 DOI: 10.1136/spcare-2022-004117

Eran Ben-Arye, Yehudit Tapiro, Ruth Baruch, Ahuva Tal, Bella Shulman, Orit Gressel, Pesi Israeli, Jamal Dagash, Alexander Yosipovich, Ilanit Shalom Sharabi, Patricia Zimmermann, Noah Samuels

{"title":"Integrative oncology for palliative care nurses: pre-post training evaluation.","authors":"Eran Ben-Arye, Yehudit Tapiro, Ruth Baruch, Ahuva Tal, Bella Shulman, Orit Gressel, Pesi Israeli, Jamal Dagash, Alexander Yosipovich, Ilanit Shalom Sharabi, Patricia Zimmermann, Noah Samuels","doi":"10.1136/spcare-2022-004117","DOIUrl":"10.1136/spcare-2022-004117","url":null,"abstract":"Objectives: Integrative oncology (IO) is increasingly being incorporated in supportive and palliative cancer care. This study examined an IO-palliative care training programme for nurses from community and hospital settings.Methods: A 120-hour course, attended by 24 palliative care nurses without IO training, included precourse/postcourse questionnaires examining knowledge, attitudes and level of IO-palliative care skills. Qualitative analysis examined precourse and postcourse narratives.Results: Most (18; 75%) completed study questionnaires, with knowledge and attitudes towards IO changing only modestly and IO-related skills significantly for guidance on herbal medicine and lifestyle changes, manual-movement and mind-body modalities. Greater consultation skills were reported for fatigue, stomatitis, nausea, appetite, constipation/diarrhoea, insomnia, peripheral neuropathy and hot flashes. Trainees reported improved skills for pain (p=0.003), emotional (p<0.001) and informal caregiver-related concerns (p<0.001), with no change in palliative care-related skills. Qualitative analysis found both personal and professional attitude changes, with enhanced mindfulness and an expressed intent to implement the learnt skills in daily practice.Conclusions: The IO-palliative care nurse training programme increased IO-related and palliative care-related consultation skills for a wide range of quality of life-related concerns. Further research is needed to explore both short-term and long-term effects and the implementation of the learnt skills in clinical practice.Trial registration number: NCT03676153.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236842","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

Advanced hepatocellular carcinoma and palliative care: a scoping review. 晚期肝细胞癌与姑息治疗：范围界定综述。

IF 2.7 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-05-17 DOI: 10.1136/spcare-2022-003798

Tian Tian, Ju Guo, Ju-Lan Hu, Yue Hu, Ping Guo, Xiao-Yun Yu

{"title":"Advanced hepatocellular carcinoma and palliative care: a scoping review.","authors":"Tian Tian, Ju Guo, Ju-Lan Hu, Yue Hu, Ping Guo, Xiao-Yun Yu","doi":"10.1136/spcare-2022-003798","DOIUrl":"10.1136/spcare-2022-003798","url":null,"abstract":"Background: Patients with advanced hepatocellular carcinoma (HCC) have specific palliative care needs owing to the influence of the disease on abdominal pain, jaundice, bleeding, appetite, ascites, liver function and hepatic encephalopathy. This research would help develop care models and identify knowledge gaps in the field.Aims: To identify the palliative care needs and experiences of patients with advanced HCC.Methods: CINAHL, EMBASE and MEDLINE were used to search English literature from January 1998 to March 2022 for 'Palliative care' and 'Hepatocellular cancer' using precise inclusion and exclusion criteria.Results: The retrieves identified 2710 records, including 33 studies used in our research. Two additional studies were grey items. Among 35 studies, 13 studies were performed in Asia, 11 studies in North America, 8 studies in Europe and 3 studies in Australia. Quantitative investigations were mostly descriptive or observational. Eight studies were conducted on a national scale, while two were in specific regions. 20 studies were conducted by a single institution. 22 studies focused only on patients, 2 on family caregivers and 2 on healthcare professionals. 2 more studies concentrated on patients and family caregivers, while 6 concentrated on patients and healthcare professionals.Conclusions: This scoping study illustrates the complexity of advanced HCC treatment and challenges in modern healthcare systems. Formulating appropriate referral criteria, integrating and coordinating care, and assessing care contents are crucial. To enhance the treatment of patients with advanced HCC, it is important to understand the relationships between research and service design across teams, disciplines and care settings.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40694252","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

Compressive taping to prevent postmastectomy seroma: patient adherence and satisfaction. 预防乳房切除术后血清肿的加压包扎：患者的依从性和满意度。

IF 2.7 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-05-17 DOI: 10.1136/spcare-2024-004912

Maíra Carneiro Fernandes, Erica Alves Nogueira Fabro, Matheus Albino Ximenes, Rejane Medeiros Medeiros Costa, Nathalia Bordinhon Soares, Suzana Sales de Aguiar, Luiz Claudio Santos Thuler, Anke Bergmann

{"title":"Compressive taping to prevent postmastectomy seroma: patient adherence and satisfaction.","authors":"Maíra Carneiro Fernandes, Erica Alves Nogueira Fabro, Matheus Albino Ximenes, Rejane Medeiros Medeiros Costa, Nathalia Bordinhon Soares, Suzana Sales de Aguiar, Luiz Claudio Santos Thuler, Anke Bergmann","doi":"10.1136/spcare-2024-004912","DOIUrl":"https://doi.org/10.1136/spcare-2024-004912","url":null,"abstract":"Objective: Evaluate patient adherence and satisfaction concerning postmastectomy compressive taping.Methods: This comprises a preintervention and postintervention study carried out with women ≥18 years old who underwent taping during the first 7 postoperative days at the Cancer Hospital III/National Cancer Institute. Good adherence was considered as taping maintenance for 7 days. Satisfaction levels were classified as satisfied and dissatisfied.Results: A total of 124 women with a mean age of 56.54 (±11.24) were included in the study. Most lived without a partner (58.1%), had more than 8 years of study (59.7%), referred to themselves as white (68.5%) and considered their health status to be good or very good (69.4%). Regarding treatment adherence, 90.3% patients displayed adherence. Patients with no bullous lesions were more likely to adhere to taping (OR 7.00; 95% CI 1.98 to 24.74; p=0.003). Regarding satisfaction, 78.2% of the patients felt satisfied. The absence of local discomfort (OR 4.51; 95% CI 1.73 to 11.74; p=0.002) and non-existence of self-reported oedema (OR 5.81; 95% CI 1.81 to 18, 66; p=0.003) were associated with greater patient satisfaction.Conclusion: Patients exhibited good adherence and felt very satisfied with the use of postmastectomy compressive taping.Trial registration number: NCT04471142.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140955948","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

Home emergency response team for the seriously ill palliative care patient: feasibility and effectiveness. 重症姑息治疗患者的家庭应急小组：可行性和有效性。

IF 2.7 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-05-17 DOI: 10.1136/spcare-2023-004385

Nicolas Deniau, Taraneh Shojaei, Alexandre Georges, Jean Danis, Georges Czapiuk, Stephane Mercier, Claudine Maari, Sylvain Pourchet, Elisabeth Balladur, Clement Leclaire

{"title":"Home emergency response team for the seriously ill palliative care patient: feasibility and effectiveness.","authors":"Nicolas Deniau, Taraneh Shojaei, Alexandre Georges, Jean Danis, Georges Czapiuk, Stephane Mercier, Claudine Maari, Sylvain Pourchet, Elisabeth Balladur, Clement Leclaire","doi":"10.1136/spcare-2023-004385","DOIUrl":"10.1136/spcare-2023-004385","url":null,"abstract":"Objectives: To characterise trajectories associated with a new team organisation combining critical care and palliative care approaches at home.Methods: We describe the pattern of an emergency response team 24/7 directed to patients with advanced illness presenting a distressing symptom at home, who wanted to stay at home and for whom hospitalisation was considered inappropriate by a shared medical decision-making process in an emergency situation. To assess preliminary impact of this Programme, we conducted a descriptive study on all consecutive patients receiving this intervention during the first year (between 6 September 2021 and 5 September 2022).Results: Among the 352 patients included, main advanced illnesses were cancer (41%), dementia (28%) or chronic organ failure (10%). They were critically ill with acute failures: respiratory (52%), neurological (48%) or circulatory (20%). Main distressing symptoms were breathlessness (43%) and pain (17%). Median response time from call to home-visit (IQR) was 140 (90-265) min. Median length of follow-up (IQR) was 4 (2-7) days. Main outcomes were death at home (72%), improvement (19%) or hospitalisation (9%) including three visits to emergency department (1%).Conclusions: Our study supports that shared decision-making process and urgent care at home are feasible and might prevent undesired hospitalisations.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11103340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41232268","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

Supportive relationships between patients and family caregivers in specialist palliative care: a qualitative study of barriers and facilitators. 在专科姑息治疗患者和家庭照顾者之间的支持关系:障碍和促进者的定性研究。

IF 2.7 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-05-17 DOI: 10.1136/spcare-2023-004371

Rachel McCauley, Karen Ryan, Regina McQuillan, Lucy E Selman, Geraldine Foley

{"title":"Supportive relationships between patients and family caregivers in specialist palliative care: a qualitative study of barriers and facilitators.","authors":"Rachel McCauley, Karen Ryan, Regina McQuillan, Lucy E Selman, Geraldine Foley","doi":"10.1136/spcare-2023-004371","DOIUrl":"10.1136/spcare-2023-004371","url":null,"abstract":"Objectives: Patients with advanced illness and their family caregivers can be mutually supportive. However, what facilitates and/or restricts supportive relationships between patients and family caregivers in palliative care remains unclear. We aimed to identify key barriers to and facilitators of supportive relationships between people with advanced illness and family caregivers in specialist palliative care.Methods: A qualitative study using grounded theory methodology was conducted. Semistructured interviews were undertaken with 15 patients with advanced illness and 21 family caregivers purposively and theoretically sampled from a large regional specialist palliative care service. Verbatim transcripts were analysed in line with grounded theory coding procedures.Results: Mutual support was underpinned by mutual concern and understanding. Facilitators of supportive relationships included patients and family caregivers already having a close relationship, caregivers assuming caregiving duties by choice, caregivers feeling competent in a caregiving role, patients valuing caregiver efforts, availability of respite for the caregiver and direct support from healthcare professionals to help both patients and caregivers adjust to advanced illness. Barriers to supportive relationships included absence of support from the wider family, prior mutual conflict between the patient and caregiver, caregivers feeling constrained in their caregiving role and patient and caregiver distress induced by mutual loss.Conclusions: Multiple factors at both a micro (eg, relationship based) and mesolevel (eg, assistance from services) impact patient and family caregiver ability to support one another in specialist palliative care. Supportive relationships between patients and family caregivers are mediated by feelings pertaining to both control and loss.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138481926","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