Journal articles: 'Palliative treatment Study and teaching'

1

Cornetta, Kenneth, Susan Kipsang, Gregory Gramelspacher, Eunyoung Choi, Colleen Brown, Adam B. Hill, Patrick J. Loehrer, Naftali Busakhala, and F. Chite Asirwa. "Integration of Palliative Care Into Comprehensive Cancer Treatment at Moi Teaching and Referral Hospital in Western Kenya." Journal of Global Oncology 1, no. 1 (October 2015): 23–29. http://dx.doi.org/10.1200/jgo.2015.000125.

Full text

Abstract:

Purpose The prognosis for the majority of patients with cancer in Kenya is poor, with most patients presenting with advanced disease. In addition, many patients are unable to afford the optimal therapies required. Therefore, palliative care is an essential part of comprehensive cancer care. This study reviews the implementation of a palliative care service based at the Moi Teaching and Referral Hospital in Eldoret, Kenya, and describes the current scope and challenges of providing palliative care services in an East African tertiary public referral hospital. Methods This is a review of the palliative care clinical services at the only tertiary public referral hospital in western Kenya from January 2012 through September 2014. Palliative care team members documented each patient's encounter on standardized palliative care assessment forms; data were then entered into the Academic Model Providing Access to Health Care (AMPATH)-Oncology database. Interviews were also conducted to identify current challenges and opportunities for program improvement. Results This study documents the implementation of a palliative care service line in Eldoret, Kenya. Barriers to providing optimal palliative cancer care include distance to pharmacies that stock opioids, limited selection of opioid preparations, education of health care workers in palliative care, access to palliative chemoradiation, and limited availability of outpatient and inpatient hospice services. Conclusion Palliative care services in Eldoret, Kenya, have become a key component of its comprehensive cancer treatment program.

APA, Harvard, Vancouver, ISO, and other styles

2

Taubert, Mark, Lucie Webber, Timothy Hamilton, Madeleine Carr, and Mark Harvey. "Virtual reality videos used in undergraduate palliative and oncology medical teaching: results of a pilot study." BMJ Supportive & Palliative Care 9, no. 3 (February 26, 2019): 281–85. http://dx.doi.org/10.1136/bmjspcare-2018-001720.

Full text

Abstract:

BackgroundVirtual reality (VR) immersive environments have been shown to be effective in medical teaching. Our university hospital received funding from our deanery, Health Education in Wales, to film teaching videos with a 360-degree camera.AimsTo evaluate whether VR is an effective and acceptable teaching environment. VR headsets were set up for medical students who rotated through Velindre Cancer Hospital’s Palliative Care department.MethodsStudents were asked to put on a VR headset and experience a pre-recorded 27 min presentation on nausea and vomiting in palliative care settings. They subsequently viewed a radiotherapy treatment experience from a patient’s point of view.ResultsOf the 72 medical students who participated, 70 found the experience comfortable, with two students stating they felt the experience uncomfortable (1=headset too tight; 1=blurry visuals). Numerical scoring on ability to concentrate in VR from 0 to 10 (0=worst, 10=best) scored an average of 8.44 (range, 7–10). Asked whether this format suited their learning style, average score was 8.31 (range 6–10). 97.2 % (n=70) students stated that they would recommend this form of learning to a colleague, with one student saying he/she would not recommend and another stating he/she was unsure. Students left anonymous free-text feedback comments which helped frame future needs in this emerging area.DiscussionThis study suggests that there is room for exploring new ways of delivering teaching and expanding it more widely in palliative care and oncology, but also provides feedback on areas that need further careful attention. Comments from students included: “Might have been the novelty factor but I learnt more from this 20 min VR thing than I have from many lectures”.SummaryThe project has proved sufficiently popular in medical student feedback, that the VR experience is now available on YouTube and has been permanently introduced into routine teaching. Further 360-degree teaching environments have been filmed. Of note is that our 360-degree videos have been viewed in Africa, so this format of teaching could prove valuable due to its global reach.

APA, Harvard, Vancouver, ISO, and other styles

3

Harding, Richard, Shoba Nair, and Maria Ekstrand. "Multilevel model of stigma and barriers to cancer palliative care in India: a qualitative study." BMJ Open 9, no. 3 (March 2019): e024248. http://dx.doi.org/10.1136/bmjopen-2018-024248.

Full text

Abstract:

IntroductionPalliative care coverage and opioid consumption in India are relatively low compared with global data. The literature suggests commonplace concealment and collusion in withholding information, but these hypotheses lack evidence.ObjectivesThis study aimed to develop an explanatory evidence-based model of stigma, communication and access to cancer palliative care in India that can be used to develop, test and implement future interventions.DesignThis cross-sectional qualitative study sampled advanced cancer patients (n=10), their family caregivers (n=10) and oncologists (n=10). Grounded theory procedures were utilised to analyse transcripts, and a theoretical model generated.SettingA tertiary teaching hospital in South India.ResultsThe model explains how stigma associated with communicating a diagnosis of advanced cancer is enacted by treating oncologists, family members and community. This leads to patient expectations of cure and futile treatment uptake. Patients commonly only present needs with respect to pain, not within psychological, social or spiritual domains, likely due to the lack of patients’ insight into their diagnosis and prognosis. As a result of oncologists’ and families’ unwillingness to disclose the prognosis, and patient focus on pain due to their lack of insight, palliative care clinicians view their services as under-utilised, and patients perceive palliative care as a pain management service that is not ‘different’ from other clinical services. Advanced care needs and purchase of futile treatments lead to lost employment among families, increased family debt and high care costs, which are rarely disclosed due to their unwillingness to discuss their needs.ConclusionOur novel theoretical model is an essential first step to ensure that complex interventions are plausible, with mechanisms of action that address the needs of relevant stakeholders. A family-centred approach with an oncology workforce skilled in communication and an enabled patient population could increase access to palliative care, and improved outcomes may be attainable.

APA, Harvard, Vancouver, ISO, and other styles

4

Arain, Abeer Nisar Arain, Zunaira Abdul Ghaffar, Naveed-ur Rehman, M. N. Siddiqi, and Raza Rehman. "KNOWLEDGE AND UNDERSTANDING OF MEDICAL STUDENTS ABOUT RADIOTHERAPY AND PALLIATIVE CARE." Professional Medical Journal 21, no. 02 (December 7, 2018): 325–32. http://dx.doi.org/10.29309/tpmj/2014.21.02.2176.

Full text

Abstract:

Objective: To assess the knowledge of undergraduate medical students aboutradiotherapy, cancer and palliative care in cancer. Method: A descriptive study to assess theknowledge of radiotherapy, cancer and palliative care is conducted among undergraduatemedical students of Dow Medical College. 300 students from each batch of fourth and final yearwere assessed for knowledge of radiotherapy, palliative care, cancer knowledge, cancerprevention, students’ visits to radiotherapy units, source of cancer information, teachingprograms of radiotherapy in medical college, choice of career and participation in palliative carecourse during their undergraduate years. Results: 246 questionnaires were returned. 41% ofstudents correctly answered to different questions related to the knowledge about radiotherapy.Data regarding cancer treatment knowledge among students showed an average of 32%. Thegeneral knowledge regarding cancer among the students was present in approximately twothirds(60%) of participants. The knowledge regarding cancer prevention prevailed around36.04%. Conclusions: There is a need to change the perception of palliative care and radiationtherapy among medical students. Teaching of radiotherapy should begin early in theundergraduate curriculum of MBBS, and it should be mandatory for all the students. Oncologyrotations should be constructed where the principles of radiotherapy and palliative care can beconveyed.

APA, Harvard, Vancouver, ISO, and other styles

5

Wong, Aaron Kee Yee. "Are hospital clinicians aware of legislation surrounding provision of palliative care?" Journal of Clinical Oncology 34, no. 26_suppl (October 9, 2016): 118. http://dx.doi.org/10.1200/jco.2016.34.26_suppl.118.

Full text

Abstract:

118 Background: Many deaths require medical treatment to be withheld or withdrawn. Patients or their substitute decision makers may disagree with these decisions, and sometimes refuse the right to appropriate palliative care. An awareness of legal frameworks surrounding end of life decisions is vital to navigate through these conflicts. Without this, patients suffer unnecessarily. Methods: 542 hospital doctors and nurses were recruited from a large metropolitan public tertiary teaching hospital network involving 5 campuses and 2 medical schools. A questionnaire examined their regarding legislation surrounding end of life care, both in adults with and without capacity. Results: Approximately a quarter of respondents did not believe that the “Not for Resuscitation Form” is legally a medical decision. Most doctors (68%), but not nurses, believed competent patients cannot demand futile treatment. Most clinicians (79% doctors and 85% nurses) erroneously believe that competent patients can refuse appropriate palliative care. There was significant confusion regarding the roles of substitute decision makers. Most clinicians could not find the advance directive. Groups with most correct answers were doctors, had 5-10 years experience, and were in palliative care and critical care specialties. Conclusions: This study confirms poor knowledge regarding legislation surrounding provision of palliative care. An unusually high proportion believed patients could refuse appropriate palliative care. Most clinicians could not locate advance directives. Most nurses believed patients could legally demand futile treatment. Both junior and senior staff had comparably poor knowledge in this area.

APA, Harvard, Vancouver, ISO, and other styles

6

DOSSOUVI, Tamegnon, Rafiou EL-HADJI YAKOUBOU, Komlan ADABRA, Ayi AMAVI, Olivier AMOUZOU Efoé-Ga, Kouliwa KANASSOUA Kokou, Iroukora KASSEGNE, and David DOSSEH Ekoué. "Stomach cancer: epidemiological, diagnostic and therapeutic aspects at the Kara Teaching Hospital, Togo." Archives of Surgery and Clinical Research 6, no. 1 (March 16, 2022): 001–3. http://dx.doi.org/10.29328/journal.ascr.1001062.

Full text

Abstract:

Objective: To report our experience in the management of gastric cancers at the Kara University Hospital (Togo). Materials and methods: This was a retrospective and prospective study which was conducted from January 1, 2018, to July 31, 2021, in the general surgery and hepato-gastroenterology department of the Kara University Hospital (Togo). This study involved all patients treated for gastric cancer during the study period at CHU Kara (Togo). Results: We recorded 32 gastric cancers out of the 218 cases of cancer diagnosed during the study period. We had 20 men and 12 women with a sex ratio (M/F = 1.7). The average age was 58 years with the extremes ranging from 17 to 85 years. The pattern of the consultation was dominated by epigastralgia (100%) and deterioration in general condition (100%). Upper digestive endoscopy with biopsies was performed in all our patients. The antral localization was the most found in 62.5% of cases. The most common macroscopic appearance was ulcers-budding (90.6%) and the dominant histological type was moderately differentiated adenocarcinoma (87.5%). The extension assessment found liver metastasis in 10 cases, multiple regional lymphadenopathies of the hepatic pedicle and celiac trunk in 26 cases, ascites related to peritoneal carcinomatosis in 26 cases. Therapeutically, a 4/5 gastrectomy with D1 dissection was performed in 6 cases; gastrojejunal anastomosis in one case and palliative treatment in 25 cases. Survival at 1 year is 50% (3 patients) among operated patients. All the other patients (78.1%) who received palliative treatment all died within 3 months. Conclusion: Improving the prognosis of stomach cancer like other cancers requires early diagnosis to perform a gastrectomy, the only guarantee of long survival.

APA, Harvard, Vancouver, ISO, and other styles

7

Saka, M. J., S. Akinwale, Z. A. Bakare, M. A. Odunewu, and Abdulrasaq Ishola. "Physical Functionality of Cancer Patients Receiving Disease-Directed Therapy (DDT) with Palliative Care Compare with Patients on DDT Only in Kwara State, Nigeria." Asian Journal of Medicine and Biomedicine 5, no. 2 (October 29, 2021): 19–25. http://dx.doi.org/10.37231/ajmb.2021.5.2.435.

Full text

Abstract:

Physical activity is defined as any bodily movement caused by muscle contractions and resulting in energy expenditure. Palliative care is a special care for patients with active, progressive, advanced disease such as cancer where the prognosis is short and the focus of care is the quality of life. The study assessed the difference in the physical functionality of cancer patients receiving palliative care along with disease-directed therapy and cancer patients receiving only disease-directed therapy in Ilorin, Kwara State Nigeria. The study was a comparative cross-sectional research design conducted among 108 cancer patients at two tertiary institutions in Ilorin, Kwara State Nigeria. Patients who received palliative care alongside cancer-directed therapy were recruited from University of Ilorin Teaching Hospital and compared with cancer patients receiving only cancer-directed therapy from General Hospital Ilorin. About two-third 62.8% of the respondents taking palliative had good physical health, while over half 54.3% of the disease-directed therapy respondents had poor physical functioning. In addition, 34.1% of patients on both therapies reported no trouble in bending, kneeling and stooping, 23.7% could climb one flight of stairs with little help and 45.8% of the respondents reported no difficulty in bathing and dressing themselves. The relationship was statistically significant at p< 0.05. The study demonstrated that addition of palliative care services significantly improves patient outcomes in the domains of physical function. It therefore recommended that palliative care intervention should be part of care for cancer patients from onset of diagnosisas this may prevent subsequent symptoms and inappropriate treatment.

APA, Harvard, Vancouver, ISO, and other styles

8

Thakur, Deepak Kumar, B. Ghimire, and YP Singh. "Trend in Gastric Outlet Obstruction at Patients Attending Tribhuvan University Teaching Hospital, Kathmandu, Nepal." Birat Journal of Health Sciences 2, no. 2 (November 2, 2017): 219–21. http://dx.doi.org/10.3126/bjhs.v2i2.18531.

Full text

Abstract:

IntroductionGastric outlet obstruction (GOO) involves obstruc_on in the antro-pyloric region or bulb of duodenum. Malignancy is common cause of GOO in adults but many patients with GOO have benign causes. Despite the improvement in medical management, about 5% patients with complicated duodenal ulcer disease and 1%-2% with complicated gastric ulcer disease respectively develop this problem.ObjectiveThe purpose of this study was to find the etiologies of GOO, their management options and outcome in Tribhuvan University Teaching Hospital.MethodologyIn this retrospective study, the records of 44 patients admited with diagnosis of GOO from September 2007 to August 2010 in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal were retrieved. Patients' demography, etiologies of GOO, treatment given and their outcome were analysed.ResultsThirty two patients (73%) were male and 12 (27%) were female with M:F ratio of 2.7:1. The mean age of patients was 57.40 years and duration of symptoms 2.68 months. Carcinoma of stomach, 28 cases (64%) was most common ecology of GOO followed by PUD, 9 (21%), duodenal malignancy,3 (7%), corrosive stricture, 2 (5%), advanced gallbladder carcinoma, 1 (2%) and chronic pancreatis, 1 (2%). Seventeen (39%) patients were treated by gastrojejunostomy, 14 (32%) by subtotal gastrectomy and gastrojejunostomy, 5 (11%) by truncal vagotomy and gastrojejunostomy, 4 (9%) by medical management, 2 (4.5%) by feeding jejunostomy, and 2 (4.5%) were discharged on request. Complications occurred in 7 (16%) patients and mortality in 1 (2%). Twenty three (52%) patients were candidates for chemotherapy either in an adjuvant or palliative seting.ConclusionGastric malignancy was the most common cause of gastric outlet obstruction. Most of the patients in our setup presented with advanced disease and were candidates of palliative treatment only. Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 219-221

APA, Harvard, Vancouver, ISO, and other styles

9

Castillo, Cecilia, Natalia Camejo, Dahiana Amarillo, Florencia Rodriguez, Florencia Vitureira, Gabriel David Krygier, and Lucia Beatriz Delgado. "Impact of the COVID-19 pandemic on health care activities at a Uruguayan mastology teaching unit: Preliminary results." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e12502-e12502. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e12502.

Full text

Abstract:

e12502 Background: After the government declared a health emergency due to COVID-19 on March, 2020, the Mastology Teaching Unit (UDAM) providing care to breast cancer patients tried to ensure adequate oncological care, and to protect patients from the virus infection and serious complications due to a possible state of immunosuppression. Towards this objective, the Department of Clinical Oncology developed guidelines with some treatment modifications. Objective: To assess the health care activities of the UDAM during the period considered as the “peak” of the pandemic, since its beginning to June 30, 2020. Methods: This is an observational study that collected data from the electronic clinical record system called Oncology Electronic Health Record (HCEO) during the aforementioned period. Results: There werea total of 293 medical appointments (221 in person), through which 131 patients were attended to. The number of medical appointments decreased by 16.7% compared to the same period in 2019 (352 appointments). Of the patients who were attended to during the “peak” period, 109 (83.2%) were on systemic onco-specific treatment and 22 (16.8%) were attended to for disease control. The medical appointments were scheduled to evaluate the continuity of treatment and treatment modifications if necessary (95 patients; 72.5%), for disease control (17; 12.9%), for first-time consultation (12; 9.1%) and to assess paraclinical studies (7; 5.3%). The patients were on hormone therapy (HT) (81 patients; 74%), chemotherapy (CT) (21; 19%), and anti-HER2 therapies (9; 8%). A total of 20 treatments were initiated, 14 with HT and 6 with CT. Of the 21 patients on CT, 14 (66.6%) were on adjuvant/neoadjuvant therapy. Of these, 9 (64.3%) continued with the same regimen with the addition of prophylactic granulocyte colony stimulating factors (G-CSF), and 5 (35.7%), who were receiving weekly paclitaxel, continued the treatment with no changes. The remaining 7 of 21 patients (33.3%) were on palliative CT. Of these, 2 (28.5%) continued the treatment with the addition of G-CSF, 3 (42.8%) continued with weekly capecitabine or paclitaxel with no treatment changes, and 2 (28.5%) changed their treatment regimen (a less myelosuppressive regimen was selected for one of them and this decision was due to the progression of the disease in the other patient). The 90 patients who were receiving adjuvant, neoadjuvant, or palliative criteria HT and/or anti-HER2 therapies, continued the treatment with no changes Conclusions: Although these are preliminary results, the available evidence suggests that, although medical appointments decreased by approximately 17%, the UDAM was able to maintain its healthcare activities and continued most of the treatments. The most modified treatment was CT, with the addition of prophylactic G-CSF, to avoid myelosuppression and potential complications from COVID-19 infection.

APA, Harvard, Vancouver, ISO, and other styles

10

Suryani, Sri, Mirfauddin, Bualkar Abdullah, and Roni Rahmat. "Analysis of Skin Radiation Injury After External Curative and Palliative Radiotherapy of Cervix Cancer with Linac." Gravitasi 21, no. 1 (December 23, 2022): 30–34. http://dx.doi.org/10.22487/gravitasi.v21i1.15918.

Full text

Abstract:

Radiotherapy is a powerful tool for tumour control and treatment for various types of cancer. Despite the technological advances, cancer patients are still experiencing skin radiation injury. This study analyzed the probability of the skin radiation injury experienced by cervical cancer patients after external curative and palliative radiotherapy. This research was conducted at the Hasanuddin University Teaching Hospital in the Radiology section. The instrument used LINAC 6 MV external radiotherapy with the Varian brand. The state of the cancer of the samples was stage 2 B, and 3 B. The application of the dose rate for the two stages in curative therapy did not differ, such as 6.06 Gy/min to 8.26 Gy/min. On the contrary, palliative therapy uses a dose rate of 11.06 Gy/min to 13.47 Gy/min. This dose rate is higher than the curative dose rate because this therapy aims to reduce the size of cancer.

APA, Harvard, Vancouver, ISO, and other styles

11

Milki, Anthony, Amandeep Kaur Mann, Daniel Stuart Kapp, and John K. Chan. "Progress and trends in the utilization and adoption of palliative care in patients with terminal gynecologic cancer in the United States: A study of 4,264 women." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): 11606. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.11606.

Full text

Abstract:

11606 Background: To determine the factors associated with the utilization of palliative care (PC) in patients with metastatic gynecologic cancer who died while hospitalized. Methods: Data were extracted from the National Inpatient Sample (NIS) database for patients with cervical, uterine, and ovarian cancers from 2005 to 2011. Chi-squared and logistic regression models were employed for statistical analyses. Results: Of 4264 women with gynecologic cancer, 983 (23.0%) utilized PC (median age: 66 years). 2633 (61.8%), 1034 (24.3%), and 597 (14.0%) patients had ovarian, uterine, and cervical cancer, respectively. The majority were white (57.9%), and the remainder were black (12.6%), Hispanic (7.8%), and Asian (3.1%). 24.9, 23.9, 23.6, and 25.2% were low, low-middle, middle-high, and high with respect to median income. Medicare, Medicaid, and private insurance was found in 46.7, 10.8, and 37.6% of patients. 36.9, 21.0, 18.0, and 24.1% of patients were treated in hospitals in the South, West, Midwest, and Northeast. 11.3, 23.9, and 64.2% of patients were treated in small, medium, and large hospitals, designated as teaching (53.1%) and nonteaching (46.3%) institutions. The utilization of PC increased from 5.2% in 2005 to 30.4% in 2011. Older age (OR: 1.34; 95% CI: 1.10-1.64; P = 0.01), high SES (OR: 1.37; 95% CI: 1.09-1.72; P = 0.01), privately insured (OR: 1.81; 95% CI: 1.46-2.24; P < 0.001), treatment at Western (OR: 1.94; 95% CI: 1.56-2.41; P < 0.001) and Midwestern hospitals (OR: 1.43; 95% CI: 1.15-1.77; P = 0.001), and depression (OR: 1.34; 95% CI: 1.00-1.80; P = 0.05) were associated with higher PC use. However, race, cancer type, hospital teaching status, and hospital location were not associated with PC use. Conclusions: The use of inpatient palliative care has increased significantly over the study period. The lower utilization of palliative care for terminal illness associated with younger, lower socioeconomic status, Southern and smaller volume hospitals warrants further attention.

APA, Harvard, Vancouver, ISO, and other styles

12

Painschab, Matthew S., Racquel E. Kohler, Edwards Kasonkanji, Takondwa Zuze, Bongani Kaimila, Richard Nyasosela, Ruth Nyirenda, Robert Krysiak, and Satish Gopal. "Microcosting Analysis of Diffuse Large B-Cell Lymphoma Treatment in Malawi." Journal of Global Oncology, no. 5 (December 2019): 1–10. http://dx.doi.org/10.1200/jgo.19.00059.

Full text

Abstract:

PURPOSE To describe the cost of treating diffuse large B-cell lymphoma (DLBCL) in Malawi under the following circumstances: (1) palliation only, (2) first-line cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), (3) salvage etoposide, ifosfamide, and cisplatin (EPIC), and (4) salvage gemcitabine and oxaliplatin (GEMOX). METHODS We conducted a microcosting analysis from the health system perspective in the context of a prospective cohort study at a national teaching hospital in Lilongwe, Malawi. Clinical outcomes data were derived from previously published literature from the cohort. Cost data were collected for treatment and 2-year follow-up, reflecting costs incurred by the research institution or referral hospital for goods and services. Costs were collected in Malawian kwacha, inflated and converted to 2017 US dollars. RESULTS On a per-patient basis, palliative care alone cost $728 per person. Total costs for first-line treatment with CHOP chemotherapy was $1,844, of which chemotherapy drugs made up 15%. Separate salvage EPIC and GEMOX cost $2,597 and $3,176, respectively. Chemotherapy drugs accounted for 30% of EPIC and 47% of GEMOX. CONCLUSION To our knowledge, this is among the first published efforts to characterize detailed costs of cancer treatment in sub-Saharan Africa. The per-patient cost of first-line treatment of DLBCL in Malawi is low relative to high-income countries, suggesting that investments in fixed-duration, curative-intent DLBCL treatment may be attractive in sub-Saharan Africa. Salvage treatment of relapsed/refractory DLBCL costs much more than first-line therapy. Formal cost-effectiveness modeling for CHOP and salvage treatment in the Malawian and other low-resource settings is needed to inform decision makers about optimal use of resources for cancer treatment.

APA, Harvard, Vancouver, ISO, and other styles

13

Paul, Diptajit, Pawan Kumar, and Anil Kumar Dhull. "Retrospective Review of Esophageal Carcinoma: 3-Year Experience from a Tertiary Care Teaching Institute." International Journal of Health Sciences and Research 11, no. 7 (July 12, 2021): 111–18. http://dx.doi.org/10.52403/ijhsr.20210716.

Full text

Abstract:

Introduction: Esophageal carcinoma, one of the common malignancies, generally presented in advanced stage makes these neoplasms less curable and highly lethal. Having such poor prognosis, it is significant to understand various patient and tumor facts related to treatment outcome of esophageal cancer, which varies regions wise. The present retrospective study also seeks to focus on current description of patterns and trends of tumors in esophageal cancer patients attended in a tertiary care hospital in a northern state of India and their treatment outcome. Materials and Methods: Records of esophageal carcinoma patients over a period of 3-years were reviewed retrospectively. These records were analysed for incidence, demographic pattern, different treatment modalities and their response evaluation. Results: A total 439-patients of esophageal carcinoma were identified. The median age at presentation was 47-years and males slightly outnumbered females. Among all the tumors, lower thoracic esophagus involvement was most predominant and most common presentation was dysphagia. Squamous cell carcinoma constituted the predominant histopathological type. Majority of patients presented in advanced stage and treated with combined modalities approach of radiation therapy, chemotherapy and surgery. Overall average survival was 13-months. Clinically, the response at last follow-up was CR in 19%, PR and PD in 33% each. Conclusion: Despite its high prevalence in north India and poor survival rate, less initiative has been taken to increase awareness in preventing these cancers. Understandings of socio-demographic patterns and tumor characteristics may improve treatment outcome in these patients and improve quality of life. Further studies are needed in different regions of India, to get more treatment options which may convert the current scenario of palliative intent in to radical one in patients of esophageal carcinoma. Key words: Esophageal carcinoma, retrospective study, socio-demographic profile, dysphagia, squamous cell carcinoma.

APA, Harvard, Vancouver, ISO, and other styles

14

Smith, Thomas J., Vincent Chung, Mark T. Hughes, Marianna Koczywas, Nilofer Saba Azad, Louise Knight, Rhonda Cooper, Nora Ruel, and Betty R. Ferrell. "A randomized trial of a palliative care intervention for patients on phase I studies." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 12001. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.12001.

Full text

Abstract:

12001 Background: The purpose of this study was to test a Palliative Care Intervention for patients with solid tumors enrolled in phase I therapeutic trials. Methods: This randomized trial compared patients accrued to phase I Clinical Trials in groups of Usual Care compared to a Palliative Care Intervention (PCI) in two comprehensive cancer centers. The PCI included assessment of quality of life (QOL) and symptoms, an interdisciplinary meeting to discuss the care plan, including goals of care, and two nurse-delivered teaching sessions. Subjects (n=479) were followed for 24 weeks, with 12 weeks as the primary outcome point. Results: Outcomes revealed that relative to Usual Care, PCI subjects showed less Psychological Distress (1.9 in Intervention and 1.2 in Control pts, p=0.03) and a trend toward improved QOL (3.7 versus 1.6, p=0.07), with differences between sites. We observed high rates of symptom-management admissions (41.3%) and low rates of Advance Directive completion (39%), and use of supportive care services including hospice (30.7%, for only1.2 months duration), despite a median survival for all patients in both groups of 10.1 months from initiating a phase 1 study until death. Patient satisfaction with oncology care was already high at baseline, and we did not see clinically significant changes in those scores by week 12. Conclusions: Palliative care interventions can improve QOL outcomes and distress for patients participating in phase 1 trials. Greater integration of PC is needed to provide quality care to these patients and to support transitions from treatment to supportive care, especially at the end of life. Clinical trial information: NCT01828775 .

APA, Harvard, Vancouver, ISO, and other styles

15

Shamili, Mrs. "Study to assess the effectiveness of structured teaching programme on management of side effects of chemotherapy among clients with Cancer in Indian Red Cross Hospital, Nellore." NARAYANA NURSING JOURNAL 8, no. 4 (2019): 10. http://dx.doi.org/10.5455/nnj.2019.8.4.10-12.

Full text

Abstract:

Abstract: Chemotherapy is the main stay of treatment for most solid tumors and hematologic malignancies and offers cure for certain cancers, controls some instances. Offers palliative relief of symptoms especially when were or control is no longer possible. With the mergence of new treatments, patient preferences and economic realities of cancer care, it has become a challenge for the health team to provide cost effective and high quality care to cancer patient. AIM:  To assess the pre test knowledge regarding management of side effects of chemotherapy among clients with cancer.  To assess the effectiveness of structured teaching program through post test knowledge regarding management of side effects of chemotherapy among clients with cancer.  To find out association between the pretest and post test knowledge regarding management of side effects of chemotherapy with selected demographic variables.Methodology: A quantitative research approach and descriptive design was used to assess the effectiveness of structured teaching program on management of side effects of chemotherapy among 60 clients in Indian Red Cross hospitalby using convenience sampling technique. Data was collected by using structured questionnaires. The data was analyzed and tabulated by using descriptive and inferential statistics based on objectives of the study. Results: The results shows that with context to effectiveness of structured teaching program on management of side effects of chemotherapy among clients with cancer 48 (80%) obtained below average in Pretest and Nil in Post Test, 12 (20%) Obtained average knowledge in Pretest and 39 (65%) obtained average knowledge in Post test and none of them obtained above average knowledge in pre test and 21 (35%) obtained above average in post test. Conclusion: Post test knowledge score shows significant enhancement in knowledge on management of side effects of chemotherapy (73.83%) with the standard deviation 3.02

APA, Harvard, Vancouver, ISO, and other styles

16

Vincent, Sharon E., and Karen S. Mutsch. "Exploration of Self-Care Following Distribution of Acute Management Tool for Elder Heart Failure Patients in Clinic Setting." Clinical Scholars Review 8, no. 2 (2015): 215–21. http://dx.doi.org/10.1891/1939-2095.8.2.215.

Full text

Abstract:

The aim of this mixed method, quantitative descriptive study was to develop an understanding of heart failure (HF) patient symptoms and perceptions. Rehospitalization is significant, with cardiovascular disease treatment costs in the United States exceeding all other diagnostic groups. Many readmissions are preventable. Teaching gaps exist during discharge.The Palliative Care Outcome Scale instrument provided patient-reported functional outcomes. Analysis of variance (ANOVA) determined differences. Glaser and Strauss’s grounded theory guided the qualitative analysis of HF patients (N= 10) in the HF clinic setting. The transactional model of stress and adaptation (Lazarus, DeLongis, Folkman, & Gruen, 1985) gave meaning to patient adherence.Comparisons of patient, staff, and caregiver scores were not significantly different. However, when only patient and staff responses were compared, patients reported significantly higher symptom scores. Significantly, staff were not recognizing all HF symptoms. Qualitative themes were physical, psychological, management, and self-care.Limitations were small sample size and some patients did not have caregivers. The study needs to be repeated over a longer period with more participants’ caregivers and a larger, diverse sample.This project has potential to provide collaborative improvement when teaching during critical discharge processes. Nurses and patients must vigilantly recognize worsening of HF symptoms.

APA, Harvard, Vancouver, ISO, and other styles

17

Odetunde, M. O., A. M. Owojuyigbe, O. I. Aaron, and O. T. Odedeyi. "KNOWLEDGE AND ATTITUDE OF HEALTH PROFESSIONALS ON PALLIATIVE CARE OF TERMINALLY-ILL PATIENTS IN A TERTIARY HEALTH INSTITUTION OF SOUTHWESTERN NIGERIA: A CROSS SECTIONAL STUDY." Open Journal of Medical Research (ISSN: 2734-2093) 3, no. 2 (December 23, 2022): 50–66. http://dx.doi.org/10.52417/ojmr.v3i2.423.

Full text

Abstract:

Existing information on Palliative Care (PC) indicated an increase in development of services in some African countries with Nigeria in top three on specialized care. However, knowledge and skill deficit in PC among health professionals (HP) is a significant barrier to quality treatment of patients with chronic life-threatening diseases. The aim of this study was to investigate the knowledge and attitude of PC among HP in a tertiary health institution in Nigeria. This cross-sectional study involved 260 consenting HP (Medical doctors, Nurses, Occupational therapists, Physiotherapists, and Social workers), purposively recruited from Obafemi Awolowo University Teaching Hospital, Ile-Ife. Attitude and knowledge were assessed using Frommelt attitude towards care of the dying (FATCOD) and the Palliative care attitude and knowledge quiz (PCAK) questionnaires respectively. Also, socio-demographic information of the respondents was obtained. Descriptive statistics of mean, standard deviation, frequency and percentages; and inferential statistics of Chi-Square test and Pearson’s correlation were used to analyze data. Alpha level was set at p<0.05. Majority (80%) of the respondents had never received formal PC training and demonstrated poor PC knowledge. Only 13 (5%) had good knowledge of, while 257 (98%) had favourable attitude towards PC. There were significant associations between respondents’ socio-demographic characteristics and each of knowledge of PC (p<0.05) and attitude towards PC (p= 0.001). Results of Pearson’s correlation indicated significant correlation between knowledge and attitude of the respondents on PC (r= 0.167, p=0.007). Most of the HP in this study had poor knowledge but favourable attitude towards PC. PC should be included in the undergraduate curriculum of concerned HP and continuous professional training be integrated for practicing professionals

APA, Harvard, Vancouver, ISO, and other styles

18

Yang, Chiu-Hsien, Chien-Yi Wu, Joseph T. S. Low, Yun-Shiuan Chuang, Yu-Wen Huang, Shang-Jyh Hwang, and Ping-Jen Chen. "Exploring the Impact of Different Types of Do-Not-Resuscitate Consent on End-of-Life Treatments among Patients with Advanced Kidney Disease: An Observational Study." International Journal of Environmental Research and Public Health 18, no. 15 (August 2, 2021): 8194. http://dx.doi.org/10.3390/ijerph18158194.

Full text

Abstract:

Background: Patients with advanced kidney disease have a symptomatic and psychological burden which warrant renal supportive care or palliative care. However, the impact of do-not-resuscitate consent type (signed by patients or surrogates) on end-of-life treatments in these patients remains unclear. Objective: We aim to identify influential factors correlated with different do-not-resuscitate consent types in patients with advanced kidney disease and the impact of do-not-resuscitate consent types on various life-prolonging treatments. Methods: This was a retrospective observational study. We included patients aged 20 years and over, diagnosed with advanced kidney disease and receiving palliative and hospice care consultation services between January 2014 and December 2018 in a tertiary teaching hospital in Taiwan. We reviewed medical records and used logistic regression to identify factors associated with do-not-resuscitate consent types and end-of-life treatments. Results: A total of 275 patients were included, in which 21% signed their do-not-resuscitate consents. A total of 233 patients were followed until death, and 32% of the decedents continued hemodialysis, 75% underwent nasogastric (NG) tube placement, and 70% took antibiotics in their final seven days of life. Do-not-resuscitate consents signed by patients were associated with reduced life-prolonging treatments including feeding tube placement and antibiotic use in the last seven days (odd ratio and 95% confidence interval were 0.16, 0.07–0.34 and 0.33, 0.16–0.69, respectively) compared to do-not-resuscitate consents signed by surrogates. Conclusions: Do-not-resuscitate consent signed by patients and not by surrogates may reflect better patients’ autonomy and reduced life-prolonging treatments in the final seven days of patients with advanced kidney disease.

APA, Harvard, Vancouver, ISO, and other styles

19

Tolani, Musliu Adetola, Peter Pase Abur, Muhammad Daniyan, Stanley Emeka Nwabuoku, Aisha Mustapha, and Mutiu Bashiru. "Psychological distress, social function and financial burden of cancer patients receiving treatment in an African setting." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e19048-e19048. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e19048.

Full text

Abstract:

e19048 Background: The improvement in the quality of cancer treatment is key to increasing survival. However, the functional well-being of these patients is equally important. This study aimed to assess the degree of psychological distress, social function and financial burden in patients undergoing cancer treatment in our center. Methods: A cross-sectional study was designed to prospectively recruit patients in our teaching hospital between December 2019 to February 2020. Those with cancer, aged 18 years and above, who had surgery, chemotherapy and (or) radiotherapy for treatment were included while those who had not commenced cancer treatment were excluded. Information on their clinicopathologic characteristics was obtained. The degree of psychological distress was assessed using a distress thermometer (DT) based on an 11-point scale. Social function was assessed using validated SCARF social functioning index (SSFI) (Cronbach's alpha = 0.818) which has 4-domains, each with scores ranging from 0 (very poor) to 4 (very good). Financial burden (FB) was assessed on a 5-point Likert scale. SPSS was used for data analysis with p < 0.05 considered significant. Results: Seventy-two patients were analyzed with a mean age of 50.3 ± 13.7 years and male to female ratio of 0.8:1.0. The median time from diagnosis was 6.0 (2.5 – 16.0) months and 51 (70.8%) were on palliative treatment. The median psychological distress score was 6.0 (4.0 – 8.0) while the mean SSFI score was 12.0 ± 3.3. Relationship with immediate family (3.4 ± 0.7) had a significantly higher sub-score than two other domains (occupational role: 2.3 ± 1.4, p < 0.001; self-concern/care: 3.0 ± 1.0, p < 0.001). Fifty patients (69.4%) had heavy or extreme financial burden with 34 (47.2%) admitting to income reduction since onset of therapy. Female sex (p < 0.001, 95% CI: 1.246 – 3.597), higher ECOG score (p = 0.033, 95% CI: 0.061 – 1.383) and palliative treatment (p = 0.038, 95% CI: 0.084 – 2.768) were independent predictors of psychological distress. Conclusions: Despite the marked psychological distress and huge financial burden in patients receiving cancer treatment in this setting, they still maintained a relatively normal status in most of the social function domains.

APA, Harvard, Vancouver, ISO, and other styles

20

Babasahib, S. K., S. Maria, and S. Chillakunnel Hussain Rawther. "Drug Utilization and Cost Analysis Review of Anticancer Drugs Used in a Tertiary Care Teaching Hospital in South India." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 73s. http://dx.doi.org/10.1200/jgo.18.43100.

Full text

Abstract:

Background: Cancer is ranked high among noncommunicable diseases and millions of people in India receive treatment of cancer every year. Aim: The current study aims to evaluate the trends and pattern of prescribing of anticancer drugs. The objectives of the study were to assess the rational use of anticancer drugs, to identify various types of cancer and to analyze the cost distribution of anticancer drugs. Methods: An observational, prospective study was conducted in 200 prescriptions in oncology department. Data were collected from case reports, prescriptions and medication charts in specially designed forms. Results: Out of 200 patients enrolled, majority were female (59.5%) and in the age group of 40-60 years (52%). Gastrointestinal tract cancers (25%) were most commonly observed, followed by breast cancer (18.5%) and genitourinary cancers (16.5%). Cisplatin (35%) was the most commonly prescribed anticancer drug, followed by paclitaxel (18.5%), carboplatin (14%), 5-fluorouracil (12.5%) and oxaliplatin (7.5%). Ranitidine, dexamethasone and ondansetron were used as palliative therapy either to prevent or manage the adverse reactions of the anticancer drugs. Trastuzumab contribute to the major cost (Rs. 450,000) in the drug therapy. The average cost of drug per prescription was Rs. 11,135. The overall prescribing indicators, point that the average number of total drugs, anticancer drugs and antibiotics were 12.22, 1.73 and 0.43 respectively. Conclusion: The usage of drugs was found to be rational and about 99.38% of the drugs used were from the hospital formulary. The prescribing habits are appropriate and are in accordance with WHO guidelines. The current study may support best prescribing practices to promote cost effective treatment and better health care delivery.

APA, Harvard, Vancouver, ISO, and other styles

21

Slone, Jeremy, Catherine Chunda-Liyoka, Marta Perez, Nora Mutalima, Robert Newton, Chifumbe Chintu, Chipepo Kankasa, et al. "Treatment outcomes of pediatric oncology patients in Zambia." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 9558. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.9558.

Full text

Abstract:

9558 Background: Due to challenges in the delivery of pediatric oncology care in low-middle income countries (LMIC), diagnosis and treatment remains inadequate for the majority of patients. The University of Zambia School of Medicine/University Teaching Hospital (UTH) and Vanderbilt University School of Medicine/Vanderbilt Institute for Global Health established a partnership to investigate treatment outcomes at UTH, the only institution providing pediatric oncology care in Zambia, and assess risk factors associated with treatment abandonment. Methods: A retrospective study was conducted in a cohort of patients, presenting from July 2008 – June 2010, using an established database and medical record review. Results: Of the 230 children enrolled in the database, 162 met the inclusion criteria. The average age at diagnosis was 6.0 years; males comprised 55.6% of the cohort; 51.6% had a histopathological diagnosis and 10.5% of the cohort was HIV positive. The most common diagnoses were lymphoma (25.9%), Wilms tumor (22.8%), and retinoblastoma (17.9%). Leukemia and Kaposi sarcoma accounted for 7.4% each. Death (46.3%) and abandonment of treatment (45.7%) were the most common outcomes with only 8.0% having completed treatment or currently undergoing treatment, including palliative regimens, at the time of data acquisition. Residence in Lusaka or Central provinces, closest in proximity to UTH, was associated with a decreased risk for abandonment of treatment (Odds Ratio (OR) 0.41 (95% CI 0.21-0.81, p = 0.009) while maternal education less than secondary school (OR 2.73 95% CI 1.2-6.6, p = 0.03) was associated with an increased risk for abandonment of treatment. Conclusions: At the only pediatric cancer center in Zambia, treatment outcomes are dire with the majority of the cohort abandoning treatment or dying during therapy. Challenges include access to cancer chemotherapy, logistical facilitation, fiscal support of radiotherapy, and community engagement. Further investigation is required to inform effective intervention strategies to improve outcomes.

APA, Harvard, Vancouver, ISO, and other styles

22

Painschab, Matthew, Racquel E. Kohler, and Satish Gopal. "Microcosting and Budget Impact Analysis of Diffuse Large B-Cell Lymphoma Treatment in Malawi." Blood 132, Supplement 1 (November 29, 2018): 3558. http://dx.doi.org/10.1182/blood-2018-99-115237.

Full text

Abstract:

Abstract INTRODUCTION: Diffuse large B-cell lymphoma (DLBCL) is the commonest NHL subtype in sub-Saharan Africa (SSA), as in other parts of the world. Limited prospective data from the region have shown that DLBCL is curable in a substantial proportion of cases with chemotherapy and appropriate supportive care. However, little is known about costs of DLBCL treatment in the region. METHODS: We conducted a microcosting and budget impact analysis from a health systems prospective in Malawi, a low-income country in SSA. All costs were determined based on real-world costs for treating DBLCL patients at Kamuzu Central Hospital (KCH), a national teaching hospital in Lilongwe, Malawi, as part of a prospective, ongoing, longitudinal cohort study, the KCH Lymphoma Study. We calculated costs of care for palliative care only, first-line chemotherapy with cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP), and second-line chemotherapy for relapsed/refractory DLBCL with either ifosfamide, cisplatin, prednisone, and etoposide (EPIC) or gemcitabine and oxaliplatin (GemOx). Cost data were taken directly from costs paid for goods and services at KCH. Costs were calculated on a per-patient, activity basis, and total costs were estimated based on the average patient experience in our cohort through two years of care. Likewise, data from the KCH Lymphoma Study was used to estimate supportive care events and costs, including the number of hospitalizations during treatment for each type of chemotherapy delivered. Personnel costs were calculated based on interviews of clinic personnel, as well as actively observing time spent on clinical activities. Overhead costs consisted primarily of pathology and laboratory infrastructure and were amortized over 25 years. All costs were collected in, or converted to, 2017 USD using Malawian GDP deflator. Total cost is also shown in International Dollars to facilitate comparisons across countries. Finally, using national cancer registry data and data from the KCH Lymphoma Study, we calculated the annual budget impact for Malawi to treat all DLBCL cases. RESULTS: All costs are shown on a per-patient basis (Table 1) using median chemotherapy cycles as received by the historical cohort of patients in the KCH Lymphoma Study, with follow-up visits for two years from chemotherapy initiation. Median number of chemotherapy cycles were as follows: CHOP (5), EPIC (3.5), and GemOx (5). CONCLUSIONS: To our knowledge, this is one of the first studies to rigorously examine cost and budget implications of DLBCL care in SSA. We calculated that first-line chemotherapy with CHOP can be delivered for $1050 more per patient compared with palliative care alone in this single-institution microcosting analysis. Strengths include microcosting based on real-life costs derived from utilization data in this highly resource-limited setting. Although this single-institution study may limit generalizability, these data can help guide resource allocation for a common curable cancer throughout SSA. Planned analyses include an ongoing formal cost-effectiveness analysis to compare DLBCL treatment to other accepted health care interventions in SSA. Disclosures No relevant conflicts of interest to declare.

APA, Harvard, Vancouver, ISO, and other styles

23

Szmola, Richárd, Gyula Farkas, Péter Hegyi, László Czakó, Zsolt Dubravcsik, István Hritz, Dezső Kelemen, et al. "Pancreatic cancer.Evidence based management guidelines of the Hungarian Pancreatic Study Group." Orvosi Hetilap 156, no. 8 (February 2015): 326–39. http://dx.doi.org/10.1556/oh.2015.30063.

Full text

Abstract:

Pancreatic cancer is a disease with a poor prognosis usually diagnosed at a late stage. Therefore, screening, diagnosis, treatment and palliation of pancreatic cancer patients require up-to-date and evidence based management guidelines. The Hungarian Pancreatic Study Group proposed to prepare an evidence based guideline based on the available scientific evidence and international guidelines. The preparatory and consultation board appointed by the Hungarian Pancreatic Study Group translated and complemented/modified the recent international guidelines. 37 clinical statements in 10 major topics were defined (Risk factors and genetics, Screening, Diagnosis, Staging, Surgical care, Pathology, Systemic treatment, Radiation therapy, Palliation and supportive care, Follow-up and recurrence). Evidence was graded according to the National Comprehensive Cancer Network (NCCN) grading system. The draft of the guideline was presented and discussed at the consensus meeting in September 12, 2014. Statements were accepted with either total (more than 95% of votes, n = 15) or strong agreement (more than 70% of votes, n = 22). The present guideline is the first evidence based pancreatic cancer guideline in Hungary that provides a solid ground for teaching purposes, offers quick reference in everyday patient care and guides patient financing options. The authors strongly believe that these guidelines will become a standard reference for pancreatic cancer treatment in Hungary. Orv. Hetil., 2015, 156(8), 326–339.

APA, Harvard, Vancouver, ISO, and other styles

24

Dharsee, Nazima Jaffer, Beatrice W. Addai, Lisa Murray, Amanda Shewbridge, Maria Aresu, Susannah Jane Stanway, Sheila Small, Geraldine o'Gara, Seth A. Wiafe, and Theresa Wiseman. "Developing survivorship services in Ghana and Tanzania." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e24132-e24132. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e24132.

Full text

Abstract:

e24132 Background: The incidence of breast cancer is increasing in low- & middle- income countries (LMICs). Alongside attempts to reduce the disparity in cancer survival between high-income countries (HIC) & LMICs, it is important that survivorship is well understood and managed in an evidence based, resource and culturally sensitive manner. This project aimed to develop knowledge, skills and services concerning living with and beyond breast cancer primary treatment. Methods: This 3-phase study used mixed methods. Phase 1 used participant observation and focus group interviews (FGIs) to scope experience, resources, current practice, and challenges to implementing a recovery package. In Phase 2 nurses used the adapted Holistic Needs Assessment (HNA) with 500 women in Tanzania and Ghana, who were also offered a recovery care plan and treatment summary following their breast cancer primary treatment. Data was entered into a macro database & analysed using descriptive statistics. Phase 3 was the development of a culturally sensitive “Foundations in Cancer Care” training toolkit for nurses. The toolkit was based on a “train the trainer” model and included slides, an existing palliative care toolkit and exercises. The training programme consisted of 5 days teaching covering theory and practice. Data collection included: Initial FGIs to ascertain learning needs, confidence in knowledge & skills, assessed pre & post teaching course, and course evaluation. Data were analysed using descriptive statistics. Results: In Phase 1 six themes were identified concerning experience of breast cancer which included cultural beliefs & practices and access to treatment & support. Phase 2 data from Tanzania showed a similar level of unmet need at the end of treatment to a previous similar published analysis from the UK. Data from Ghana showed a much higher level of unmet need. Evaluation following Phase 3 showed a positive change in nurses’ confidence in their knowledge. Conclusions: This mixed methods three-phase study has documented experience, resources and current practise around breast cancer survivorship in two African centers treating breast cancer. The feasibility of using HNA to identify unmet needs in these women has been demonstrated and needs the identified. Results from the HNA informed a training toolkit which was implemented and positively received and could be adapted for use in other LMICs.

APA, Harvard, Vancouver, ISO, and other styles

25

Huang, Hsiu-Li, Wei-Ru Lu, Huei-Ling Huang, and Chien-Liang Liu. "The effect of a family-centered advance care planning intervention for persons with cognitive impairment and their family caregivers on end-of-life care discussions and decisions." PLOS ONE 17, no. 9 (September 6, 2022): e0274096. http://dx.doi.org/10.1371/journal.pone.0274096.

Full text

Abstract:

Advanced care planning (ACP) includes advance directives (AD), which can specify provisions for palliative care and types of life-sustaining treatments for an individual requiring end-of-life (EoL) care. ACP for persons in the early stages of cognitive decline can decrease anxiety and conflict for family members needing to make decisions about EoL-care, which is especially critical for family caregivers (FCGs) if they play a role as a surrogate regarding healthcare decisions. However, ACP for persons with cognitive impairment (PWCIs) is often overlooked. This study explored the effects of a family-centered ACP intervention on decisions about EoL-care, life-sustaining treatment decisions, and discussions of related topics among PWCIs and FCGs. The study was conducted in outpatient clinics of regional teaching hospitals in northern Taiwan. Participants were dyads consisting of persons diagnosed with mild cognitive impairment or mild dementia and their FCGs. The family-centered ACP intervention was provided by an ACP-trained senior registered nurse. A one-group, pretest–posttest design was used to evaluate the effect of the intervention on 44 dyads. Four structured questionnaires collected data regarding familiarity with ACP, intention to engage in ACP, participation in personal discussions between the dyads about ACP, and consistency between PWCIs and FCGs for decisions about life-sustaining treatments at EoL. Paired t, Kappa, and McNemar tests were used to compare differences between pre-intervention data (pretest) and post-intervention data (posttest). There were significant increases in familiarity with ACP, components of ACP, and the number of topics PWCIs and FCGs personally discussed surrounding EoL-care decisions. There was no change for either group in wanting to have a formal ACP consultation and only modest increases in consistency between PWCIs and FCGs for life-sustaining treatment decisions after completion of the family-centered ACP intervention. Clinicians caring for PWCIs should incorporate family-centered ACP interventions and support ongoing discussions about life-sustaining medical treatments to ensure their preferences regarding EoL-care are respected. The accessibility and availability of consultations about ACP should also be provided.

APA, Harvard, Vancouver, ISO, and other styles

26

Camejo, Natalia, Cecilia Castillo, Nora Artagaveytia, Dahiana Amarillo, Florencia Vitureira, Florencia Rodriguez, and Lucia Beatriz Delgado. "Evaluation of the effectiveness of telephone consultations and the level of satisfaction of patients attending the Unidad Docente Asistencial de Mastología [Mastology Care Teaching Unit] using this method during the COVID health emergency." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e13610-e13610. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e13610.

Full text

Abstract:

e13610 Background: In March 2020, a health emergency was decreed due to COVID-19 and this produced changes in the organization of health services. One of the objectives of the reorganization that took place was a reduction in face-to-face consultations (FTFC), and the promotion of telephone consultations (TC). Objective: Evaluate the effectiveness of TC and the level of satisfaction of patients attending the Mastology Unit using this method during the COVID health emergency. Methods: A prospective, cross-sectional study. A survey was used to assess the effectiveness of TC and the level of satisfaction with the method. Results: : Forty-two patients were surveyed, of which 69% were receiving adjuvant treatment and 14.2% palliative treatment. With regard to the effectiveness of TC, 76.1% of those surveyed had their appointment resolved by telephone; 78.6% of patients preferred to do the consultation by telephone; 97.6% believed that sufficient time was spent and that the timing of the appointment was appropriate. The responses showed a high degree of satisfaction with the care received. The medical care met the expectations of all patients, and 83.3% believed that once normalcy was restored, TC would be an option for their situation Conclusions: The TC method was evaluated with a high degree of satisfaction and allowed care to be maintained during the emergency. Although it is early to assess the healthcare impact of TC and the method's capacity to resolve issues, preliminary results show that it is a useful and valuable tool in clinical practice during periods of healthcare emergency.

APA, Harvard, Vancouver, ISO, and other styles

27

Aghabarary, Maryam, and Nahid Dehghan Nayeri. "Reasons behind providing futile medical treatments in Iran." Nursing Ethics 24, no. 1 (August 3, 2016): 33–45. http://dx.doi.org/10.1177/0969733016638142.

Full text

Abstract:

Background: Despite their negative consequences, evidence shows that futile medical treatments are still being provided, particularly to terminally ill patients. Uncovering the reasons behind providing such treatments in different religious and sociocultural contexts can create a better understanding of medical futility and help manage it effectively. Research objectives: This study was undertaken to explore Iranian nurses’ and physicians’ perceptions of the reasons behind providing futile medical treatments. Research design: This was a qualitative exploratory study. Study data were gathered through conducting in-depth semi-structured personal interviews and analyzed using the conventional content analysis method. Participants and research context: Twenty-one nurses and nine medical specialists were recruited purposively from four teaching hospitals affiliated to Tehran University of Medical Sciences. Ethical considerations: This study was approved by the Nursing and Midwifery Research Center and the Research Ethics Committee of Tehran University of Medical Sciences. All participants gave informed consent for the research and that their anonymity was preserved. Findings: The main theme of the study was “having an obligation to provide medical treatments despite knowing their futility.” This theme consisted of three main categories including patients’ and family members’ request for continuing life-sustaining treatments, healthcare professionals’ personal motives, and organizational atmosphere and structure. Discussion and conclusion: Different personal and organizational factors contribute to providing futile medical treatments. Promoting the structure and the function of hospital ethics committees, establishing and developing home care facilities, increasing the number of palliative care centers and hospices, and educating healthcare professionals, patients, and family members about the services and the benefits of such centers can facilitate making wise decisions about continuing or discontinuing treatments which have been labeled as futile.

APA, Harvard, Vancouver, ISO, and other styles

28

Malapati, Sindhu, Sunny R. K. Singh, Rohit Kumar, Jibran Ahmed, Ishaan Vohra, and Vatsala Katiyar. "In-Hospital Outcomes in Elderly Acute Myeloid Leukemia (AML) Receiving Aggressive Inpatient Care: An Analysis of National Inpatient Sample (NIS) Database between Years 2005 and 2014." Blood 134, Supplement_1 (November 13, 2019): 2149. http://dx.doi.org/10.1182/blood-2019-121439.

Full text

Abstract:

Background: The median age of diagnosis in acute myeloid leukemia (AML) is 67 years and it is the second most common subtype of leukemia in the elderly, after CLL. Management of elderly leukemics has unique challenges related to disease characteristics and health status of host, leading to a disproportionate representation of this population in AML related deaths (>75% of all AML related deaths on population analysis). A SEER analysis demonstrated that close to half of elderly patients diagnosed with AML do not receive any treatment, seemingly with a greater focus on palliative care. We aim to study in-hospital outcomes in elderly patients with AML when they receive aggressive inpatient medical care. Methods: This is a retrospective cohort analysis of NIS database (years 2005 to 2014) of patients with the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) diagnosis code for AML not in remission and aged ≥ 65 years. Aggressive inpatient care was defined as use of mechanical ventilation, vasopressors, hemodialysis (end stage renal disease excluded) or cardiopulmonary resuscitation. Inpatient encounter with Palliative service was identified using ICD-9-CM diagnosis codes. Our cohort of interest was elderly AML patients receiving aggressive inpatient care. Primary outcome was inpatient mortality within this cohort and factors associated with it were analyzed using multivariate logistic regression. Secondary outcome was proportion of admissions which had an inpatient encounter with palliative care within this cohort. Longitudinal analysis was conducted to determine trends in inpatient mortality and rates of encounter with palliative care over the study years. We used a linear (continuous outcome)/ logistic (binary) regression model with year as the independent variable for trend analysis. We also estimated the mean total charge of hospitalization on a yearly basis after adjusting for inflation. Statistical analysis was done using STATA. Results: A total of 230,074 elderly AML admissions were identified between the years 2005 and 2014. Aggressive inpatient care as defined above was utilized in 6.3% (n=14,606) of total admission. Mean age for those receiving aggressive inpatient care was 73.3 years, 61.5% were males and 76.2% Caucasian. The utilization of aggressive inpatient care in these patients remained stable over the years on longitudinal trend analysis after adjusting for patient and hospital factors. Amongst elderly AML patients receiving intensive care, 71.6% (n=10,461) died in the same admission. Also, inpatient mortality had no association with age, gender, race, Charlson Co-morbidity Index, mean income quartile for patient's zip-code, insurance type and hospital characteristics (teaching status, urban or rural location and hospital bed size). Proportion of elderly AML patients experiencing inpatient mortality over the years after adjusting for age, race, gender, mean income quartile for zip-code, Charlson comorbidity index and hospital characteristics are shown in the attached graph. Amongst elderly AML patients receiving aggressive inpatient care, the adjusted inpatient mortality improved from 77.27% in 2005 to 67.40% in 2014 (p for trend <0.001). Also, we noted an improvement in adjusted inpatient mortality rates for elderly AML patients who did not receive aggressive inpatient care, from 15.60% in 2005 to 10.08% in 2014 (p for trend <0.001). Rates of documented inpatient encounter with palliative service in elderly AML patients receiving aggressive inpatient care improved from 1.38% of all admissions in 2005 to 18.78% of all admissions in 2014 (p for trend <0.001). Mean total charge of hospitalization (adjusted for inflation) for the same cohort increased considerably over the years of study, going up from $177,544 in 2005 to $252,869 in 2014. Conclusion: Amongst elderly AML patients undergoing aggressive inpatient care, inpatient mortality has seen a modest decline over the years, which is likely due to improved supportive care. Despite improvement in inpatient outcomes of this high risk group, about two thirds of them died within the same admission in the year 2014. However, we noted an encouraging increase in involvement of palliative service in the care of this cohort of patients associated with high mortality and rising cost of care. Figure Disclosures No relevant conflicts of interest to declare.

APA, Harvard, Vancouver, ISO, and other styles

29

Malapati, Sindhu Janarthanam, Sunny R. K. Singh, Rohit Kumar, Jibran Ahmed, Ishaan Vohra, Vatsala Katiyar, and Zyad Kafri. "Outcomes of in-hospital cardiopulmonary resuscitation (ICPR) for cardiac arrest in adult patients with metastatic solid cancers: A nationwide inpatient sample (NIS) database analysis from 2012 to 2014." Journal of Clinical Oncology 37, no. 31_suppl (November 1, 2019): 44. http://dx.doi.org/10.1200/jco.2019.37.31_suppl.44.

Full text

Abstract:

44 Background: Cardiopulmonary arrest is known to have a poor prognosis which is further worsened by existing co-morbidities. The prevalence of metastatic malignancy is rapidly increasing with improved cancer treatments and yet the outcomes of ICPR are not well studied in these patients. We aim to study the epidemiology, associations and outcomes in this subpopulation. Methods: Retrospective cohort analysis of the 2012 to 2014 NIS database. We included patients ≥ 18 years with the International Classification of Diseases, 9th Revision, Clinical Modification procedure codes for ICPR and diagnosis codes for solid metastatic cancers. Primary diagnosis of cardiopulmonary arrest was excluded (represents out‐of‐hospital arrest.) Primary outcome was inpatient mortality following ICPR and the factors associated were analyzed using logistic regression. Results: Amongst 1,432,240 admissions of adults with metastatic solid cancers, 0.6% (n = 8840) received ICPR, of which 82% (n = 7245) died in the same admission. Inpatient mortality following ICPR in adults without metastatic solid cancers was 68.7%. For adults with metastatic solid cancers receiving ICPR, mean age was 65.9 years, 57.7% were males and 60.6% Caucasian. Also, 11.5% of them had an inpatient palliative care encounter. On multivariate logistic regression analysis, African Americans had higher mortality than Caucasians (OR 1.5, p 0.01) while elective admission and age < 50 years had lower mortality (OR 0.5, p < 0.05 and OR 0.5, p 0.01 respectively.) There was no difference in mortality based on site of primary tumor, gender, day of admission, Charlson Comorbidity Index, insurance status and hospital teaching status, location or size. Conclusions: Amongst adult patients with metastatic solid cancers receiving ICPR, 82% died within the same admission. Race, age and admission type predicted mortality. Despite known poor prognosis, only 11.5% had a palliative care encounter. [Table: see text]

APA, Harvard, Vancouver, ISO, and other styles

30

Abudari, Gassan, Hassan Hazeim, and Gilda Ginete. "Caring for terminally ill Muslim patients: Lived experiences of non-Muslim nurses." Palliative and Supportive Care 14, no. 6 (April 20, 2016): 599–611. http://dx.doi.org/10.1017/s1478951516000249.

Full text

Abstract:

AbstractObjective:The nursing profession demands knowledge, awareness, and experience regarding the ethnic, religious, cultural, and social constructs involved in patient care. Non-Muslim nurses must have theoretical and empirical insights into treatment methods and caring for terminally ill Muslim patients. In particular, non-Muslim nurses should acquire knowledge of Islamic rules and regulations. They should also be familiar with the unique religious and sociocultural practices that pertain to healthcare practices. Our study aimed to explore non-Muslim nurses' experiences in caring for terminally ill Muslim patients and their families regarding physical, social, cultural, spiritual, and religious practices. The study also sought to investigate the context or situations that influence these experiences as described by the nurses.Method:In this qualitative descriptive study, 10 nurses working in medical, oncology, and oncology/palliative care units in a tertiary care hospital in Saudi Arabia were interviewed. A modified Stevick–Colaizzi–Keen method was employed for data analysis.Results:Three main themes constituted the nurses' lived experiences: family matters, end-of-life practices, and nurse challenges. Cultural values, religious practices, and a family approach to the process of care influenced nurses' experiences. Issues related to an absence of palliative care integration and the unavailability of members in the interdisciplinary team also influenced their experiences. Nurses showed a lack of cultural knowledge of some practices due to a lack of awareness of cultural diversity and the unavailability of formal cultural education.Significance of Results:Provision of culturally competent care at the end of life for Muslim patients in Saudi Arabia requires a thoughtful understanding of religious and cultural practices as well as knowledge of the role of the family throughout the care process. The introduction of a cultural care nursing delivery model that incorporates a cultural education program with Islamic teachings and practices at its core is recommended.

APA, Harvard, Vancouver, ISO, and other styles

31

Raphael, Dr John E., and Dr Victor Abhulimen. "Retrospective Analysis of Complications from Prostate Cancer among Nigerians." Saudi Journal of Medicine 7, no. 2 (February 16, 2022): 99–104. http://dx.doi.org/10.36348/sjm.2022.v07i02.002.

Full text

Abstract:

Background: Prostate cancer (PCa) may be asymptomatic at an early stage and may run an indolent course that requires minimal or no treatment. Early diagnosis through screening reduces the rate of advanced diseases. Whereas, in the western countries where screening is more prevalent, many presents early with a chance for curative treatment. In Africa, late presentation is often the case with palliative treatment sadly the only choice. Objective: To evaluate the associated complications in patients with prostate cancer and assess the Gleason’s grade as a risk factor for complications observed in patients with prostate cancer, in Port Harcourt, Rivers, Nigeria. Method and Methodology: This was a retrospective study carried out over ten years, between January 2011 and December 2020. All patients with histologically confirmed prostate cancer who presented to the University of Port Harcourt Teaching Hospital, Sophia clinic, and Rosivylle clinic were evaluated. The folders were retrieved and their age, presenting complaints, skeletal survey, and biopsy reports were evaluated. Patients with incomplete records were excluded from the study. These data were collated using Microsoft Excel 2016 version and they were analyzed using SPSS version 20. Results: There were 335 patients with PCa with a mean age of 68.71year. The commonest complication was urinary symptoms observed in 192 with urine retention 119(35.5%) and nephropathy 73(21.8%). The spine was the commonest site of bone spread observed in 160(47.8%) followed by the femur 62(18.5%). Anaemia was the next common. There was an association between age, presence of urinary symptoms, and bone involvement with the Gleason’s Grade. However, there was a strong association of the overall presence of complications with Gleason’s score. Conclusion: Men with prostate cancer tend to present with advanced disease in Port Harcourt. The most common presentation was lower urinary tract symptoms followed by low back pain. Complications are associated with high Gleason’s grade cancers. Screening may aid in early diagnosis and cure of the disease especially for men of African descent.

APA, Harvard, Vancouver, ISO, and other styles

32

Shikdar, Sufana, Vinay Edlukudige Edlukudige Keshava, Peter Lambert, Sindusha Gudipally, Anthony Esposito, Brad Bendesky, and Eric Green. "The Impact of a Mandatory Prescription Drug Monitoring Program (PDMP) on Opioid Prescription Among Sickle Cell Disease Patients By Emergency Medicine Physicians in Community Teaching Hospitals in Philadelphia." Blood 134, Supplement_1 (November 13, 2019): 4703. http://dx.doi.org/10.1182/blood-2019-122394.

Full text

Abstract:

Introduction: Although opioids are the recommended treatment for acute pain management in sickle cell disease (SCD) patients, the opioid epidemic may have negatively affected the care of these patients in the emergency care settings. Literature suggested that ED physicians routinely overestimate opioid misuse in patients with SCD. Pennsylvania mandated Prescription drug monitoring programs (PDMP) in August 2016 which may affect ED opioid prescription among SCD patients. We evaluated the impact of that PDMP on opioid prescription in the management of acute pain for patients with SCD. Method: The data collection took place in the two community hospitals (Mercy Fitzgerald and Mercy Philadelphia Hospital) in Philadelphia. Participants were adults (aged ≥18 years) diagnosed with SCD who triaged for pain in the ED was included in the study. We grouped the encounter by year of PDMP implementation: prior to September 2016 (January 2016-August 2016), and after September 2016 (January 2017-August 2017) to collect patient records of a 6-month period and analyzed the data on number of visits, treatment types, opioid dispensing and total morphine milligram equivalents (MMEs) drug prescriptions during the ED visit. Paired t-test and chi square test were used to compare pre- and post-intervention results. Repeat encounters within 7 days period were excluded in the study. Result: The study included 180 qualifying ED visits (92 pre-intervention; 88 post-intervention). PDMP intervention was not significantly associated with reductions in the with opioid prescribing or the amount of prescribed MMEs. The mean age is 32.7 and 58% were male; and all were of African American race/ethnicity. However, prescriptions for non-opioid analgesics increased significantly during the same periods (p<0.012). Conclusion: During January 2017-August 2017, PDMP implementation was not associated with a change in opioid prescription among SCD patients in our community teaching hospitals in Philadelphia. The use of the PDMP would be expected to increase narcotic use by correctly identifying SCD patients as not having opioid misuse. The failure to increase narcotics suggests that the use of PDMP data to adjust prescribing for SCD patients is not adequate. As PDMP is crucial for addressing the opioid crisis, clinicians should also use PDMP data for more tailored care in SCD patients. Integration of palliative care could be more pragmatic approach in balancing opioid abuse and access to opioids for pain management among SCD patients. Disclosures No relevant conflicts of interest to declare.

APA, Harvard, Vancouver, ISO, and other styles

33

Nichkaode, Prabhat, Shusrut Bhukte, and Aakash Bandhe. "Audit of 62 cases of pancreatic resections for pancreatic cancer." International Surgery Journal 4, no. 10 (September 27, 2017): 3382. http://dx.doi.org/10.18203/2349-2902.isj20174500.

Full text

Abstract:

Background: Varieties of pancreatic pathologies, needs resection of pancreatic tissue. Adenocarcinoma of the pancreatic duct is the most common malignancy presenting with early metastasis and seen as resistant to alternative treatment regimens currently available. Management and handling of such tumors is a complex and challenging task for a surgeon. Surgical resection offers an improved prognosis, with a median survival after resection of 14-20 months and up to 25% 5-year survival rates. Present study is aimed at presenting data of 62 pancreatic resections for various malignant pancreatic lesions.Methods: This is an ongoing longitudinal study which started in 2009 at teaching institute in central India. Though we had 109 patients for pancreatic resection, only 62 patients were considered suitable for the study. All patients after admission were thoroughly investigated and then considered for surgery. 48 patients were male and 14 patients were female. Age group was ranging from 33 to 65 years with mean age between 45 to 55 years. Spectrum of various malignancies and different types of pancreatic resections were done and results are presented here.Results: Pancreatic adenocarcinoma is an aggressive malignancy responds to surgical treatment better than other alternative modalities. In the present series out of 62 patients 27 patients with pancreatic head cancer, 22 patients with periampullary cancer, 2 patients with duodenal cancer, 6 patients with distal cholangio carcinoma, 1 patient with mucinous cystadenocarcinoma. 4 patients with body and tail of pancreas cancer. Average age 38 to 65 years, 47 males and 15 females. Commonest procedure was Whipple’s operation, and distal pancreatectomy. Survival in present series was 18 -24 months and 5-year survival was 12 % that is seen mainly with Periampullary cancer.Conclusions: Surgery is the only chance of cure or long-term survival in pancreatic cancer. Chemo radiation as a primary therapy is ineffective. But some reports suggest the improved quality of life with palliative chemotherapy. Biology of the disease is the king and dictates the survival, the type of surgical procedure had no impact on survival, nor on morbidity and mortality.

APA, Harvard, Vancouver, ISO, and other styles

34

Morrison, Laura, Rebecca Clarke, Claire McAteer, Eamon Dolan, and Marie O'Connor. "251 Communicating End of Life Care Decisions in an Acute Hospital." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.155.

Full text

Abstract:

Abstract Background Research by the Irish Hospice Foundation reports 43% of Irish deaths occur in hospital. The aim of this study was to review in-hospital deaths in a university teaching hospital to examine whether escalation of care and resuscitation instructions were documented clearly where death was a likely outcome during hospitalisation. Methods Medical records from 50 deaths in 2018 were reviewed. A proforma was designed to record detail on: demographics, if death was expected, and if resuscitation status, ceiling of care and discussion of these with the patient or family were clearly documented. Results 50 patients were included, median age 83.5 years. In 84%, end of life was anticipated by the medical team. 74% of patients were seen by palliative care. The most common cause of death was pneumonia/respiratory sepsis (46%) and median length of stay was 13 days. 3 patients (6%) had cardiac arrest calls. A clear ceiling of care was recorded in 46% of cases. Goals of care were documented as discussed with the patient in 2% of cases and family in 78%. Resuscitation status was recorded as discussed with family in 62% and the patient in 4%. Resuscitation status was documented in 96% of cases; 60% by the primary team, 36% by on-call staff. In only 54% of cases the name, position and Medical Council number of the person recording resuscitation status were all clearly written. Resuscitation status was correctly documented on the Early Warning Score chart in 32% of cases. Conclusion Clear documentation around treatment escalation plans is needed in patients admitted to an acute hospital. Resuscitation status and ceiling of care, if appropriate, should be decided and documented by the primary team where possible and discussed with the patient/family. This study showed a need to improve documentation and discussion with patients and families approaching end of life.

APA, Harvard, Vancouver, ISO, and other styles

35

Sharma, Anup, and Pradip Thapa. "Surgical Management of Gastric Cancer: An Institutional Experience." Journal of Nepalgunj Medical College 17, no. 2 (December 31, 2019): 82–85. http://dx.doi.org/10.3126/jngmc.v17i2.31662.

Full text

Abstract:

Introduction: Gastric cancer (GC) is the second most common cause of cancer-related deaths causing about 800,000 deaths worldwide/year. In Nepal gastric cancer is the second common cancer among males after the lung cancer. Gastric cancer shows a wide variation in incidence worldwide, being highest in Korea and Japan. It is detected early due to the low threshold for upper gastrointestinal endoscopy and screening programs. In the rest of the world and particularly in developing countries, GC is advanced in most of the cases. Inspite of controversies in extent of resection and lymphadenectomy, surgery remains the gold standard treatment. The study was conducted to determine the outcome of the patients with gastric cancer. Methods: The study was conducted in the department of surgery at Nepalgunj Medical College and Teaching Hospital Kohalpur from November 2015 to Dec 2018. Patients diagnosed with GC were studied. The patients with resectable disease underwent radical resection followed by adjuvant chemo-radiation as indicated. Patient’s demography, clinical presentation, stage of disease, types of surgery performed and survival were analysed. Results: 58 patients were diagnosed with gastric cancer. The age ranged from 20-83 years with the mean of 61.26±11.28. Male to female ratio was 2.41: 1. The common clinical presentations were weight loss, anorexia and anemia, 17 (29.31%) had gastric outlet obstruction at initial presentation and 4 (6.89%) presented with perforation peritonitis. Antropyloric region was the commonest site of tumor location seen in 41 (70.68%). 7 (12.06%) patients had distant metastasis and 5 (8.62%) had ascites at presentation. Out of 58 patients, 43 (74.13%) were operated. Only 18 (41.86%) patients underwent R0 resection. 14 (24.13%) underwent palliative gastrojejunostomy. Two (3.44%) patients underwent primary repair for perforation and in 9 (15.51%) the procedure was abandoned due to and presence of metastasis. There was one post-operative mortality. The histology of gastric cancer was found to be adenocarcinoma in all patients. There was no patient in stage I. 3(16.66%) patients were in stage II and 15 (83.33%) in stage III. 17 (29.31%) had stage IV disease. Out of 43 operated patients, 13 lost follow up. All 17 resected patients and those with metastatic disease were followed up. There was no death and no local recurrence in stage II. In stage III, 78.57% were alive and in stage IV 35.29% were alive. Conclusion: Gastric cancer is one of the common gastrointestinal malignancies affecting predominantly male gender. Stage of the disease is one of the major prognostic factors related with the survival. Adenocarcinoma is the commonest histology. Radical resection followed by adjuvant chemotherapy is the standard of care. Palliative chemotherapy can prolong the overall survival in patients with metastatic disease.

APA, Harvard, Vancouver, ISO, and other styles

36

Hasenburg, Annette, Frederic Amant, Leen Aerts, Astrid Pascal, Patriciu Achimas-Cadariu, and Vesna Kesic. "Psycho-Oncology: Structure and Profiles of European Centers Treating Patients With Gynecological Cancer." International Journal of Gynecologic Cancer 21, no. 9 (November 2011): 1520–24. http://dx.doi.org/10.1097/igc.0b013e31822925db.

Full text

Abstract:

ObjectivePsycho-oncological counseling should be an integrated part of modern cancer therapy. The aim of this study was to assess the structures and interests of psycho-oncology services within European Society of Gynecological Oncology (ESGO) centers.MethodsIn 2010, a survey, which consisted of 15 questions regarding organization of psycho-oncological services and interests in training and research, was sent to all ESGO-accredited centers (n = 41).ResultsThe response rate was 65.8% (27 centers). 96.3% (n = 26) of the surveys came from universities, and 3.7% (n = 1) came from nonacademic institutions. Most of the institutions (92.6%, n = 25) offer psycho-oncological care, mainly by psychologists (64%, n = 16) or psycho-oncologists (48%, n = 12). Fifty-two percent of patients are evaluated for sexual dysfunction as sequelae of their disease or treatment-related adverse effects. Fifty-two percent (n = 14) of institutions offer psychological support for cancer care providers. Eighty-five percent (n = 23) of all centers are interested in psycho-oncological training, and the preferred teaching tools are educational workshops (87%). The main issues of interest are sexual problems in patients with cancer, communication and interpersonal skills, responses of patients and their families, anxiety and adjustment disorders, and palliative care. Eighty-five percent (n = 17) of the 20 institutions look for research in the field of psycho-oncology, and 55% (n = 11) of those are already involved in some kind of research.ConclusionsAlthough psycho-oncological care is provided in most of the consulted ESGO accredited centers, almost 50% of women lack information about sexual problems. The results of the survey show the need for and interest in psycho-oncology training and research, including sexual dysfunction. Furthermore, psychological support should be offered to all cancer care providers.

APA, Harvard, Vancouver, ISO, and other styles

37

Sharma, Anup, P. Thapa, and A. Dhakal. "Gallbladder Cancer: A Hospital Based Study." Journal of Nepalgunj Medical College 15, no. 2 (June 1, 2017): 2–5. http://dx.doi.org/10.3126/jngmc.v15i2.22815.

Full text

Abstract:

Introduction: Gallbladder carcinoma (GBC) is the commonest cancer of the biliary tree and the most frequent cause of death from biliary malignancies. The overall resection rates at presentation range from 10%-30% only. Therefore, a large number of patients are inoperable with overall survival of only 6-8 months. Palliation of the pain, jaundice, pruritus is a big challenge in patients with advanced disease. Methods: A prospective cross sectional study of patients with GBC during the period of October 2014 to September 2017 at Nepalgunj Medical College and Teaching Hospital, Kohalpur, department of surgery. Results: There were 216 cases of gastrointestinal malignancies with 54(25%) GBC. There was female (75.92%) preponderance with a male to female ratio of 1:3.15. The mean age was 61.41±12.18. The most common symptom at presentation was pain in a right upper abdomen (87.03%) followed by abdominal lump (41.23%) and surgical jaundice (18.51%). Fundus (70.37%) was the most common site of involvement followed by body (5.55%) and neck (24.05%). Gall stone was associated in 44 (81.48%) patients. Only 7 (12.96%) patients had localized GBC, 25 (46.29%) patients had locally advanced disease and 22 (40.74%) had metastatic disease. Liver was the commonest site of metastatis followed by peritoneum and two patients had left supraclavicular lymph node metastatis. There were two (3.72%) incidental gall bladder cancer after laparoscopic cholecystectomy. 13 (24.07%) patients were operated with intention of radical cholecystectomy but only six (46.15%) patient could undergo radical resection. Staging laparoscopy was done in all patients except for incidental gall bladder cancer. Metastatic disease was identified in 3 (23.07%) on staging laparoscopy. In eight (61.33%) among 13 patients the disease was unresectable. The most common histology was adenocarcinoma and most common stage was stage III and stage IV when both operated and non-operated groups were combined. Conclusions: GBC was the commonest gastrointestinal tract cancer with a female preponderance. A majority of patients were inoperable at presentation with pain in abdomen being the most common symptom. Surgery although is the main stay of treatment is not possible in many.

APA, Harvard, Vancouver, ISO, and other styles

38

Lysecki, David, Daryl Bainbridge, Tracy Akitt, Georgia Georgiou, Ralph M. Meyer, and Jonathan Sussman. "Feasibility of a child life specialist program for oncology patients with minor children at home: Demand and implementation." Journal of Clinical Oncology 39, no. 28_suppl (October 1, 2021): 28. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.28.

Full text

Abstract:

28 Background: Up to 24% of adult oncology patients have minor children at home. Children may experience emotional problems, somatic complaints, social isolation, depression, and post-traumatic stress as a result. Typical support networks often fail to meet the needs of these families. To address this gap, an innovative Child Life Specialist (CLS) program for patients with minor children at home was offered at a tertiary oncology center. Methods: To understand the feasibility of this program, we examined the demand for and implementation of the CLS program over its initial 10 months. Demand was characterized using administrative data (referred patient/family demographics, referral details, and disease/treatment characteristics). Implementation was described through encounter data (audience, type of visit, interventions provided, time for preparation, and time of direct interaction for each encounter). Results: The program received 100 referrals, 93 of whom accessed the program. Patients were most often female (66%) with a median age of 45 years (range: 19 to 72). 81% were parents of minor children, 10% grandparents, and 9% other. Families predominantly had multiple children (98%), most commonly school-aged (ages 5-9, 39%; 10-14, 37%). 53% of families had two birth parents co-parenting in the same household; the remainder had alternate parent/living scenarios. Most referrals came from social work (57%). Median time from diagnosis to referral was 79 days (range: 9d-6.5y). Breast cancer (26%) was the most common diagnosis, followed by gastrointestinal (19%) and hematologic (16%). Cancer phase at referral was defined as at new diagnosis (within 30d, 18%), undergoing treatment with curative intent (20%), undergoing treatment with palliative intent (39%), at end of life (within 30d, 16%) and after death/bereavement (5%). 1 patient (1%) did not have cancer. The CLS recorded 257 unique encounters. 55% of encounters included patients, 40% non-patient parents, 21% children, and 21% others. 75% were individual encounters, while 25% were group encounters. 95% of encounters that included children also included an adult. Phone calls were the most frequent encounter type (43%), but hospital visits consumed the largest proportion of recorded CLS time (38%). Mean encounter time (all visit types) included 20min for preparation and 51min of direct interaction. CLS interventions included: guidance on talking with children (67% of encounters), providing resources (37%), diagnostic teaching (21%), end-of-life support (18%), discussing change in status (10%), grief (8%), and emotional expression (4%). Conclusions: This study characterized the demand for this program and described its implementation over the pilot period. This period occurred during the Covid-19 pandemic, which dramatically altered healthcare and family visitation, likely influencing the results of this study.

APA, Harvard, Vancouver, ISO, and other styles

39

Buiting, Hilde M., Mirian Brink, Marleen N. Wijnhoven, Martine E. Lokker, Lydia GM van der Geest, Wim E. Terpstra, and Gabe S. Sonke. "Doctors’ reports about palliative systemic treatment: A medical record study." Palliative Medicine 31, no. 3 (August 19, 2016): 239–46. http://dx.doi.org/10.1177/0269216316661685.

Full text

Abstract:

Background: Decisions about palliative systemic treatment are key elements of palliative and end-of-life care. Such decisions must often be made in complex, clinical situations. Aim: To explore the content of medical records of patients with advanced non-small cell lung cancer and pancreatic cancer with specific emphasis on doctors’ notes about decisions on palliative systemic treatment. Design: Medical record review (2009–2012) of 147 cancer patients containing 276 notes about palliative systemic treatment. We described the proportion of notes/medical records containing pre-specified items relevant to palliative systemic treatment. We selected patients using the nationwide Netherlands Cancer Registry. Setting: Hospital based. Results: About 75% of all notes reported doctors’ considerations to start/continue palliative systemic treatment, including information about the prognosis (47%), possible survival gain (22%), patients’ wish for palliative systemic treatment (33%), impact on quality of life (8%), and patient’s age (3%). Comorbidity (82%), smoking status (78%) and drinking behaviour (63%) were more often documented than patients’ performance status (16%). Conversations with the patient/family about palliative systemic treatment were reported in 49% of all notes. Response measurements and dose adaptations were documented in 75% and 71% of patients who received palliative systemic treatment respectively. Conclusion: Medical records provide insight into the decision-making process about palliative systemic treatment. The content and detail of doctors’ notes, however, widely varies especially concerning their palliative systemic treatment considerations. Registries that aim to measure the quality of (end-of-life) care must be aware of this outcome. Future research should further explore how medical records can best assist in evaluating the quality of the decision-making process in the patient’s final stage of life.

APA, Harvard, Vancouver, ISO, and other styles

40

Pandey, Samiksha, Deepshikha Gaire, Sheela Dhakal, Neelam Jaishwal, Pushpa Mani Kharal, and Pradeep Vaidhya. "Perception of Palliative Care among Medical Students in a Teaching Hospital." Journal of Nepal Medical Association 53, no. 198 (June 30, 2015): 113–17. http://dx.doi.org/10.31729/jnma.2772.

Full text

Abstract:

Introduction: Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness. Palliative care must be a part of every medical personnel’s practice. But still medical education curriculums have not included palliative care in its syllabus, sufficiently due to which most of the health professional are not aware about this specialty. The purpose of this study is to find out the perception of the medical students in palliative care in a teaching hospital. Methods: A descriptive study was done among 270 undergraduate medical students studying in Institute of Medicine using a self structured pretested questionnaire. Data was entered in Microsoft Excel and analyzed by using SPSS 21. Results: Of the total 270 undergraduate medical students only 152 has heard the word “palliative care”. Only 84 students know, palliative care can be provided early in the life threatening illness. Total 80 students know it doesn’t intend to postpone and hasten death. Though only 49 students didn’t know PC is not included in our curriculum, 227 are interested to learn about it if given any opportunity. Conclusions: The perception of palliative care medicine is low in first couple of year of medical study. It is increased in clinically exposed students but is surprisingly more in fourth year than final year undergraduate medical students. However, it should be included in undergraduate medical study. Keywords: medical students; palliative care; perception.

APA, Harvard, Vancouver, ISO, and other styles

41

Cooper, Garry. "Lymphoedema treatment in palliative care: a case study." British Journal of Nursing 21, no. 15 (August 7, 2012): 897–903. http://dx.doi.org/10.12968/bjon.2012.21.15.897.

Full text

APA, Harvard, Vancouver, ISO, and other styles

42

Ofosu-Poku, Rasheed, Michael Owusu-Ansah, and John Antwi. "Referral of Patients with Nonmalignant Chronic Diseases to Specialist Palliative Care: A Study in a Teaching Hospital in Ghana." International Journal of Chronic Diseases 2020 (March 16, 2020): 1–11. http://dx.doi.org/10.1155/2020/8432956.

Full text

Abstract:

Ghana’s chronic disease burden is on the rise. An essential aspect of clinical care in chronic disease management is to improve the quality of life of both patients and their families and to help them cope with the experience of life-limiting illness. Specialist palliative care services help reach this objective, especially in the context of complex psychosocial challenges and high symptom burden. It is, therefore, necessary that as many patients as possible get access to available specialist palliative care services. This paper explores the factors influencing referral of patients with nonmalignant chronic diseases for specialist palliative care. A qualitative approach was used to explore these factors from eight (8) participants—four (4) physician specialists and four (4) next of kin of patients with advanced nonmalignant chronic illness. Individual face-to-face interviews were conducted using a semistructured interview guide. Interviews were audio-recorded and data coded, themes and subthemes were identified, and thematic analysis was done. Barriers and motivators identified were categorized as either related to physicians, institution, or family. Barriers to referral were perception of the scope of palliative care, medical paternalism, lack of an institutional referral policy, poor human resource capacity of the palliative care team, and lack of awareness about the existence of specialist palliative care service. Poor economic status of the patient and family, poor prognosis, previous interaction with the palliative care team, and an appreciation of patients’ expectations of the healthcare system were identified as motivators for referral. The palliative care team must therefore increase awareness among other health professionals about their services and facilitate the development and availability of a clear policy to guide and improve referrals.

APA, Harvard, Vancouver, ISO, and other styles

43

Maddison, André R., Shiraz Malik, and Andrew Smaggus. "Inpatient Palliative Care Consultations From a Canadian Clinical Teaching Unit." Journal of Palliative Care 33, no. 4 (June 8, 2018): 204–8. http://dx.doi.org/10.1177/0825859718781363.

Full text

Abstract:

Inpatient palliative care consultation has been demonstrated to improve quality of life as well as decrease hospital readmissions, intensive care unit transfers, and hospital costs for people with a life limiting illness. The clinical teaching units (CTUs) at London Health Sciences Centre (LHSC) routinely admit patients with noncurable cancer as well as end-stage heart, lung, liver, or kidney disease. However, the use of inpatient palliative care consultations for CTU patients remains unexamined. We conducted a descriptive study of all patients referred from LHSC CTU from both University and Victoria hospital to inpatient palliative care over a 1-year period from August 2013 to July 2014. The purpose of this study was to characterize the population and identify possible areas for quality improvement. In a 1-year period, 638 patients were referred from CTU to the inpatient palliative care consultation service. Of referrals, 55% died during their admission. Based on data collected, we conclude that many patients are referred early in their admission to CTU and patients are referred for a variety of noncancer diseases, suggesting knowledge and appreciation of the benefit of early palliative care consultation for malignant and nonmalignant disease. However, when further analyzed, there is indication that patients with noncancer diagnoses are referred statistically significantly later than those with a cancer diagnosis. The CTUs are sites of core medical training, and therefore, it is imperative that we model early integration of palliative care in order to continue to improve care of patients at end of life.

APA, Harvard, Vancouver, ISO, and other styles

44

Hamdoune, Meryem, and Abdellah Gantare. "Teaching palliative care skills via simulation-based learning." International Journal of Palliative Nursing 27, no. 7 (September 2, 2021): 368–74. http://dx.doi.org/10.12968/ijpn.2021.27.7.368.

Full text

Abstract:

Background: The scarcity of palliative care (PC) services in Morocco, and their absence in Settat, limits the opportunities for nursing students at the Higher Institute of Health Sciences (HIHS) to benefit from clinical placements. As a consequence of this, most students feel underprepared to care for patients with PC needs. Aim: The purpose of this study is to share a simulation-based learning experience in a PC context and to evaluate the effectiveness of this learning method. Methods: The simulation experience took place in the simulation centre of the HIHS and involved 20 nursing students in their second year. The main goal of the simulation session was to simulate the support given to patients going through the five stages of grief. A post-simulation survey was conducted to explore the nursing students reflections on this learning experience. Findings: The simulation is recommended as a powerful learning approach to compensate for the lack of PC clinical placements available to nursing students. Conclusion: The simulation-based training was an excellent opportunity for nursing students to experience caring for patients in extreme end-of life-situations, which was not possible before due to the lack of specialised PC services.

APA, Harvard, Vancouver, ISO, and other styles

45

Dein, Simon. "Psychiatric liaison in palliative care." Advances in Psychiatric Treatment 9, no. 4 (July 2003): 241–48. http://dx.doi.org/10.1192/apt.9.4.241.

Full text

Abstract:

Palliative care is the active, total care of patients whose disease is not responsive to curative treatment. Psychological problems such as depressive illness, anxiety, delirium, problems coping and body image disturbances are common in the palliative care setting, although they are often missed. A full assessment of these patients should take into account physical, emotional and spiritual factors; therapeutic work should include the patient's family. Pharmacological (antidepressants, anxiolytics and antipsychotics) and cognitive–behavioural treatments are often effective in allaying distress in this group of patients, and can improve coping skills and quality of life. Liaison psychiatrists have a role in teaching palliative care staff to recognise psychiatric disorders. A number of case studies are presented to illustrate these points.

APA, Harvard, Vancouver, ISO, and other styles

46

Thompson, Andrea, Tanisha Jowsey, Helen Butler, Augusta Connor, Emma Griffiths, Hadley Brown, and Marcus Henning. "Deeper conversations: Palliative care education for pharmacists makes a difference." Asia Pacific Scholar 5, no. 2 (May 5, 2020): 22–31. http://dx.doi.org/10.29060/taps.2020-5-2/oa2173.

Full text

Abstract:

Objective: The aim of this study was to identify the impact of a series of palliative care educational packages on pharmacists’ practice for improved service delivery. We asked, what are the educator and learner experiences of a short course comprised of workshops and a series of palliative care learning packages, and how have learners changed their practice as a result of the course? Method: Semi-structured interviews were conducted and transcribed verbatim. Interpretive thematic analysis was undertaken. Results: Eight people participated in this study; five pharmacists who had completed learning packages in palliative care and three educators who facilitated teaching sessions for the learning packages. The teaching and assessment approaches were applied and transferable to the clinical setting. The teaching strategies stimulated engagement, enabling participants to share their ideas and personal experiences. Participants’ understanding of palliative care was improved and they developed confidence to engage in deeper conversations with patients and/or their families and carers. Although the completion of assessment for the learning packages enabled credit for continuing professional development, their impact on the long-term practice of pharmacists was not established. Conclusions: The findings of this study suggest that interactive teaching methods assisted the interviewed pharmacists to further develop their understanding of palliative care, and communication skills for palliative care patients and/or their families/carers. Pharmacists were better equipped and felt more comfortable about having these potentially difficult conversations. We recommend educators to place more emphasis on reflective activities within learning packages to encourage learners to develop more meaning from their experiences.

APA, Harvard, Vancouver, ISO, and other styles

47

Shah, Narender Singh, Dhiraj Daga, Deepti Singh, Manish Kumar Chaturvedi, Upen Kishor Mathur, Poonam Banthia, and Ashish Kavia. "Retrospective Study of Palliative Radiotherapy in Locally Advanced and Metastatic Head and Neck Carcinoma: A Single Institution Study." Bengal Journal of Otolaryngology and Head Neck Surgery 29, no. 3 (March 18, 2022): 231–37. http://dx.doi.org/10.47210/bjohns.2021.v29i3.514.

Full text

Abstract:

Introduction The most common cancer of India is head and neck, and about 70% of them present in locally advanced or metastatic disease. Palliative radiotherapy is one of the commonly used treatments in such cases. A retrospective study on the outcomes and toxicity of palliative radiotherapy is studied at a tertiary centre. Materials and Methods In this study, 74 patients who underwent palliative radiotherapy at the tertiary centre between Nov 2017 and Oct 2019 were retrospectively analysed. The frequency of different presenting symptoms, radiotherapy regimens, their outcome in form of symptomatic relief and disease status along with toxicity was studied and analysed through the available records. Results We identified 74 eligible patients. The median age was 48years (range, 26–82). Oropharyngeal primary cancer was the most common primary site. The Eastern Cooperative Oncology Group performance status was 3 or more in 74.4% patients. The radiation regimen used were ranged from 8Gyin single fraction, 20Gy in 4 fractions, 20Gy in 5 fractions, 30Gy in 10 fractions and 60Gy in 30 fractions. 93.2% of them completed their treatment. Pain and swelling were the most common presenting symptoms and 90.6% of them had more than 50% relief, while 46.5% had complete or partial response to the treatment. Conclusion Palliative radiotherapy to the head and neck provides some symptomatic benefit in most patients, there are multiple dose fractionation regimens currently being used for palliative radiation treatment, and consideration should be given to higher dose palliative RT regimens in patients having good performance status to maximize locoregional control and minimize late toxicity, patient with poor performance status will benefit from a hypofractionated palliative radiation treatment.

APA, Harvard, Vancouver, ISO, and other styles

48

Heidari, Haydeh, Marjan Mardani-Hamooleh, and Marjaneh Fooladi. "Design of a Palliative Care Program for Nursing Students in the Neonatal Intensive Care Unit: A Mixed-Method Study." Creative Nursing 28, no. 2 (April 1, 2022): 126–32. http://dx.doi.org/10.1891/cn-2021-0058.

Full text

Abstract:

This study introduces an innovative design for a palliative care program by nursing students in an internship in a neonatal intensive care unit. An embedded mixed-method approach simultaneously collected quantitative and qualitative data. Themes identified were supporting and encouraging palliative care, changing the nursing culture, and promoting quality of care. Teaching palliative care during this internship rotation helped promote quality care by the students, with positive results for infants and their families, and empowerment of the students through increased knowledge and awareness of human needs for high-quality nursing care.

APA, Harvard, Vancouver, ISO, and other styles

49

Shikdar, Sufana, Noel Medeiros, Erin Kelly, Nicholas Ghionni, Deborah Cassidy, and Eric Green. "Residents' attitudes and beliefs towards palliative care in a community teaching hospital." Journal of Clinical Oncology 36, no. 34_suppl (December 1, 2018): 89. http://dx.doi.org/10.1200/jco.2018.36.34_suppl.89.

Full text

Abstract:

89 Background: Early integrated palliative care improves the quality of life in patients with cancer. Wong et al. (2016) recently demonstrated that residents and fellows in a university hospital-based large comprehensive cancer center believed palliative care services to be beneficial for patient care. However, there are substantial differences between the clinical learning environments of a university and community teaching hospital. We aim to assess residents' attitudes and beliefs towards palliative care in the oncologic population in a community teaching hospital. Methods: We surveyed all residents (n = 90) in Mercy Catholic Medical Center's internal medicine, transitional year, and general surgery residencies about their knowledge, training, attitudes and beliefs regarding palliative care using a survey modified from Wong et al. (2015). Mercy Catholic Medical Center is a conglomeration of two community teaching hospitals in greater Philadelphia. The factors associated with awareness were analyzed using chi square or fisher exact test and logistic regression. Results: A total of 57 (63%) residents participated. The differences between the knowledge of residents from other specialties were not statistically significant. The awareness was reported more among residents who are American medical graduates (p = 0.03). The majority of the residents believed palliative care was beneficial to patients and families (98%), reduce health care costs (91%), decrease overall symptom burden (86%) and symptomatic management in newly diagnosed cancer (81%). Residents who reported having palliative care training during residency had significantly higher awareness (OR = 2.99, p = 0.04). Conclusions: Our study shows that the attitude and belief of residents at community teaching hospital is similar to the trainees at university teaching hospital. The implementation of palliative care rotation for all residents from clinical specialties can be effective in improving trainee’s attitude and belief regarding increased and early referral to palliative care.

APA, Harvard, Vancouver, ISO, and other styles

50

Gadoud, Amy, Wei-Hsin Lu, Lisa Strano-Paul, Susan Lane, and Jason W. Boland. "A pilot study of interprofessional palliative care education of medical students in the UK and USA." BMJ Supportive & Palliative Care 8, no. 1 (June 21, 2017): 67–72. http://dx.doi.org/10.1136/bmjspcare-2016-001267.

Full text

Abstract:

BackgroundEducating medical students to care for patients at the end-of-life is increasingly recognised as an essential component of training. Traditionally, medical student programmes are run by doctors, but patient care is delivered by an interprofessional team. Our programmes in the UK and USA independently developed a teaching experience led by an interprofessional team of palliative care health professionals.ObjectivesThis study explores the palliative care health professionals’ perceptions, regarding their unique role in medical student palliative care education.MethodsThis is the first study to ascertain views of an interprofessional team delivering palliative care education to medical students. Focus groups enable interaction between members of the group as well as the generation of consensus of comments among group members.ResultsTwo major themes were identified: perceived benefits and value of the experience, and the challenges and lessons learnt from the experiences.ConclusionsDespite different structures and settings, this experiential learning in palliative care provided a rewarding interprofessional experience that has historically been difficult to achieve.

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Palliative treatment Study and teaching'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles