Palliative care integration in the intensive care unit: healthcare professionals' perspectives - a qualitative study.

Objectives: The complex care needs and high mortality of critically ill patients in intensive care unit (ICU) warrants a team approach. While studies have affirmed the integral role of palliative care teams in ICU, little is known about the ICU healthcare professional's perception on how this integration affects the care of the critically ill.This study examines their perception of how integration of palliative care into ICU practice affects interprofessional collaborative practices and relationships in the delivery of care.

Protocol for a randomised controlled trial on impact of comprehensive geriatric and supportive assessment versus standard care in older adults with cancer undergoing curative treatment: The Geriatric Oncology SuPportive clinic for ELderly (GOSPEL) study.

Cancer affects older adults with varying levels of frailty, but cancer treatment is extrapolated from clinical trials involving predominantly young and robust subjects. Recent geriatric oncology randomised controlled trials (RCT) report that geriatric assessment leading to frailty-guided intervention reduces treatment-related toxicity whilst maintaining survival and improving quality of life (QoL). However, these positive results have not have been consistently reported in the literature.

Burnout in Palliative Care - Difficult Cases: Qualitative Study.

Objectives: Burnout is common among palliative care clinicians, occurring as a result of emotions experienced in caring for challenging patients or families. Awareness of these scenarios helps clinicians and teams appropriately manage their own emotions and prevent burnout. We studied challenging clinical situations and the emotions encountered by experienced palliative care clinicians which could potentially contribute to burnout.

End-stage organ disease-Healthcare utilisation: Impact of palliative medicine.

Objectives: Although patients living with end-stage organ disease (ESOD) suffer unmet needs from the physical and emotional burdens of living with chronic illness, they are less likely to receive palliative care.The aims of the study were to determine if palliative care referrals reduced healthcare utilisation and if impact on healthcare utilisation was dependent on the timing of the referral.

Methods: Patients with ESOD who received palliative care support were matched with those who did not using coarsened exact matching and propensity score matching, and compared in this retrospective cohort study.

Integrating Palliative Care Into a Neurosurgical Intensive Care Unit (NS-ICU): A Quality Improvement (QI) Project.

Objectives: We conducted a pilot quality improvement (QI) project with the aim of improving accessibility of palliative care to critically ill neurosurgical patients.

Methods: The QI project was conducted in the neurosurgical intensive care unit (NS-ICU). Prior to the QI project, referral rates to palliative care were low.

How Leaders, Teams and Organisations can prevent Burnout and build Resilience: a thematic analysis'.

Content: Burnout occurs commonly in palliative care. Building resilience helps to mitigate the effects of burnout. Little is known about the importance of leaders, teams and organisations in preventing burnout and promoting resilience in palliative care.

Prognostication in Home-Dwelling Patients with Advanced Dementia: The Palliative Support DEMentia Model (PalS-DEM).

Objective: Difficulties with prognostication prevent more patients with advanced dementia from receiving timely palliative support. The aim of this study is to develop and validate a prognostic model for 6-month and 1-year mortality in home-dwelling patients with advanced dementia.

Design: Prospective cohort study.

Integrated palliative homecare in advanced dementia: reduced healthcare utilisation and costs.

Objectives: To determine the economic benefit of an integrated home-based palliative care programme for advanced dementia (Programme Dignity), evaluation is required. This study aimed to estimate Programme Dignity's average monthly cost from a provider's perspective; and compare healthcare utilisation and costs of programme patients with controls, accounting for enrolment duration.

Methods: This was a retrospective cohort study.

Comfort and Satisfaction With Care of Home-Dwelling Dementia Patients at the End of Life.

Context: Despite the preference to pass away at home, many dementia patients die in institutions, resulting in a paucity of studies examining end-of-life care outcomes in the home setting.

Objective: The objective of this study was to identify modifiable factors associated with the comfort of dementia patients dying at home and families' satisfaction with care.

Methods: This is a prospective cohort study conducted from October 2014 to April 2019 in Singapore.

Shared leadership in interprofessional teams: beyond team characteristics to team conditions.

Shared leadership has been shown to enhance processes, effectiveness, and performances in interprofessional teams. While earlier studies suggest the association of internal team environment (ITE) and transactive memory system (TMS) with shared leadership, the relative influence of these team conditions vis-a-vis team characteristics (such as team size, stability, and interprofessional roles) on shared leadership is not well understood. This study aims to examine the comparative influence of team characteristics versus team conditions of ITE and TMS on shared leadership during interprofessional team meetings (IPTMs).

Burnout and Resilience After a Decade in Palliative Care: What Survivors Have to Teach Us. A Qualitative Study of Palliative Care Clinicians With More Than 10 Years of Experience.

Context: Burnout is common among palliative care clinicians (PCCs). Resilience helps to reduce burnout, compassion fatigue, and is associated with longevity in palliative care.

Objectives: We aimed to study PCCs who have remained in the field for longer than 10 years to deepen our understanding on their views on burnout and resilience.

Advanced dementia: an integrated homecare programme.

Objectives: We established an integrated palliative homecare programme for advanced dementia. This study explores patients' symptoms and quality-of-life and their association with enteral feeding, evaluates the impact of the programme on these parameters and examines familial caregiver burden.

Methods: This is a prospective cohort study.

PROgnostic Model for Advanced Cancer (PRO-MAC).

Objective: To develop and validate a simple prognostic tool for early prediction of survival of patients with advanced cancer in a tertiary care setting.

Design: Prospective cohort study with 2 years' follow-up.

Setting: Single tertiary teaching hospital in Singapore.

ED-PALS: A Comprehensive Palliative Care Service for Oncology Patients in the Emergency Department.

Background: The American College of Emergency Physicians has identified early palliative care referral for patients with advanced cancer as a key competent of the Choosing Wisely campaign.

Objectives: To study the feasibility of a new 3-way model of care between emergency department (ED), hospital palliative care department, and inpatient/home hospice.

Methods: This was a prospective, descriptive study that included oncology patients who attended the hospital ED over a 3-year period from January 2015 to December 2017.

Burnout, psychological morbidity and use of coping mechanisms among palliative care practitioners: A multi-centre cross-sectional study.

Background: The prevalence of burnout, psychological morbidity and the use of coping mechanisms among palliative care practitioners in Singapore have not been studied.

Aim: We aimed to study the prevalence of burnout and psychological morbidity among palliative care practitioners in Singapore and its associations with demographic and workplace factors as well as the use of coping mechanisms.

Design: This was a multi-centre, cross-sectional study of all the palliative care providers within the public healthcare sector in Singapore.