Purpose: To evaluate factors associated with continuation of systemic anti-cancer therapy (SACT) after palliative care consultation, and SACT administration in the last 30 days of life, in outpatients with cancer referred to palliative care. Timing of referral was of particular interest.
Methods: Patient, disease, and treatment-related factors associated with SACT before and after palliative care, and in the last 30 days of life, were identified using 3-level multinomial logistic regression. Referral to palliative care was categorized by time from death as early (>12 months), intermediate (6-12 months), and late (≤6 months).
Results: Of the 337 patients, 240 (71.2%) received SACT for advanced cancer; of these, 126 (52.5%) received SACT only prior to palliative care while 114 (47.5%) also received SACT afterward. Only 35/337 (10.4%) received SACT in the last 30 days of life. On multivariable analysis, factors associated with continuing SACT after palliative care consultation were a cancer diagnosis for <1 year (OR 3.09, p = 0.01), breast primary (OR 11.88, p = 0.0008), and early (OR 28.8, p < 0.001) or intermediate (OR 6.67, p < 0.001) referral timing. No factors were significantly associated with receiving SACT in the last 30 days versus earlier, but the median time from palliative care referral to death in those receiving SACT in the last 30 days versus stopping SACT earlier was 1.78 versus 4.27 months.
Conclusion: Patients who received SACT following palliative care consultation were more likely to be referred early; however, patients receiving SACT in their last 30 days tended to be referred late.
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http://dx.doi.org/10.1177/0825859720975949 | DOI Listing |
BMC Nurs
December 2024
Palliative Care Unit, Health Sciences University Tepecik Training and Research Hospital, İzmir, Türkiye.
Background: Adequate, balanced, and individualized nutrition, planned according to the patients' life expectancy in palliative care units, is crucial for maintaining essential functions.
Aim: To determine the knowledge levels of nurses working in palliative care units regarding enteral nutrition practices and their perceptions of nutritional care quality in their units.
Methods: This descriptive, cross-sectional study was conducted in 25 palliative care units located in Izmir, Türkiye, between June and September 2022.
BMC Public Health
December 2024
Institute for Health Research, University of Bedfordshire, Luton, UK.
Background: Inequalities in cancer, palliative, and end-of-life care services remain a significant challenge, particularly for ethnic minorities who face systemic barriers such as limited awareness, cultural stigmas, and language differences. These disparities hinder equitable access to essential services and contribute to poorer health outcomes for affected communities. Addressing these challenges requires targeted, culturally sensitive initiatives that promote both awareness and uptake of care.
View Article and Find Full Text PDFBMC Med Educ
December 2024
Newcastle University, Newcastle upon Tyne, UK.
Context: The COVID-19 pandemic led to an increase in numbers of patients dying at home in the UK, meaning that general practitioners (GPs) were exposed to more patient death than would be pre-COVID. This project aimed to gain insight into GP trainees' experiences of patient death between March and July 2020. This insight can inform support for GPs, leading to improved wellbeing, workforce retention and ultimately, better patient-centred care.
View Article and Find Full Text PDFBMC Palliat Care
December 2024
National Cancer Survivorship Center, National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si Gyeonggi-do, 10408, Republic of Korea.
Background: The Integrated Palliative care Outcome Scale (IPOS) is a key tool for assessing the quality of palliative care using patient-reported outcomes. This study aimed to culturally adapt and translate the IPOS to Korean and verify its psychometric properties for use in palliative care settings.
Methods: The IPOS was translated and culturally adapted, followed by validation in 119 terminally ill cancer patients and 28 healthcare providers across six Hospice and Palliative Care Units from September 2023 to January 2024.
Background And Objectives: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive motor neuron degeneration resulting in loss of muscle function. Care management is restricted to symptomatic and palliative strategies, while clinical manifestations are heterogeneous. However, assessing the timing and benefits of ALS major clinical interventions remains challenging, with varying and nonspecific time-to-events estimates reported in the literature.
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