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Top ten tips palliative care clinicians should know about mental health and serious illness

RIORDAN, Paul ; BRISCOE, Joshua ; KAMAL, Arif H. ; JONES, Christopher A. ; WEBB, Jason A.
JOURNAL OF PALLIATIVE MEDICINE, 08/2018, vol.21, n°8, p. 1171-1176

Conceptualizing and counting discretionary utilization in the final 100 days of life - a scoping review

DUBERSTEIN, Paul R. ; CHEN, Michael ; HOERGER, Michael ; EPSTEIN, Ronald M. ; PERRY, Laura M. ; YILMAZ, Sule ; SAEED, Fahad ; MOHILE, Supriya G. ; NORTON, Sally A.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 19/10/2019 , 97 p.

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Thème : Recherche - Evaluation - Méthodologie. Cote : eD15.00.02.02

FIN VIE ; EVALUATION ; QUALITE SOIN ; REVUE LITTÉRATURE

Context: There has been surprisingly little attention to conceptual and methodological issues that influence the measurement of discretionary utilization at the end-of-life (DIALs), an indicator of quality care.
Objective: To examine how DIALs have been operationally defined, and identify areas where evidence is biased or inadequate to inform practice.
Methods: We conducted a scoping review of the English language literature published from 1/1/04-6/30/17. Articles were eligible if they reported data on =2 DIALs within 100 days of the deaths of adults =18 years old. We explored the influence of research design on how researchers measure DIALs and whether they examine demographic correlates of DIALs. Other potential biases were explored.
Results: We extracted data from 254 articles published in 79 journals covering research conducted in 29 countries, mostly on cancer (69.1%). More than 100 DIALs have been examined. Relatively crude, simple variables (e.g., ICU admissions [56.9% of studies], chemotherapy [50.8%], palliative care [40.0%]) have been studied more frequently than complex variables (e.g., burdensome transitions; 7.3%). We found considerable variation in the assessment of DIALs, illustrating the role of norms and disciplinary habit. Variables are typically chosen with little input from the public (including patients or caregivers) and clinicians. Fewer than half the studies examined age (44.6%), gender (37.3%), race (26.5%), or socioeconomic (18.5%) correlates of DIALs.
Conclusions: Unwarranted variation in DIALs assessments raises difficult questions concerning how DIALs are defined, by whom, and why. We recommend several strategies for improving DIALs assessments. Improved metrics could be used by the public, patients, caregivers, clinicians, researchers, hospitals, health systems, payers, governments, and others to evaluate and improve end-of-life care.

Origine : PubMed

Assessing the validity of the clinician-rated distress thermometer in palliative care

VAN LANDER, A. ; TAROT, A. ; SAVANOVITCH, C. ; PEREIRA, B. ; VENNAT, B. ; GUASTELLA, V.
BMC palliative care, 17/10/2019, vol.18, n°1, p. 1-7

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Thème : Recherche - Evaluation - Méthodologie. Cote : eD15.00.02.03

DEMARCHE PALLIATIVE ; DETRESSE PSYCHOLOGIQUE ; EVALUATION ; RECHERCHE QUANTITATIVE

BACKGROUND: The distress of patients suffering from a terminal illness can lead to a state of despair and requests for euthanasia and assisted suicide. It is a major challenge for palliative care workers. The Distress Thermometer (DT) is recommended by the National Comprehensive Cancer Network as a means of more easily assessing distress. It is available as a Self-assessment reported Distress Thermometer, but for a wider use in palliative care it should also be implemented in the form of a clinician-reported outcome (clinRO). Clinicians need to rate patient's distress when the patient is not able to do so (subject that cannot be addressed, defensive patient…). The primary aim of the quantitative study was to assess the validity of the Clinician-Rated Distress Thermometer in palliative care.
METHOD: The assessments were performed by teams working in three palliative care centres. The primary endpoint was concordance between the patient and clinicians’ responses via Lin’s concordance coefficient. Eligible patients were aged 18 years or older, suffering from a severe disease in the palliative phase, and with a sufficient level of awareness to consent to participate in the study. A total of 51 patients were recruited, 55% were male, with a mean age of 65.8 years [39–90 years].
RESULTS: Three hundred sixty-four clinician-Rated Distress Thermometer and 467 Self-Reported Distress Thermometer were performed. Only 364 of the 467 Self-Reported Distress Thermometer were used for the study, as investigators did not systematically ask the patient to give an account of his distress. Concordance between patient and clinician responses: The Lin's concordance coefficient with a threshold (alpha) of 5% was 0.46 [0.38; 0.54]. At the first assessment, it was 0.61 [0.44; 0.79]. The Cohen's kappa coefficient was 0.52, with a concordance rate of 79.6%. The sensitivity was 82.9% [66.4-93.4] and the specificity 71.4% [41.9-91.6].
CONCLUSION: The first assessment gave the best results in terms of concordance between Clinician-Rated DT and Self-Reported DT. In the next assessments, the Clinician-Rated DT were less consistent with the patients' Self-Reported DT.

Origine : PubMed

Evaluation tools for interdisciplinary palliative care learning experiences - a literature review

THIEL, Meghan ; HARDEN, Karen ; BRAZIER, Lori-Jene ; MARKS, Adam D. ; SMITH, Michael A.
JOURNAL OF PALLIATIVE MEDICINE, 16/10/2019, Pagination inconnue

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Early-integrated palliative home care and standard care for end-stage COPD (EPIC) - a phase II pilot RCT testing feasibility, acceptability and effectiveness

SCHEERENS, Charlotte ; PYPE, Peter ; VAN CAUWENBERG, Jelle ; VANBUTSELE, Gaëlle ; EECLOO, Kim ; DEROM, Eric ; VAN BELLE, Simon ; JOOS, Guy ; DELIENS, Luc ; CHAMBAERE, Kenneth
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 09/10/2019, Pagination inconnue

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Thème : Médecine.

HOSPITALISATION DOMICILE SOINS PALLIATIFS ; MALADIE CHRONIQUE ; MALADIE RESPIRATOIRE ; EFFICACITE ; EVALUATION

BACKGROUND: While early-integrated palliative home care (PHC) is believed to be beneficial for COPD patients, trials testing this hypothesis are rare and show inconclusive results.
AIM: To test feasibility, acceptability and preliminary effectiveness of early-integrated PHC for end-stage COPD.
METHOD: Testing a six-month early-integrated PHC pilot RCT given by PHC nurses for end-stage COPD with five components: (1) pre-inclusion COPD support training for PHC nurses; (2) monthly PHC visits; (3) leaflets on coping mechanisms; (4) a protocol on symptom management and support, a care and action plan; (5) integration of PHC and usual care through reporting and communication mechanisms. Patient-reported outcomes were assessed six-weekly. Participants and healthcare professionals involved were interviewed.
RESULTS: Of 70 eligible patients, 39 (56%) participated (20:19 intervention-control) and 64% completed the trial. A patient received on average 3.4 PHC visits, mainly for disease insight, symptom management and care planning. Nurses distributed all reports but hardly connected with health professionals except general practitioners (GPs); 8/10 interviewed patients referred to the psychosocial support, breathing exercises and care decisions as helpful. Some GPs criticised PHC being given too early but pulmonologists and PHC nurses did not. Effectiveness analysis showed no overall intervention effect for the outcomes, but between baseline and week 24 fewer hospitalisations in the control group (p=0.03) and a trend of higher perceived quality of care in the intervention group (p=0.06) was found. A clinically relevant difference was observed at week 24 for health-related quality of life in favour of the control group.
CONCLUSION: Our intervention on early-integrated PHC for end-stage COPD is feasible and accepted but did not yield the anticipated preliminary effectiveness. Before moving to a Phase III-trial, enhanced coordination of care, more GP involvement, more intensive training for PHC nurses in COPD support and revision of the trial design, e.g. of targeted outcomes in line with individual patient goals and care preferences should be improved.

Origine : PubMed

How to help researchers in palliative care improve responsiveness to migrants and other underrepresented populations - developing and testing a self-assessment instrument

TORENSMA, M. ; ONWUTEAKA-PHILIPSEN, B. D. ; STRACKEE, K. L. ; OOSTERVELD-VLUG, M. G. ; DE VOOGD, X. ; WILLEMS, D. L. ; SUURMOND, J. L.
BMC palliative care, 21/10/2019, vol.18, n°1, p. 1-11

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Fan therapy for the relief of dyspnea in adults with advanced disease and terminal illness - a meta-analysis of randomized controlled trials

YU, Shui ; SUN, Kai ; XING, Xiufang ; ZHONG, Yinbo ; YAN, Xuemei ; QIU, Weidong ; YAN, Min
JOURNAL OF PALLIATIVE MEDICINE, 01/10/2019, p. 1-7

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Palliation of thirst in intensive care unit patients - translating research into practice

LEEMHUIS, Ann ; SHICHISHIMA, Yuriko ; PUNTILLO, Kathleen
Critical care nurse, 10/2019, vol.39, n°5, p. 21-28

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La qualité de vie des enfants en contexte palliatif, comment la documenter ? Peut-on la mesurer ?

FRIEDEL, Marie ; DEGRYSE, Jean-Marie ; AUJOULAT, Isabelle
MEDECINE PALLIATIVE, 09/2019, vol.18, n°4-5, p. 184-187

Influence of training on first-year nursing department students’ attitudes on death and caring for dying patients - a single-group pretest-posttest experimental study

CERIT, Birgül
OMEGA JOURNAL OF DEATH AND DYING, 2019, vol.78, n°4, p. 335-347

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Cognitive predictors of grief trajectories in the first months of loss - a latent growth mixture model

SMITH, Kirsten V. ; EHLERS, Anke
Journal of consulting and clinical psychology, 26/09/2019, p. 1-14

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Efficacy of nursing support in the pre- and postmedical termination of pregnancy phases - a randomized study

MECDI KAYDIRAK, Meltem ; ASLAN, Ergül
OMEGA JOURNAL OF DEATH AND DYING, 24/09/2019, Pagination inconnue

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Appropriate frameworks for economic evaluation of end of life care - a qualitative investigation with stakeholders

KINGHORN, Philip ; COAST, Joanna
PALLIATIVE MEDICINE, 01/07/2019, vol.33, n°7, p. 823-831

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Potential use of ayahuasca in grief therapy

GONZALEZ, Débora ; CARVALHO, María ; CANTILLO, Jordi ; AIXALA, Marc ; FARRÉ, Magi
OMEGA JOURNAL OF DEATH AND DYING, 01/08/2019, vol.79, n°3, p. 260-285

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Fidelity is fundamental - intervention predictors in advance care plans in terminal cancer

VACCARO, Lisa ; BUTOW, Phyllis N. ; LEE, Deborah ; JOHNSON, Stephanie B. ; BELL, Melanie ; CLAYTON, Josephine ; DETERING, Karen Margaret ; TATTERSALL, Martin
BMJ supportive and palliative care, 19/09/2019, Pagination inconnue

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Assessing the decision-making capacity of terminally ill patients with cancer

KOLVA, Elissa ; ROSENFELD, Barry ; SARACINO, Rebecca
The American journal of geriatric psychiatry, 01/01/2018, vol.26, n°5, p. 523-531

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Assessment of primary palliative care content within prelicensure nursing education - a multisite feasibility study

LIPPE, Megan
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, 01/10/2019, vol.21, n°5, p. 373-381

Effective delivery of palliative radiotherapy - a prospective study

CLÉMENT-ZHAO, A. ; LUU, M. ; BIBAULT, J.-E. ; DAVEAU, C. ; KREPS, S. ; JAULMES, H. ; DESSARD-DIANA, B. ; HOUSSET, M. ; GIRAUD, P. ; DURDUX, C.
Cancer radiotherapie, 09/2019, vol.23, n°5, p. 365-369

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Adaptation and psychometric evaluation of the short version of family sense of coherence scale in a sample of persons with cancer in the palliative stage and their family members

MOLLERBERG, Marie-Louise ; ARESTEDT, Kristofer ; SANDGREN, Anna ; BENZEIN, Eva ; SWAHNBERG, Katarina
Palliative and supportive care, 09/09/2019, p. 1-9

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Palliative chemotherapy in carcinoma nasopharynx

PATIL, Vijay M. ; JOSHI, Amit ; NORONHA, Vanita ; TALREJA, Vikas ; SIMHA, Vijai ; DHUMAL, Sachin ; BANDEKAR, Bhavesh ; CHANDRASEKHARAN, Arun ; PRABHASH, Kumar
South Asian journal of cancer, 09/2019, vol.8, n°3, p. 173-177

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