Palliative Care For Cancer Patients Research Articles

A PRÁTICA INTERDISCIPLINAR DA EQUIPE DE ASSISTÊNCIA AO PACIENTE NO CUIDADO PALIATIVO ONCOLÓGICO

Palliative care is composed of an interdisciplinary care team with an approach with the purpose of improving the quality of life of the patient and their families. This research aims to discuss the interdisciplinary practice of the care team as an important ally in the palliative care of cancer patients based on a literature review. This was a bibliographic research that is justified by the need to mobilize a theoretical foundation, carried out in the databases through the search for electronic information: Latin American and Caribbean Literature in Health Sciences (LILACS), and in the virtual library Scientific Electronic Library Online (SCIELO), which were published between 2014 and 2024. As for the interdisciplinary practice of the cancer care team, it is considered an important ally because it enables a closer bond between professionals and between patients/families. It is concluded that the interdisciplinary practice of the oncology care team provides a greater approximation with patients and families, being evaluated and controlled not only pain, but all symptoms of physical, social, emotional and spiritual nature, with a palliative proposal, thus distancing itself from the assistentialist view.

Behind the scenes of palliative care: Qualitative study with oncology family caregivers.

Long-term caregiving tasks can be exhausting for family caregivers, resulting in high psychological morbidity. The study aims to explore the experiences, challenges, and strengths of family caregivers providing care for cancer patients in palliative care, in-patient or at home. Nine caregivers were included, predominantly women aged 34 to 70, from various regions of Portugal. They participated in four focus groups between May 2021 and May 2022, held online due to COVID-19 restrictions. A qualitative research methodology was employed, using semi-structured interviews conducted through focus groups. Data were analyzed using thematic analysis to identify key themes in caregivers' experiences. The study revealed several challenges, categorized into three main themes, listed in order of frequency: (lack of) communication, pain and suffering, and caregiver burden. Death emerged as a meta-category. Despite these difficulties, caregivers identified sources of strength and support that helped them cope during this time. The findings underscore the profound impact of caregiving on family members and highlight the need for enriched support systems and interventions to reduce caregiver burden and suffering, boosting their resources. Despite its limitations, the study's diverse and rich content illustrate the value of group settings in fostering belonging and comfort among caregivers.

Optimal Machine Learning Models for Developing Prognostic Predictions in Patients With Advanced Cancer.

Accurate prognosis prediction for cancer patients in palliative care is critical for clinical decision-making and personalized care. Traditional statistical models have been complemented by machine learning approaches; however, their comparative effectiveness remains underexplored. To assess the prognostic accuracy of statistical and machine learning models in predicting 30-day survival in patients with advanced cancer using objective data, such as the result of the blood test. A secondary analysis of the Japan-Prognostic Assessment Tools Validation (J-ProVal) study was performed from September 2012 to April 2014.We used data from 58 palliative care services in Japan and enrolled 915 patients. Four models, fractional polynomial (FP) regression, Kernel Fisher discriminant analysis (KFDA), Kernel support vector machine (KSVM), and XGBoost, were compared using 17 objective clinical characteristics. Models were evaluated with the area under the receiver operating characteristic curve (AUC) as the primary metric. The KSVM model demonstrated the highest predictive accuracy (AUC: 0.834), outperforming the FP model (AUC: 0.799). XGBoost showed comparatively lower performance; however, it was likely limited by the size of the dataset. Machine learning, particularly KSVM, has high predictive accuracy in palliative care when sufficient data are available. However, our findings suggest that traditional statistical models offer advantages in stability and interpretability, underscoring the importance of tailored model selection based on data characteristics.

Evaluation of Emotional Distress in Oncology Palliative Patients: Edmonton Symptom Assessment System (ESAS) and Palliative Outcome Scale (POS)-A Portuguese Cross-Sectional Study.

Cancer patients in palliative care frequently experience psychological distress, encompassing cognitive, behavioral, and emotional dimensions. This distress can significantly affect their capacity to accept the inevitability of death. Commonly, such distress manifests as sadness, depression, anxiety, and fear, which may culminate in an existential crisis. The purpose of this study was to analyze the psychometric properties of the Edmonton Symptom Assessment System (ESAS) and the Palliative Outcome Scale (POS) among hospitalized cancer patients receiving palliative care in a Portuguese palliative care unit. Data were collected from psychological screening instruments (ESAS and POS) used in oncology patients admitted to an oncology palliative service. The study period spanned from January 2021 to March 2021. The study included a convenience sample of 60 patients diagnosed with advanced cancer who were sequentially admitted to a palliative care unit. The most frequently reported primary oncological diagnoses were gastrointestinal (41.7%) and head/neck (20%) tumors. The majority of the patients were male (n = 37; 61.7%), with a median age of 72 years (range: 43-94 years). Key findings from the analysis indicated the following associations: anxiety and self-reported symptoms (higher levels of patient anxiety related to illness or treatment were strongly correlated with increased self-reported anxiety (p < 0.01)); emotional sharing and perceived meaning of life (patients who shared their feelings less frequently with family and friends were significantly less likely to find meaning in life (p < 0.01) and were more likely to report a poorer self-perception (p < 0.05)); understanding the importance of life and self-perception (a diminished understanding of the importance of life was associated with worsened self-perception (p < 0.01)); anxiety and depressive symptoms (greater anxiety related to the disease or its treatment correlated with an increased severity of depressive symptoms (p < 0.01)). There are numerous validated instruments available for measuring emotional distress. Among these, the ESAS and POS complement each other as practical and easy-to-use tools for evaluating emotional distress in patients admitted to palliative care settings. Findings revealed that anxiety and concerns related to the disease and its treatment, as measured by the POS, served as predictors of the risk for self-reported anxiety and depression identified by the ESAS. Furthermore, the items within the POS that evaluate the emotional component demonstrated strong internal correlation, supporting their combined use for a comprehensive assessment of this dimension.

PT14 Economic Evaluation of an eHealth Application Fostering Palliative Care for Cancer Patients in Greece

PT14 Economic Evaluation of an eHealth Application Fostering Palliative Care for Cancer Patients in Greece

The Influence of Spiritual Well-being on the Quality of Life of Cancer patients in Palliative care, Chennai.

Cancer has become a big threat to India as it has been estimated to have a mortality rate of 0.3 million deaths per day, also there have been recorded 80.6000 existing cases of Cancer patients by the end of the last century. This study is about the influences of spirituality on the quality of life of cancer patients in palliative care. The study was conducted in RMD palliative care and Jeevodaya hospice. All the institutions work with cancer patients who are in their end stage. The researcher used semi- semi-structured interview schedule consisting of Two scales formulated by the European Organization for Research and Treatment of Cancer. The scales were EORTC QLQ- C30 and EORTC QLQ-SWB32. The collected data is analyzed using SPSS software. Pearson’s correlation is done to find the relation between spiritual well-being and the Quality of Life of patients. It is found that spiritual well-being has a weak influence on the quality of life. In the Indian context, the patients relate spirituality only to their religious faith and hope. They don’t realize how to find meaning in their lives. All the questions answered were about religion, faith, and belief. They live without undergoing much pain, therefore they think their quality of life is good. According to them, pain determines their quality of life. Enhancing their bodily symptoms will not result in a good quality of life. Quality of life is achieved through holistic care. They measure their quality of life in the context of physical well-being and spirituality in the context of religion, due to which the perceived spirituality is different from the actual spirituality.

The relationship between nutritional status and prognosis in advanced gastrointestinal cancer patients in palliative care: a prospective cohort study.

The study aimed to determine the nutritional status and its prognostic effect on the survival of patients with advanced gastrointestinal cancer. A prospective cohort study design was conducted in a tertiary hospital in Shanghai, China. The study consisted of 202 advanced gastrointestinal (GI) cancer patients from a palliative care unit. The following data were collected from the patients: biochemical indicators, i.e., anemia (hemoglobin levels), albumin, pre-albumin, C-reactive protein (CRP), and anthropometric parameters, i.e., body mass index (BMI), nutritional status by Patient-Generated Subjective Global Assessment (PG-SGA), and performance status by Karnofsky Performance Status (KPS). Severe malnutrition was confirmed with the PG-SGA score of ≥ 9. Kaplan-Meier survival analysis and the log-rank test were used to calculate overall survival (OS). The effect of nutritional status on survival was performed by Cox regression analysis. Severe malnutrition was found in 71.3% of patients according to the cutoff of the PG-SGA. PG-SGA score ≥ 9, albumin level < 35g/L, and CRP level ≥ 10mg/L predicted shortened life expectancy. Multivariate Cox regression analysis results showed that the PG-SGA score ≥ 9 and the albumin level < 35g/L were predictive of OS. Our data support that severe malnutrition is a predictor for OS in patients with advanced GI cancer. Information on nutritional status should be considered to individualize palliative care plan for these patients, and hence improve their quality of life.

Re-Signifying Palliative Care for Cancer Patients as a Right to Worthy Health

Re-Signifying Palliative Care for Cancer Patients as a Right to Worthy Health

Bridging the gap and developing a home-based palliative care model for cancer patients

ObjectiveEarly integration of palliative care into home health care services is essential for cancer patients to improve their Quality of Life and reduce their health care costs. Thus, this study aimed to develop a home-based palliative care model for adult cancer patients in Iran. MethodsThis is a health policy and systems research based on the World Health Organization guide. It consists of four phases; an integrative review, a qualitative study through individual semi-structured interviews (n = 37), and one focus group interview (n = 8), integrating these results in the third phase and generating model indicators. In the last phase, the evaluation of the importance of the indicators and the validation of the model were carried out during four classic Delphi rounds. ResultsBarriers to home-based palliative care were extracted from the first phase, and then 22 categories in eight pillars emerged from the qualitative phase. The indicators created for the model from two phases were integrated in the third phase (n = 118). After the four-round of the Delphi, a conceptual model for home-based palliative care in cancer patients, including 92 indicators within eight pillars was created. ConclusionsAlthough this model was designed for our society, it can be utilized as a useful guide in other similar societies to design practical models and innovative programs to provide home-based palliative care in cancer patients. The application of the model in predicting different outcomes should be investigated in future trials.

Age- and gender-based social inequalities in palliative care for cancer patients: a systematic literature review.

Cancer is a major public health problem worldwide, given its magnitude and growing burden, in addition to the repercussions on health and quality of life. Palliative care can play an important role improving quality of life and it is cost-effective, but some population groups may not benefit from it or benefit less based on age and gender inequalities. The aim of this systematic review was to analyze the available evidence on age- and gender-based social inequalities in access to and use of palliative care in cancer patients. A systematic review was conducted following the PRISMA guidelines. An exhaustive literature research was performed in Pubmed, CINHAL and Embase until November 2022 and were not restricted by language or date of publication. Eligible studies were observational studies analyzing the access and use of palliative care in cancer patients. Fifty-three studies were included in the review. Forty-five analyzed age and 44 analyzed gender inequalities in relation to use of and access to palliative care. Our results show that older people receive poorer quality of care, worst symptom control and less preferences for palliative care. In relation to gender, women have a greater preference for the use of palliative care and generally have more access to basic and specialized palliative care services and palliative care facilities. This review reveals difficulties for older persons and men for access to key elements of palliative care and highlights the need to tackle access barriers for the most vulnerable population groups. Innovative collaborative services based around patient, family and wider community are needed to ensure optimal care.

Emotional support and Palliative care for cancer patients

Emotional support and Palliative care for cancer patients

1888P PalliScore: Validation of a rapid scoring system for enhancing decision-making in the Emergency Department for cancer patients in palliative care

1888P PalliScore: Validation of a rapid scoring system for enhancing decision-making in the Emergency Department for cancer patients in palliative care

Assessment of Caregiver’s knowledge, Attitude, and Practice Regarding Palliative Care for Cancer Patients undergoing Chemotherapy in Port Said City

Assessment of Caregiver’s knowledge, Attitude, and Practice Regarding Palliative Care for Cancer Patients undergoing Chemotherapy in Port Said City

Economic burden on families: Analyzing the financial impact of palliative care for cancer patients.

Economic burden on families: Analyzing the financial impact of palliative care for cancer patients.

Palliative Social Work Services for Cancer Patients in Southeast Nigeria: An Exploration

Palliative social work services are essential for addressing the complex psychosocial needs of cancer patients, particularly in resource-constrained areas like Southeast Nigeria. Despite the recognition of social work in palliative care for cancer patients, effective delivery faces significant challenges impacting both social service delivery and patient outcomes. This study investigates the provision of palliative social work services for cancer patients using in-depth interviews with 18 participants (six social workers and twelve cancer patients) from two hospitals in Southeast Nigeria. Participants were purposefully sampled based on their roles in providing or receiving palliative care support. Thematic analysis of the data revealed that social work palliative services encompass psychosocial support, spiritual guidance, and educational resources. However, social workers encounter barriers such as emotional stress, burnout, communication gaps, financial constraints, and socio-cultural factors. The study suggests that regular debriefing sessions and educational programs could improve palliative care delivery. Policy advocacy is recommended to recognize and support the pivotal role of palliative social workers in cancer care. Future research should explore innovative strategies using quantitative methods to overcome barriers and enhance palliative social work effectiveness across diverse cultural and healthcare contexts, ultimately improving social service delivery to cancer patients and advancing social service research.

ONCOLOGY PATIENT'S ATTITUDE TOWARDS THE PERCEPTION OF AN EXISTENTIAL BEING, THAT IS: A finite being

The conception of birth, considered a spontaneous act, which results after a long heating process that refers to gestation, as well as the human life cycle, is, on an existential level, a heating process, but for another spontaneous act, death. In this study, we sought to understand the perceptions about finiteness that cancer patients in palliative care have. Being a qualitative, phenomenological study, semi-structured interviews were used, and Bardin's content analysis approach was used. Six patients admitted to an oncology clinic in a hospital in the west of Santa Catarina were interviewed. The results of this study demonstrate that cancer patients present the perception of presenting their own death, since the impact of the diagnosis causes adverse reactions, making it possible to question their own existence, as well as the restrictions that the disease imposes and the coping resources used, recognizing the responsibility of your choices will reflect the death process, since being aware of death makes you think about life. It is considered the need to promote spaces for listening and welcoming the anxieties of cancer patients in the hospital environment, with psychological care being essential to carry out interventions and improve comprehensive care for patients, helping to find or create meaning in existence, taking into account consideration of the cultural, spiritual and social context. Likewise, pay attention to total pain care, so that everyone who goes through a terminal illness has the relief and lightness of living until the act of death.

Analysis of the Complexity of Palliative Care for Cancer Patients.

The Spanish National Health System has defined complexity as a set of factors of increased difficulty that require the intervention of a palliative care team. Palliative care aims to improve the quality of life of patients with chronic terminal illnesses. This study aims to describe the degree of complexity of cancer patients in palliative care, to determine which elements of complexity are most prevalent and to determine which other hospital clinical factors are associated with the level of complexity. This study is a descriptive, observational, and cross-sectional analysis that included patients diagnosed with advanced oncological pathology undergoing palliative treatment who were admitted to the Medical Oncology ward of the Miguel Servet University Hospital between March and April 2023. A total of 100 patients were selected for the study. According to the IDC-Pal, 68% of patients were classified as highly complex, 26% of patients were complex and only 6% of patients were classified as non-complex. The presence of pain (P < .001), nausea and vomiting (P = .027), depression (P = .033) and functional status (P = .011) were statistically independent predictors of high complexity. This study has shown that a high proportion of hospitalized palliative care cancer patients have high complexity, suggesting a good matching of healthcare resources to patient complexity. Four factors related to complexity have been identified, namely pain, nausea and vomiting, depression and a bedridden functional state. The presence of any of the 4 factors could help healthcare professionals to identify patients for early specialized palliative care.

Cancer patients have a reduced likelihood of dying in hospital with advance care planning in primary health care and a summarizing palliative plan: a prospective controlled non-randomized intervention trial

Background Advance care planning (ACP) allows patients to define their goals and preferences. Spending more time at home and less time in the hospital, along with avoiding death in the hospital, are often considered desirable outcomes of palliative care (PC). In 2015, 36% of cancer patients died in the hospital and 13% died at home in Norway. Method From 2015 to 2022, this prospective controlled non-randomized intervention trial observed 144 cancer patients with or without an organized ACP conversation in primary health care and a summarizing palliative plan (ClinicalTrials.gov Identifier: NCT02170168, 23 June 2014). The patients were identified through contact with the local cancer outpatient clinic or hospital-based PC team. Results A total of 128 patients died during the observation period. Of these, 67 patients had an organized ACP conversation and summarizing palliative plan (intervention (I) group) and 61 had not (control (C) group). Dying in the hospital was significantly less common for patients in the I group compared to the C group (17.9% vs. 34.4%; X 2 (1, n = 128) = 4.55, p = 0.033). There were no differences between the groups in terms of where they spent their time in the last 90 days of life (home, nursing home, or hospital). Most patients (62%) preferred to die at home. The observed differences between the groups regarding preferred and actual places of death did not reach statistical significance. Conclusion With organized ACP conversations in primary health care and a summarizing palliative plan, cancer patients died less often in the hospital in our observational study. A structured ACP approach integrating palliative care for cancer patients into primary health care can support patients´ preferences at the end of life.

Integrating Mixed Method Research in Palliative Care of Cancer Patients: Enhancing Holistic Understanding and Patient-Centered Care

Integrating Mixed Method Research in Palliative Care of Cancer Patients: Enhancing Holistic Understanding and Patient-Centered Care

Conference report: Fourth annual young researcher forum of the Japan Society of Medical and Pharmaceutical Sciences for Traditional Medicine

AbstractFour young researchers presented their studies in the field of traditional Japanese herbal medicine (Wakan‐yaku) at the Fourth Annual Young Researcher Forum held the day before the 2023 annual meeting of the Japan Society of Medical and Pharmaceutical Sciences for Traditional Medicine. Mr Sakoda outlined his research plan, emphasizing the potential of yokukansan to enhance palliative care for cancer patients. Meanwhile, Ms Tanide and Mr Nishihara explored the correlation among component contents in Coptis japonica on Sado Island. Additionally, Mr Okayama presented his study, focusing on the use of Sinomenium acutum‐derived compounds to inhibit the Wnt/β‐catenin pathway and eradicate cancer stem cells. Finally, Mr Muraoka shared insights from his research on the inhibitory properties of Cassia obtusifolia sprout components. The event, conducted both in person and online, attracted a total of 58 participants. Looking ahead, we aim to further develop and continue hosting this forum in 2024 and beyond, fostering the advancement of research in this field.