Dataset Information

Advancing Palliative Care Integration in Hematology: Building Upon Existing Evidence.

ABSTRACT:

Opinion statement

Patients with hematologic malignancies and their families are among the most distressed of all those with cancer. Despite high palliative care-related needs, the integration of palliative care in hematology is underdeveloped. The evidence is clear that the way forward includes standard-of-care PC integration into routine hematologic malignancy care to improve patient and caregiver outcomes. As the PC needs for patients with blood cancer vary significantly by disease, a disease-specific PC integration strategy is needed, allowing for serious illness care interventions to be individualized to the specific needs of each patient and situation.

SUBMITTER: Robbins-Welty GA

PROVIDER: S-EPMC10074347 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Publications

Advancing Palliative Care Integration in Hematology: Building Upon Existing Evidence.

Robbins-Welty Gregg A GA Webb Jason A JA Shalev Dan D El-Jawahri Areej A Jackson Vicki V Mitchell Chandler C LeBlanc Thomas W TW

Current treatment options in oncology 20230405 5

<h4>Opinion statement</h4>Patients with hematologic malignancies and their families are among the most distressed of all those with cancer. Despite high palliative care-related needs, the integration of palliative care in hematology is underdeveloped. The evidence is clear that the way forward includes standard-of-care PC integration into routine hematologic malignancy care to improve patient and caregiver outcomes. As the PC needs for patients with blood cancer vary significantly by disease, a ...[more]

PMID: 37017909

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Project description:BackgroundIntegration of palliative care (PC) in cancer management is critical to improving the overall quality of life of cancer patients and their families. Nevertheless, only a few people in need of PC services actually receive them.ObjectiveThe study explored the barriers to the successful integration of PC in cancer management in Ghana.DesignThe design was an exploratory descriptive qualitative research design.MethodsIn all, we conducted 13 interviews with service providers (7), patients (4) and caregivers (2). An inductive thematic analysis was carried out. Data were managed using QSR NVivo 12.ResultsOur study reveals the different levels of barriers that adversely affect the successful integration of PC and cancer management. Emerging from the findings are patient- and family-level barriers (denial of the primary diagnosis and understanding of PC and financial constraints), service provider-level barriers (healthcare providers' misunderstanding of PC and late referrals), and institutional and policy-level barriers (infrastructural and logistical constraints, non-inclusion of PC in the National Health Insurance Scheme, low staff strength).ConclusionWe conclude that different levels of barriers are encountered in the integration of PC in cancer management. There is a need for policymakers to develop comprehensive guidelines and protocols for the integration of PC into cancer management. These guidelines should address the various levels of factors that serve as barriers to PC integration. The guidelines should also emphasise the importance of early referral for PC and educate service providers on the benefits of PC for patients with life-limiting illnesses. Our findings underscore a need to include PC services and medication in the benefits package of the health insurance scheme to reduce the financial burden on patients and their families. In addition, continuous professional training of all cadre of service providers is needed to facilitate PC integration.

Project description:BackgroundIn order to close the gap between discoveries that could improve health, and widespread impact on routine health care practice, there is a need for greater attention to the factors that influence dissemination and implementation of evidence-based practices. Evidence synthesis projects (e.g., systematic reviews) could contribute to this effort by collecting and synthesizing data relevant to dissemination and implementation. Such an advance would facilitate the spread of high-value, effective, and sustainable interventions.ObjectiveThe objective of this paper is to evaluate the feasibility of extracting factors related to implementation during evidence synthesis in order to enhance the replicability of successes of studies of interventions in health care settings.DesignDrawing on the implementation science literature, we suggest 10 established implementation measures that should be considered when conducting evidence synthesis projects. We describe opportunities to assess these constructs in current literature and illustrate these methods through an example of a systematic review.SubjectsTwenty-nine studies of interventions aimed at improving clinician-patient communication in clinical settings.Key resultsWe identified acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, intervention complexity, penetration, reach, and sustainability as factors that are feasible and appropriate to extract during an evidence synthesis project.ConclusionsTo fully understand the potential value of a health care innovation, it is important to consider not only its effectiveness, but also the process, demands, and resource requirements involved in downstream implementation. While there is variation in the degree to which intervention studies currently report implementation factors, there is a growing demand for this information. Abstracting information about these factors may enhance the value of systematic reviews and other evidence synthesis efforts, improving the dissemination and adoption of interventions that are effective, feasible, and sustainable across different contexts.

Project description:BackgroundResearch evidence suggests that a lack of engagement with palliative care and advance care planning could be attributed to a lack of knowledge, presence of misconceptions and stigma within the general public. However, the importance of how death, dying and bereavement are viewed and experienced has been highlighted as an important aspect in enabling public health approaches to palliative care. Therefore, research which explores the public views on strategies to facilitate engagement with palliative care and advance care planning is required.MethodsExploratory, qualitative design, utilising purposive random sampling from a database of participants involved in a larger mixed methods study. Online semi-structured interviews were conducted (n = 28) and analysed using reflexive thematic analysis. Thematic findings were mapped to the social-ecological model framework to provide a holistic understanding of public behaviours in relation to palliative care and advance care planning engagement.ResultsThree themes were generated from the data: "Visibility and relatability"; "Embedding opportunities for engagement into everyday life"; "Societal and cultural barriers to open discussion". Evidence of interaction across all five social ecological model levels was identified across the themes, suggesting a multi-level public health approach incorporating individual, social, structural and cultural aspects is required for effective public engagement.ConclusionsPublic views around potential strategies for effective engagement in palliative care and advance care planning services were found to be multifaceted. Participants suggested an increase in visibility within the public domain to be a significant area of consideration. Additionally, enhancing opportunities for the public to engage in palliative care and advance care planning within everyday life, such as education within schools, is suggested to improve death literacy and reduce stigma. For effective communication, socio-cultural aspects need to be explored when developing strategies for engagement with all members of society.

Dataset Information

Advancing Palliative Care Integration in Hematology: Building Upon Existing Evidence.

Opinion statement

Publications

Advancing Palliative Care Integration in Hematology: Building Upon Existing Evidence.

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