Dataset Information

Outcomes of an Acute Palliative Care Unit at a Comprehensive Cancer Center in Korea.

ABSTRACT:

Background

The acute palliative care unit (APCU) bridges between active cancer treatment and hospice care. However, no study has proven the efficacy of APCU in Korea.

Objective

To evaluate the first-year outcomes of the patients admitted to an APCU at a tertiary hospital in Korea.

Design

The APCU admitted 205 patients between April 14, 2014, and April 30, 2015. Of these patients, 57 were evaluable for baseline and one-week follow-up Edmonton Symptom Assessment System (ESAS).

Results

Of the 57 participants, 56.1% were male, with a median age of 60 years (range, 52.8-69.5 years). All patients had advanced cancer, and 42 out of 57 had terminal illnesses. The median APCU stay was 14 days (range, 10-17 days). The 42 (73.7%) patients were referred to the APCU after anticancer treatment was completed. Ten (17.5%) patients died during their stay, and 20 (35.1%) were discharged home. Among those who completed the ESAS, there were significant improvements in scores in the following symptoms: fatigue, depression, loss of appetite, and shortness of breath. Physical symptoms (pain, fatigue, nausea, drowsiness, appetite, and shortness of breath) and the total ESAS scores were significantly improved (p = 0.002 and p = 0.005, respectively). Each non-medical palliative care program, such as art and music therapy, yoga, foot massage, haircut, and body care, showed no significant differences between the group who received them and those who did not.

Conclusion

During the APCU stay, the overall symptoms of inpatients were reduced. A comprehensive and multidisciplinary team approach is essential for patients who need palliative care.

SUBMITTER: Lee SW

PROVIDER: S-EPMC9892919 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Outcomes of an Acute Palliative Care Unit at a Comprehensive Cancer Center in Korea.

Lee Si Won SW Kwon Jung Hye JH Beom Seung-Hoon SH Shin Sang Joon SJ Kim Hyo Song HS Rha Sun Young SY Jung Minkyu M Sohn Joo Hyuk JH Ahn Joong-Bae JB Chung Hyun Cheol HC Kim Gun Min GM Kim Hye Ryun HR Kang Beodeul B Hu Youn Jung YJ Choi Hye Jin HJ

Palliative medicine reports 20230117 1

<h4>Background</h4>The acute palliative care unit (APCU) bridges between active cancer treatment and hospice care. However, no study has proven the efficacy of APCU in Korea.<h4>Objective</h4>To evaluate the first-year outcomes of the patients admitted to an APCU at a tertiary hospital in Korea.<h4>Design</h4>The APCU admitted 205 patients between April 14, 2014, and April 30, 2015. Of these patients, 57 were evaluable for baseline and one-week follow-up Edmonton Symptom Assessment System (ESAS) ...[more]

PMID: 36743339

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Project description:BackgroundIntegrated patient-centred palliative care for cancer patients is widely advocated internationally, but promoting it often proves difficult. The literature suggests that one key factor is physicians' perspectives of palliative care (PC). Nurses' views, however, from their pivotal stance within the healthcare team between patients and physicians, have been less well researched. This study explores French nurses' perspectives on PC, how their view frames their role, and how they experience PC implementation. Nurses' discourse is then explored as a reflection of their experience.MethodsSemi-structured interviews were audio-recorded of 21 registered nurses, purposively sampled, in a French comprehensive cancer centre. Reflexive thematic analysis was applied by a team including a patients' rights representative (a PC carer and applied linguist), the quality manager, and three PC physicians. Considerations of speech emphasis and style completed the analysis.ResultsAnalysis generated three themes. Nurses perceive PC as a complex and continuous journey, passing through phases to the end of life. It revolves around patients' physical and psychological well-being, timeliness, patient communication and empowerment. This perception frames their caring role as members of the healthcare team, based on necessary knowledge, training, and working conditions allowing them to fulfil their mission. Consequently, they experience PC implementation as either a virtuous or a vicious circle and suggest ways to improve the latter. Analysis of nurses' discourse enhances the meaningfulness of the thematic analysis, reflecting that the more difficult the care context, the more in-depth the description and the more evaluative and emphatic the words chosen.ConclusionsThese French nurses see their holistic view of PC as diverging from that of physicians, keeping them (painfully) from fulfilling their caregiving role. While the nurses are able to "speak PC" with patients, they see it as a foreign concept/language for physicians (and management), resulting in a sometimes vicious circle of care. Physicians' and management's openness to hearing nurses' views would be a first step towards patient and professional well-being. As the nurses suggest, a palliative approach and communication skills can be learned, and institutions can commit to rethinking priorities, policies, and resources. PC can become a shared language.

Project description:BackgroundAccording to current oncological guidelines, early integration of specialist palliative care (SPC) represents standard cancer care supporting not only the patients, but also their family caregivers. Data on the actual implementation in daily oncology practice in Germany are lacking.MethodsThe Palliative Care Working Group of the network of Comprehensive Cancer Centers certified by the German Cancer Aid (CCC) assessed the implementation of measures for family caregiver support and involvement within the CCC/within SPC in the CCC/local outside the CCC in all 17 CCC locations.ResultsIn the CCC/in SPC psycho-oncological (100 %/94 %), social (94 %/100 %) and spiritual counselling of family caregivers (94 % each) as well as support for children with parental cancer (88 %/100 %) and information materials for family caregivers (88 % each) are well established. Training on nursing skills (77 %/94 %) and family conferences (59 %/88 %) are established more frequently within SPC than in the rest of the CCC. SOPs are rather rare (23 %/18 %) as well as screenings for family caregiver needs (0/24 %). Bereavement or self-help groups are with 82 % each more frequent locally outside the CCC. Psycho-oncological and social counselling as well as support for children with parental cancer were scored as most important (94 % each). For SPC, training on nursing skills and information materials were rated equally (94 % each). SOPs were rated as very/extremely important in 47 %/41 % and routine screening for family caregiver in 53 %/65 %.ConclusionIn correspondence to their importance, psychosocial and spiritual counselling and support for children with parental cancer are well implemented in CCC. In SPC, training on nursing skills and family conferences are also well implemented. SOPs for family caregiver support and involvement as well as routine screenings for family caregiver needs have to be implemented urgently in the CCC.

Dataset Information

Outcomes of an Acute Palliative Care Unit at a Comprehensive Cancer Center in Korea.

Background

Objective

Design

Results

Conclusion

Publications

Outcomes of an Acute Palliative Care Unit at a Comprehensive Cancer Center in Korea.

Similar Datasets

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