No abstract

Terminally ill cancer patients are considered at high risk for pressure ulcers because of their clinical condition. However, in Italy, data about pressure ulcers and their prevalence are insufficient. This paper reports a study on pressure ulcers incidence and prevalence in a population of oncology patients cared for in an Italian palliative care service. A retrospective analysis of 414 clinical records of patients admitted over 6 months showed a prevalence of pressure ulcers of 22.9% and an incidence of 6.7%. Karnofsky Performance Scale Index scores, age and length of the stay were significantly related to the pressure sore development. These results support the need to focus attention on pressure ulcers prevention and treatment in terminally ill cancer patients, and to further define specific guidelines aimed at warranting patients' comfort and quality of life.

The notable pressure ulcers' incidence and prevalence rates suggest the need to include this issue among the main outcomes to pursue during home palliative care. The accuracy of body mass index, Braden Scale and Karnofsky Performance Scale in predicting the pressure ulcers risk is confirmed. Therefore, they appear as essential tools, in combination with nurses' clinical judgment, for a structured approach to pressure ulcers prevention. Further research is needed to explore the home caregivers' characteristics and attitudes associated with the occurrence of pressure ulcers and the relations between their strategies for pressure ulcer prevention and gender-related patient's needs.

Caring for dying patients requires special attention when teenagers are present in the family. The aim of this study was to understand palliative care professionals' experiences of providing supportive care for teenaged children of patients in palliative care. From April 2014 to November 2015, 7 focus groups were conducted with 62 health professionals working in different Italian hospices. The study design is the descriptive phenomenological approach using the method presented by Giorgi. Eight themes were identified: during adolescence, the reality of the loss is unthinkable; the loss generates negative emotions; the loss can free up resources; a loss takes time to process; the loss is a catalyst for change; the authentic relationship is central to the loss; being present in the loss; and dealing with the loss requires competent help. This study suggests the importance of establishing open and honest communication with the adolescents as soon as possible and involving them in assisting the parent who is dying to enable the adolescents to have more positive reactions to death and to better elaborate the loss. The health professionals can develop competencies that enable them to identify the needs and resources required for specific and personalized interventions.