Early Palliative Care and Its Impact on End-of-Life Care for Cancer Patients in Brazil

Rozman, Luciana Martins; Campolina, Alessandro Gonçalves; López, Rossana Verónica Mendonça; Kobayashi, Silvia Takanohashi; Chiba, Toshio; Soárez, Patrícia Coelho de

doi:10.1089/jpm.2017.0418

Cited by 21 publications

(22 citation statements)

References 34 publications

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“…In our study, we found that patients who received palliative care and their FCs have more needs than those who did not receive palliative care. Although, it can be expected that those who received palliative care are more ill (tended to be inpatients and lower KPS) and therefore have more needs, as early palliative care has been proven to improve the QOL of the patients with advanced cancer [52][53][54][55][56], we postulate that this may also imply that patients with advanced cancer were referred by their oncologists to palliative care physicians late in their cancer trajectory. This late referral may have resulted in patients who are more ill and therefore, have more needs and require more care.…”

Section: Discussionmentioning

confidence: 94%

“…The findings that almost 75% of the patients group and almost 63% of the FCs group cared for patients who were not referred to palliative care physicians in spite of their advanced stage in cancer, and patients have also identified under the domain on “Information” as the top second information needs as “I needed information about palliative care services” may add credence to this view. In order to ascertain the real reason why patients and their FCs who received palliative care have more needs, further study would be needed as late referral to palliative care is associated with aggressive end of life treatment [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

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Supporting the patients with advanced cancer and their family caregivers: what are their palliative care needs?

Chua

Pang²,

Yee

et al. 2020

BMC Cancer

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Background: The impact and consequences of cancer on the patients and their family caregivers (FCs) are closely intertwined. Caregivers' burdens can be increased due to the patients' unmet needs and unresolved problems. Additionally, the caregivers' unmet needs may adversely affect their own well-being and the patients' health outcomes. This study aims to determine the palliative care needs and the factors associated with these needs in patients with advanced solid cancer and their FCs. Methods: In a cross-sectional survey, 599 patients with advanced solid tumours and 599 FCs were recruited from the largest ambulatory cancer centre and the inpatient ward of the largest hospital in Singapore. Determinants of patients' and FCs' needs were assessed by the Comprehensive Needs Assessment Tool (CNAT) and CNAT-C respectively. Clinical characteristics of patients were obtained from medical records. Results: The FCs (median age 51 years) were younger than the patients (median age 62 years), and were mostly female (62.6%) whereas the gender distribution of patients was quite balanced (49.2% male and 50.8% female). Both patients and FCs had "information" and "practical support" in their top three domains of palliative care needs. The second highest domain of needs was "psychological problems" (16.4 ± 21.5) in patients and "health-care staff" (23.4 ± 26.5) in FCs. The item that had the highest need score in "information" domain for both patients and FCs was "financial support for patients, either from government and/ or private organizations". Under clinical setting, the inpatients (19.2 ± 16.4) and their FCs (26.0 ± 19.0) tend to have higher needs than the outpatients (10.5 ± 12.1) and their FCs (14.7 ± 14.3). In terms of palliative care, higher total CNAT score was observed in both patients (16.6 ± 12.9 versus 13.3 ± 15.2) and their FCs (25.1 ± 18.6 versus 17.7 ± 16.7) who received palliative care. In terms of patients' KPS scores, patients with lower KPS scores tend to have higher needs. Conclusion: Overall, the findings confirm that patients with advanced cancer and their FCs have many palliative care needs irrespective of their clinical settings. Initiatives and interventions for the development of a comprehensive support system for both patients with advanced cancer and their FCs are warranted and can be derived from these findings.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Supporting the patients with advanced cancer and their family caregivers: what are their palliative care needs?

Chua

Pang²,

Yee

et al. 2020

BMC Cancer

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“…In them, PC consultation was described as late in 60.5% of the patients; a higher rate of late PC consultation has been reported in a cohort of cancer patients in Tennessee, USA (84.5%) [ 16 ]. In Brazil, cancer patients have been referred to palliative care late in the course of the disease [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Different figures have been reported from different studies carried out in various countries. In Brazil [ 17 ], the mean time from entry into PC service to death was 72 days. In the USA [ 18 ], the median times were 42 and 57 days in two different studies.…”

Section: Discussionmentioning

confidence: 99%

The Magnitude and Effects of Early Integration of Palliative Care Into Oncology Service Among Adult Advanced Cancer Patients at a Tertiary Care Hospital

Ghabashi¹,

Sharaf

Kalaktawi³

et al. 2021

Cureus

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“…Only a minority of doctors in our study understood palliative care by the newer de nition. Oncology research in various countries suggests physicians' understanding of palliative care as equivalent to end-of-life care can be a barrier to early use of palliative care for advanced cancer patients [9,29,30]. Because many patients in China already have advanced cancer at the time of diagnosis, there is particular need for palliative care early in treatment to aid quality of life [2].…”

Section: Discussionmentioning

confidence: 99%

Chinese Physicians’ Perceptions of Palliative Care Decision-making for Advanced Cancer Patients: A Qualitative Analysis at a Tertiary Hospital in Changsha, China

Hahne¹,

Wang²,

Liu³

et al. 2021

Preprint

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Background: Little previous research has been conducted outside of major cities in China to examine how physicians currently perceive palliative care, and to identify specific goals for training as palliative care access expands. This study explored physicians’ perceptions of palliative care decision-making for advanced cancer patients in Changsha, China.Methods: We conducted semi-structured qualitative interviews with physicians (n=24) specializing in hematology or oncology at a tertiary hospital. Results: Most physicians viewed palliative care as equivalent to end-of-life care, while a minority considered it possible to integrate palliative care with active treatment. Almost all physicians maintained separate conversations about palliative care with family members and patients, communicating more directly with family members than with patients about palliative care decisions. Physicians described experiencing ethical tension between the desire of family members to protect the patient from knowing they have advanced cancer, and the patient’s “right to decide” about palliative treatment. Physicians varied overall regarding perceptions of the role they should have in palliative care decision-making.Conclusions: As palliative care access expands in China, medical training should encourage earlier integration of palliative care for advanced cancer, address ethical issues faced by physicians communicating about palliative care, and establish guidance on the role of the physician in palliative care decision-making.

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Early Palliative Care and Its Impact on End-of-Life Care for Cancer Patients in Brazil

Abstract: Among cancer patients in Brazil, late referral to palliative care is common. Patients who enter palliative care earlier appear to receive less aggressive end-of-life treatment.

Cited by 21 publications

References 34 publications

Supporting the patients with advanced cancer and their family caregivers: what are their palliative care needs?

Supporting the patients with advanced cancer and their family caregivers: what are their palliative care needs?

The Magnitude and Effects of Early Integration of Palliative Care Into Oncology Service Among Adult Advanced Cancer Patients at a Tertiary Care Hospital

Chinese Physicians’ Perceptions of Palliative Care Decision-making for Advanced Cancer Patients: A Qualitative Analysis at a Tertiary Hospital in Changsha, China

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