Early Intervention With Transplantation Recipients to Improve Access to and Knowledge of Palliative Care

Harden, Karen

doi:10.1188/16.cjon.e88-e92

Cited by 34 publications

(17 citation statements)

References 5 publications

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“…3,6 Early palliative care, including ACP, involves complex interventions 7 in which professionals discuss symptom management, support end-of-life decision-making and coordinate care. Intervention trials 6,[8][9][10][11][12][13][14][15][16][17][18][19] confirm that patients with advanced cancer who receive early palliative care experience improved quality of life, 6,[19][20][21] symptoms, 6,19 and mood, 6 are more likely to document end-of-life care decisions, 19 and be knowledgeable about palliative and hospice care. 20 To provide person-centered care 22 and to involve patients in medical and future care decisions, health professionals need to understand the patient and family perspectives about their values and the impact on their care.…”

Section: Introductionmentioning

confidence: 95%

An early palliative care intervention can be confronting but reassuring: A qualitative study on the experiences of patients with advanced cancer

et al. 2019

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Background: Intervention trials confirm that patients with advanced cancer receiving early palliative care experience a better quality of life and show improved knowledge about and use of palliative care services. To involve patients in future health-care decisions, health professionals should understand patients’ perspectives. However, little is known about how patients’ experience such interventions. Aim: To explore advanced cancer patients’ experiences with a structured early palliative care intervention, its acceptability and impact on the patients’ life including influencing factors. Design: Qualitative content analysis of in-depth, semi-structured interviews. Setting/participants: Patients with various advanced cancer diagnoses were enrolled in a multicenter randomized controlled trial (NCT01983956), which investigated the impact of “Symptoms, End-of-life decisions, Network, Support,” a structured early palliative care intervention, on distress. Of these, 20 patients who underwent the intervention participated in this study. Results: Participants received the intervention well and gained a better understanding of their personal situation. Patients reported that the intervention can feel “confronting” but with the right timing it can be confirming and facilitate family conversations. Patients’ personal background and the intervention timing within their personal disease trajectory influenced their emotional and cognitive experiences; it also impacted their understanding of palliative care and triggered actions toward future care planning. Conclusion: Early palliative care interventions like “Symptoms, End-of-life decisions, Network, Support” may provoke emotions and feel “confrontational” often because this is the first time when issues about one’s end of life are openly discussed; yet, advanced cancer patients found it beneficial and felt it should be incorporated into routine care.

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Section: Introductionmentioning

confidence: 95%

An early palliative care intervention can be confronting but reassuring: A qualitative study on the experiences of patients with advanced cancer

et al. 2019

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“…Furthermore, implementing a model of early referral to PC has also proven successful in improving the understanding of patients about PC. Evidence of this is a study that showed how 92% of patients informed and exposed to early referrals to PC felt better informed about the specialty and more eager to use their services in the future [27].…”

Section: Discussionmentioning

confidence: 97%

Revisiting Early Palliative Care for Patients With Hematologic Malignancies and Bone Marrow Transplant: Why the Delay?

Sánchez¹,

Armesto²,

Chavez³

et al. 2020

Cureus

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Palliative care has been defined as specialized care for patients facing serious illnesses. Despite advancements in the field and studies documenting the effectiveness of early palliative care (PC) interventions in seriously ill patients, the fields of hematologic malignancies and bone marrow transplant still lag behind of a comprehensive framework for early and effective interventions. The aim of this literature review is to analyze and discuss the possible barriers to care and delayed referrals for hematologic malignancies and bone marrow transplant patients. Using the EBSCO and PubMed databases, articles regarding PC among patients with hematologic malignancies and bone marrow transplant were analyzed. There are three main domains with its respective barriers in PC: physicians, patients and caregivers, and the healthcare system. Issues that were identified included the lack of knowledge and misconceptions about PC among physicians, patients, and caregivers, delayed referral of patients with hematologic malignancies, unrealistic treatment expectations, lack of communication between specialties, difficulties with appointment availability, geographical distance between clinics, and lack of insurance coverage for PC services. We suggest possible alternatives including obligatory continuing medical education (CME) credits, loan forgiveness, rotations during residency and fellowship training, use of informational videos and pamphlets to educate patients and caregivers, obligatory early consults despite prognosis, an algorithm to evaluate patient's needs, creating a platform within electronic medical records (EMR) systems shared by specialties, and having PC service in every cancer center. Findings suggest a need for further studies aimed towards implementing solutions to increase the early referral of patients with hematologic malignancies and bone marrow transplantation (BMT) to palliative care.

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“…Récemment, des auteurs ont proposé d'offrir des services de soins palliatifs aux receveurs d'une GCSH parallèlement aux soins curatifs (El-Jawahri et al, 2016;Harden et Schembri, 2016;Loggers et al, 2016;Roeland et Ku, 2015;Selvaggi et al, 2014). De son côté, l'ASCO a établi des lignes directrices recommandant le recours aux soins palliatifs dans les huit semaines suivant le diagnostic lorsque les symptômes physiques ou psychosociaux sont difficiles à contrôler ou que le cancer est avancé (métastases à distance, stade avancé, pronostic de 6 à 24 mois ou cancer limitant l'espérance de vie ;Ferrell et al, 2017;Smith et al, 2012).…”

Section: Contexteunclassified

Optimiser les soins palliatifs précoces aux patients atteints d’un cancer hématologique recevant une greffe de cellules souches : rôle de l’infirmière praticienne

Lewis¹

2020

CONJ

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La greffe de cellules souches hématopoïétiques (GCSH) est une approche thérapeutique intensive des hémopathies malignes qui s’accompagne d’un important risque de morbidité et de mortalité. Malgré la lueur d’espoir qu’elle apporte aux patients, les traitements sont longs et pénibles, tant du point de vue physique que psychosocial. Habituellement, la greffe de cellules souches hématopoïétiques a une visée curative qui laisse peu de place à un partenariat éventuel avec les services de soins palliatifs et, lorsque ces derniers sont proposés, il est souvent trop tard pour en tirer un bénéfice notable. Il faudrait donc systématiser le recours aux soins palliatifs pour les patients atteints d’hémopathie maligne qui reçoivent une GCSH; cependant, il demeure difficile de trouver la meilleure voie pour établir un tel partenariat. Les infirmières praticiennes, qui sont de plus en plus nombreuses, possèdent les connaissances et les compétences requises pour combler les lacunes dans la prestation de soins palliatifs aux patients recevant une GCSH. L’algorithme de soins palliatifs précoces dispensés par les infirmières praticiennes aux patients recevant une GCSH (dit NEST en anglais, pour « Nurse-Practitioner-Delivered Early Palliative Care for Stem Cell Transplant ») vise justement à faire le pont entre les services palliatifs et les équipes d’hématologie et de greffe afin d’offrir aux patients les meilleurs soins possible.

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Early Intervention With Transplantation Recipients to Improve Access to and Knowledge of Palliative Care

Abstract: Patient comments were positive about the successful intervention of early palliative care. The palliative care team, however, revealed a different view of the situation, showing that patients were often overwhelmed, anxious, and sometimes did not remember the content of their meetings.

Cited by 34 publications

References 5 publications

An early palliative care intervention can be confronting but reassuring: A qualitative study on the experiences of patients with advanced cancer

An early palliative care intervention can be confronting but reassuring: A qualitative study on the experiences of patients with advanced cancer

Revisiting Early Palliative Care for Patients With Hematologic Malignancies and Bone Marrow Transplant: Why the Delay?

Optimiser les soins palliatifs précoces aux patients atteints d’un cancer hématologique recevant une greffe de cellules souches : rôle de l’infirmière praticienne

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