Integration of oncology and palliative care

Kaasa, Stein; Loge, Jon Håvard; Albreht, Tit; Bruera, Éduardo; Caraceni, Augusto; Higginson, Irene J; Jordan, Kim; Sjögren, Per; Stone, Patrick; Zimmermann, Christa; Lundeby, Tonje

doi:10.1093/annonc/mdy295.018

Cited by 25 publications

(39 citation statements)

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“…Our study show the significance of advance care planning, which involves patients and family caregivers in the process. The goal of advance care planning is to ensure that medical care is consistent with patients' and family caregivers' values, goals and preferences (Kaasa et al, 2018). Nurses experienced that advance care planning gave patients and family caregivers a sense of security and prepared them for future challenges.…”

Section: Discussionmentioning

confidence: 99%

“…Griggs (2010) describes symptom control as a key element in supporting patients' process of dying. International recommendations (Kaasa et al, 2018) have also highlighted the importance of physical comfort-relief of bothersome symptoms. Nurses experienced that they play a crucial role in collaboration with physicians to ensure that a patient receives effective pain relief.…”

Section: Discussionmentioning

confidence: 99%

“…This framework outlines four values, which optimize compassionate nursing in the palliative pathway: (1) relationships that express care, (2) the process of establishing good relationships, (3) the use of contextualized knowledge and 4 is necessary to enable nurses to fulfil these aims (Kaasa et al, 2018).…”

Section: What Does This Paper Contribute To the Wider Global Clinicalmentioning

confidence: 99%

“…The integration of palliative care with oncology is recommended; however, this has been insufficiently addressed in healthcare systems (Kaasa et al, 2018). Six main elements of patient-centred care are highlighted: (1) respect for patients' values, preferences, and expressed needs; (2) coordination and integration of care; (3) information, communication, and education; (4) physical comfort-relief of bothersome symptoms; (5) emotional support-relief of fear and anxiety; and (6) involvement of family and friends (Kaasa et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Nurses’ experiences of compassionate care in the palliative pathway

Tarberg

Landstad

Hole

et al. 2020

Journal of Clinical Nursing

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Aims and objectives: The aim was to explore how nurses experience compassionate care for patients with cancer and family caregivers in different phases of the palliative pathway. Background: Compassion is fundamental to palliative care and viewed as a cornerstone of high-quality care provision. Healthcare authorities emphasize that patients should have the opportunity to stay at home for as long as possible. There are, however, care deficiencies in the palliative pathway. Design: This study employed a qualitative design using focus groups and a hermeneutic approach. Methods: Four focus groups with three to seven female nurses in each group were conducted in Mid-Norway in 2018. Nurses' ages ranged from 28-60 years (mean age = 45 years), and they were recruited through purposive sampling (N = 21). Compassionate care was chosen as the theoretical framework. Reporting followed the COREQ guidelines. Results: Three themes expressing compassionate care related to different phases of the pathway were identified: (a) information and dialogue, (b) creating a space for dying and (c) family caregivers' acceptance of death. Conclusions: This study showed that it was crucial to create a space for dying, characterized by trust, collaboration, good relationships, empathy, attention, silence, caution, slowness, symptom relief and the absence of noise and conflict. Relevance to clinical practice: The quality of compassion possessed by individual practitioners, as well as the overall design of the healthcare system, must be considered when creating compassionate care for patients and their family caregivers. Nursing educators and health authorities should pay attention to the development of compassion in education and practice. Further research should highlight patients' and family caregivers' experiences of compassionate care and determine how healthcare systems can support compassionate care. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: What Does This Paper Contribute To the Wider Global Clinicalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nurses’ experiences of compassionate care in the palliative pathway

Tarberg

Landstad

Hole

et al. 2020

Journal of Clinical Nursing

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“…Palliative care and supportive care are often differently organised across locations, on the basis of resources and traditions. In some centres, the two are organised as one service, whereas in others they are completely separate [ 33 ]. The ESC programme required rebranding, a closer collaboration with oncology and referral within 6 weeks of diagnosis of incurable cancer.…”

Section: Enhanced Supportive Care Programme – Nhs Englandmentioning

confidence: 99%

Supportive Care: An Indispensable Component of Modern Oncology

et al. 2020

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The advent of new cancer therapies, alongside expected growth and ageing of the population, better survival rates and associated costs of care, is uncovering a need to more clearly define and integrate supportive care services across the whole spectrum of the disease. The current focus of cancer care is on initial diagnosis and treatment, and end of life care. The Multinational Association of Supportive Care in Cancer defines supportive care as ‘the prevention and management of the adverse effects of cancer and its treatment’. This encompasses the entire cancer journey, and necessitates involvement and integration of most clinical specialties. Optimal supportive care can assist in accurate diagnosis and management, and ultimately improve outcomes. A national strategy to implement supportive care is needed to acknowledge evolving oncology practice, changing disease patterns and the changing patient demographic.

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The effect of a palliative care pathway on medical interventions at the end of life: a pre-post-implementation study

Padt-Pruijsten

Leys

Hoop

et al. 2022

Support Care Cancer

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Purpose Adequate integration of palliative care in oncological care can improve the quality of life in patients with advanced cancer. Whether such integration affects the use of diagnostic procedures and medical interventions has not been studied extensively. We investigated the effect of the implementation of a standardized palliative care pathway in a hospital on the use of diagnostic procedures, anticancer treatment, and other medical interventions in patients with incurable cancer at the end of their life. Methods In a pre- and post-intervention study, data were collected concerning adult patients with cancer who died between February 2014 and February 2015 (pre-PCP period) or between November 2015 and November 2016 (post-PCP period). We collected information on diagnostic procedures, anticancer treatments, and other medical interventions during the last 3 months of life. Results We included 424 patients in the pre-PCP period and 426 in the post-PCP period. No differences in percentage of laboratory tests (85% vs 85%, p = 0.795) and radiological procedures (85% vs 82%, p = 0.246) were found between both groups. The percentage of patients who received anticancer treatment or other medical interventions was lower in the post-PCP period (40% vs 22%, p < 0.001; and 42% vs 29%, p < 0.001, respectively). Conclusions Implementation of a PCP resulted in fewer medical interventions, including anticancer treatments, in the last 3 months of life. Implementation of the PCP may have created awareness among physicians of patients’ impending death, thereby supporting caregivers and patients to make appropriate decisions about medical treatment at the end of life. Trial registration number Netherlands Trial Register; clinical trial number: NL 4400 (NTR4597); date registrated: 2014–04-27.

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Integration of oncology and palliative care

Cited by 25 publications

References 0 publications

Nurses’ experiences of compassionate care in the palliative pathway

Nurses’ experiences of compassionate care in the palliative pathway

Supportive Care: An Indispensable Component of Modern Oncology

The effect of a palliative care pathway on medical interventions at the end of life: a pre-post-implementation study

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