Patient Home Visits: Measuring Outcomes of a Community Model for Palliative Care Education

Allo, Julio; Cuello, Deanna; Zhang, Yi; Reddy, Suresh; Azhar, Ahsan; Bruera, Éduardo

doi:10.1089/jpm.2015.0275

Cited by 9 publications

(13 citation statements)

References 27 publications

(26 reference statements)

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“…Hospitals are not fit for managing patients' and their families' psychosocial problems. 29 Hospital-based oncologic treatment is limited to the hospital, and are not considered to be able to give the continued care for physical, psychosocial, emotional, and spiritual symptoms patients and their families are probably going through. 12 Those bariers made optimal PPC services are difficult to be achieved.…”

Section: Discussionmentioning

confidence: 99%

Home-based Palliative Intervention to Improve Quality of Life in Children with Cancer: A Randomized Controlled Trial

Andriastuti

Halim

Tunjungsari

et al. 2019

Preprint

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Background: In these last few years, an integrated approach between palliative care (PC) and chronic and/or life-threatening conditions care have been widely used. Home-based PC service is developed to meet the needs of the patients at home, but hasn’t been applied widely. This study is aimed to determine the benefit of integrated home-based PC in the quality of life (QOL) and symtomps intensity of Indonesian children with malignancies. Method: A randomized controlled trial to compare the quality of life between patients who were given PC (a 3-month home visit) and those who were not (intervention vs control group) was conducted, each group containing 30 children with cancer aged 2-18 years old who were consulted to palliative team. Participants were randomly assigned into each group. In the first and twelfth week of the intervention, all patients were assessed with the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire cancer module 3.0 (report by proxy or self-report). Symptoms intensity (pain, anorexia, sleep disturbance) were scored by using Edmonton Symptoms Assessment Scale (ESAS). Mean score and each dimension score of both group were compared and analyzed using bivariate analysis. Results: A total 50 participants were included in analysis. Significant difference was found between two groups with average total score in control group 62.39 and intervention group 81.63 (p<0.001). In the intervention group QoL tends to improve, whereas in the control group, those did not get palliative intervention, quality of life tends to decrease as the disease progress. The most improved aspect in QoL is pain and nausea (p<0.001), followed by procedural anxiety (p=0.002), treatment anxiety (p=0.002), and worry (p=0.014). Palliative intervention was found to be able to reduce sleep disturbances (p=0.003) and anorexia (p<0.001) significantly. Conclusion: Home-based PC improved several aspects of the QOL and provide better symptoms management of children with malignancies. An early intervention concurrent with the underlying treatment is believed to be able to improve their quality of life. Trial Registration: This study has been retrospectively registered in ClinicalTrials.gov ID: NCT04067687 (August, 22nd 2019).

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Section: Discussionmentioning

confidence: 99%

Home-based Palliative Intervention to Improve Quality of Life in Children with Cancer: A Randomized Controlled Trial

Andriastuti

Halim

Tunjungsari

et al. 2019

Preprint

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“…Johnston et al [21] found that joint training and collaborative work between general physicians, district nurses, and specialist palliative care teams increased the knowledge amongst non-specialist services. Allo et al [22] had a similar result. The majority of participants in this study valued the patient home visit educational program that was very effective in upgrading knowledge and skills of community staff.…”

Section: Discussionmentioning

confidence: 65%

Exploring various models of hospice care worldwide that can be used and adapted to the context of Qatar: A review of the literature

Khan

Johnson

Bulushi

2020

IJH

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Background: Hospice care is an alternative for those patients who wish to die at home. Most clients who have a terminal illness would rather choose the services provided by healthcare workers who deliver hospice care in the client’s home. For some, it is important to have the ability to spend time with friends, family and to die with dignity and respect at their preferable place of death. Qatar has established end of life care services for patients with advanced stages of cancer, however these services are delivered on palliative care units housed within the National Center for Cancer Care and Research (NCCCR). Having the ability to provide at home hospice care is a necessity in order to carry out the wish of clients who wish to die at home, fulfil the gap in these facilities, and achieve the goal of Qatar’s national health strategy, which is to improve cancer services.Aim: To explore the literature for different models of at-home hospice care worldwide then find a model that can be adapted to the context of Qatar.Methods: A literature review approach was used. Nine scholarly articles were found that focused on and evaluated different at-home hospice models of care worldwide published between 2007 and 2018. Articles were critically appraised using the Mixed Method Appraisal Tool. The data were analysed by categorizing the included articles in a spreadsheet based on study design.Results: The most significant components of at-home models of hospice care were multidimensional care, staff competent in delivering end of life care services, and the ability to provide twenty-four-hour care in the home. These components had a positive impact on providing safe effective end of life care services at home.Conclusions: Taken together, all the necessary components identified in this literature review will go a long way in the successful development of hospice care in Qatar.

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“…The community-based model implemented in Steinhauser's study ought to be incorporated into medical school curricula, so future doctors are well equipped for homebased care. 8 The community-based model will ensure medical students will familiarize oneself with prescribing, managing symptoms, and working in an end-of-life care MDT.…”

mentioning

confidence: 99%

“…Allo et al demonstrated that 95% of physicians agree that home visits were an effective teaching tool. 8 The lack of training in home-based palliative care is a major hurdle in the implementation of palliative care in the community. 8 This study states that for many, the preferred place of death is at home.…”

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confidence: 99%

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Improving Student Attitudes Toward Palliative Care

Pahal

Bhagalia

Goonewardena

2020

Am J Hosp Palliat Care

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Patient Home Visits: Measuring Outcomes of a Community Model for Palliative Care Education

Cited by 9 publications

References 27 publications

Home-based Palliative Intervention to Improve Quality of Life in Children with Cancer: A Randomized Controlled Trial

Home-based Palliative Intervention to Improve Quality of Life in Children with Cancer: A Randomized Controlled Trial

Exploring various models of hospice care worldwide that can be used and adapted to the context of Qatar: A review of the literature

Improving Student Attitudes Toward Palliative Care

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