What Aspects of Quality of Life Are Important From Palliative Care Patients' Perspectives? A Systematic Review of Qualitative Research

McCaffrey, Nikki; Bradley, Sandra; Ratcliffe, Julie; Currow, David C.

doi:10.1016/j.jpainsymman.2016.02.012

Cited by 90 publications

(100 citation statements)

References 63 publications

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“…Because of this limitation, and the plausible notion that chaplaincy consultation is a phenomenon occurring naturally as a psychologic need in the EOL setting, we interpret our finding of an association between chaplaincy consultation and late admission with caution. This is an issue that merits prospective study, especially given that spiritual support is a vital component of EOL care (41), and because our findings are at odds with prior studies as mentioned above. (34) Finally, some patients followed to death at our center were not included by virtue our inclusion criteria.…”

Section: Discussionmentioning

confidence: 57%

Frequency and Predictors of Acute Hospitalization Before Death in Patients With Glioblastoma

Diamond

Panageas

Dallara

et al. 2017

Journal of Pain and Symptom Management

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Context Glioblastoma (GBM) is a devastating and incurable neuro-oncologic disease, and issues related to the end of life (EOL) are almost invariably a matter of “when,” not a matter of “if”. Optimizing symptom management and quality of life in later stages of disease is of the utmost priority. Objectives To examine the frequency of and factors associated with late acute hospital admission before death in patients with GBM. Methods Case-control study comparing patients with GBM admitted to the hospital within one month of death to those without late hospital admission. Results Of 385 GBM patients followed to death at Memorial Sloan Kettering Cancer Center, 164 (42.6%) were admitted within a month of death, most frequently (140, or 85%) to manage neurologic decline. Of these, 56 (34%) had ICU care during this admission and 22 (13%), 18 (11%), and 2 (1%) received mechanical ventilation, enteral feeding tubes, or cardiopulmonary resuscitation, respectively. In multivariable analysis, in-hospital chaplaincy consultation and participation in a therapeutic clinical trial, both at any time in the GBM disease course, were significantly associated with late hospital admission. Conclusions Late hospitalization is frequent in GBM and often involves ICU care in the management of clinical events that are part of the GBM dying process. Patients with a tendency to utilize religious support and those enrolled in clinical trials may be at greater risk for late hospitalization. Dedicated prospective study is needed to determine predictors of late hospitalization and to examine the impact of late acute medical care upon quality of life in GBM.

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Section: Discussionmentioning

confidence: 57%

Frequency and Predictors of Acute Hospitalization Before Death in Patients With Glioblastoma

Diamond

Panageas

Dallara

et al. 2017

Journal of Pain and Symptom Management

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“…Studies have demonstrated the importance of dignity in the dying process and its interrelationship with patient autonomy. 24,29 A desire to promote a patient's or surrogate decision-maker's autonomy in such situations may contribute to a physician's consideration of patient wishes, especially with regard to minimally invasive interventions such as antimicrobial therapy.…”

Section: Discussionmentioning

confidence: 99%

Physician Perceptions Regarding Antimicrobial Use in End-of-Life Care

Gaw

Hamilton

Gerber

et al. 2018

Infect. Control Hosp. Epidemiol.

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BACKGROUND The decision to utilize antimicrobials in end-of-life situations is complex. Understanding the reasons why physicians prescribe antimicrobials in this patient population is important for informing the design of antimicrobial stewardship interventions. METHODS A 51-item survey containing both closed and open-ended questions on end-of-life antimicrobial use was administered to physicians affiliated with the University of Pennsylvania and Children's Hospital of Philadelphia from January through April 2017. A mixed-methods approach was used to analyze responses. RESULTS Of 637 physicians surveyed, 283 responses (44.4%) were received. Most (86.2%) physicians believed that respecting a patient's wish to continue antimicrobials was important. Approximately half of physicians (49.8%) believed that antimicrobial use at the end of life contributes to resistance. A higher proportion of pediatricians would often or always continue antimicrobial treatment for active infections and for hospice patients whose death was imminent compared to adult physicians (P<.001). Analysis of free-text responses revealed additional reasons why physicians may continue antimicrobials at end of life, including meeting family expectations, wanting to avoid the perception of "giving up," uncertainty about prognosis, and reducing patient pain or discomfort. CONCLUSIONS Physician decision making concerning antimicrobial use in patients at the end of life is multifactorial. Clinicians may overweigh the benefits of antimicrobial therapy in end-of-life situations and view the importance of adhering to stewardship policies differently. Pediatric and adult clinicians have different approaches to this patient population. Better understanding of the complex decision making that occurs in the end-of-life patient population can help guide antimicrobial stewardship policies and improve patient care. Infect Control Hosp Epidemiol 2018;39:383-390.

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“…The authors concluded that measures need to be refined to identify issues the patients value, such as the preparation for death and aspects inherent in health care provision, among others, which the instruments available in the literature often do not address 20 . In addition, it is known that the determining factors of cancer patients’ quality of life often are not well understood 21 .…”

Section: Discussionmentioning

confidence: 99%

Quality of life and religious-spiritual coping in palliative cancer care patients

Matos

Meneguin

Ferreira

et al. 2017

Rev. Latino-Am. Enfermagem

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Objectives:to compare the quality of life and religious-spiritual coping of palliative cancer care patients with a group of healthy participants; assess whether the perceived quality of life is associated with the religious-spiritual coping strategies; identify the clinical and sociodemographic variables related to quality of life and religious-spiritual coping. Method:cross-sectional study involving 96 palliative outpatient care patient at a public hospital in the interior of the state of São Paulo and 96 healthy volunteers, using a sociodemographic questionnaire, the McGill Quality of Life Questionnaire and the Brief Religious-Spiritual Coping scale. Results:192 participants were interviewed who presented good quality of life and high use of Religious-Spiritual Coping. Greater use of negative Religious-Spiritual Coping was found in Group A, as well as lesser physical and psychological wellbeing and quality of life. An association was observed between quality of life scores and Religious-Spiritual Coping (p<0.01) in both groups. Male sex, Catholic religion and the Brief Religious-Spiritual Coping score independently influenced the quality of life scores (p<0.01). Conclusion:both groups presented high quality of life and Religious-Spiritual Coping scores. Male participants who were active Catholics with higher Religious-Spiritual Coping scores presented a better perceived quality of life, suggesting that this coping strategy can be stimulated in palliative care patients.

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What Aspects of Quality of Life Are Important From Palliative Care Patients' Perspectives? A Systematic Review of Qualitative Research

Cited by 90 publications

References 63 publications

Frequency and Predictors of Acute Hospitalization Before Death in Patients With Glioblastoma

Frequency and Predictors of Acute Hospitalization Before Death in Patients With Glioblastoma

Physician Perceptions Regarding Antimicrobial Use in End-of-Life Care

Quality of life and religious-spiritual coping in palliative cancer care patients

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