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2.
Clin J Oncol Nurs ; 25(2): 119-125, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33739351

RESUMO

The COVID-19 pandemic continues to affect the health and well-being of individuals and communities worldwide. Patients with cancer are particularly vulnerable to experiencing serious health-related suffering from COVID-19. This requires oncology nurses in inpatient and clinic settings to ensure the delivery of primary palliative care while considering the far-reaching implications of this public health crisis. With palliative care skills fully integrated into oncology nursing practice, health organizations and cancer centers will be better equipped to meet the holistic needs of patients with cancer and their families receiving care for serious illness, including improved attention to physical, psychosocial, cultural, spiritual, and ethical considerations.


Assuntos
/complicações , Neoplasias/enfermagem , Enfermagem Oncológica , Cuidados Paliativos/organização & administração , Pandemias , /epidemiologia , Humanos , Neoplasias/complicações , /isolamento & purificação
3.
Palliat Support Care ; 19(2): 182-186, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33715662

RESUMO

OBJECTIVE: On October 10, 2020, the Memorial Sloan Kettering Cancer Center Supportive Care Service hosted their first-ever United States (US) World Hospice and Palliative Care Day (WHPCD) Celebration. The purpose of this article is to describe the US inaugural event in alignment with the broader goals of WHPCD and provide lessons learned in anticipation of the second annual conference to be held on October 5-6, 2021. METHODS: Description of the inaugural event in the context of COVID-19 and WHPCD, co-planning conference team reflection, and attendee survey responses. RESULTS: The Worldwide Hospice Palliative Care Alliance initially launched WHPCD in 2005 as an annual unified day of action to celebrate and support hospice and palliative care around the world. The US-based innovative virtual conference featured 23 interprofessional hospice and palliative care specialists and patient and family caregiver speakers across nine diverse sessions addressing priorities at the intersection of COVID-19, social injustice, and the global burden of serious health-related suffering. Two primary aims guided the event: community building and wisdom sharing. Nearly 270 registrants from at least 16 countries and one dozen states across the US joined the free program focused on both personal and professional development. SIGNIFICANCE OF RESULTS: Unlike many other academic conferences and professional gatherings that were relegated to online forums due to pandemic-related restrictions, the US WHPCD Celebration was intentionally established to create a virtual coming together for collective reflection on the barriers and facilitators of palliative care delivery amid vast societal change. The goal to ensure a globally relevant and culturally inclusive agenda will continue to draw increased participation at an international level during future annual events. Finally, the transparent and respectful sharing of palliative care team experiences in the year preceding the conference established a safe environment for both individual expression and scholarly discussion.


Assuntos
Aniversários e Eventos Especiais , Cuidados Paliativos na Terminalidade da Vida/organização & administração , Cuidados Paliativos/organização & administração , /epidemiologia , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/organização & administração , Hospitais para Doentes Terminais/organização & administração , Humanos , Estados Unidos
4.
BMC Cancer ; 21(1): 274, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33722202

RESUMO

BACKGROUND: We aimed to study the mortality and intensity of health care in patients with advanced lung cancer who received systemic anti-cancer treatment (SACT) compared with patients who were not eligible for SACT (no-SACT). METHODS: A retrospective cohort of patients with lung cancer, who were treated at the North Estonia Medical Centre from 2015 to 2017, was linked to population-based health care data from the Estonian Health Insurance Fund. We calculated 14- and 30-day mortality after SACT and used a composite measure of intensity of care, comprised from the following: emergency department visit, admission to hospital, admission to intensive care unit, receipt of radiotherapy or systemic treatment. RESULTS: The median overall survival (OS) of patients who received at least one cycle of SACT (n = 489) was 9.1 months and in patients with no-SACT (n = 289) 1.3 months (hazard ratio [HR] = 4.23, 95% CI = 3.60-5.00). During the final 30 days of life, intensive EOL care was received by 69.9% of the SACT patients and 43.7% of the no-SACT patients. Intensive EOL care in the last 30 days of life is more probable among patients in the SACT group (odds ratio [OR] = 3.58, 95% CI = 2.54-5.04, p <  0.001), especially in those with a stage IV disease (OR = 1.89, 95% CI = 1.31-2.71, p = 0.001). In the SACT group 6.7 and 14.7% of patients died within 14 days and 30 days after the last cycle, respectively. CONCLUSIONS: Significant proportion of patients with advanced lung cancer continue to receive intensive care near death. Our results reflect current patterns of EOL care for patients with lung cancer in Estonia. Availability of palliative care and hospice services must be increased to improve resource use and patient-oriented care.


Assuntos
Unidades de Terapia Intensiva/estatística & dados numéricos , Neoplasias Pulmonares/terapia , Cuidados Paliativos/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Assistência Terminal/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estônia/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Cuidados Paliativos/organização & administração , Melhoria de Qualidade , Estudos Retrospectivos , Assistência Terminal/organização & administração , Fatores de Tempo
5.
Rev Infirm ; 70(269): 42-44, 2021 Mar.
Artigo em Francês | MEDLINE | ID: mdl-33742594

RESUMO

In support of caregivers in the field, the regional pediatric palliative care resource teams travel to health, medico-social and liberal structures, as well as to homes to accompany children and their families affected by serious illness. Nurses play an important role in this sensitive care. Research and teaching enable them to disseminate the palliative culture and advance knowledge.


Assuntos
Papel do Profissional de Enfermagem , Cuidados Paliativos , Cuidadores , Criança , Humanos , Cuidados Paliativos/organização & administração
6.
Int J Palliat Nurs ; 27(1): 37-45, 2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33629909

RESUMO

BACKGROUND: Occupancy is commonly used to measure bed management in hospices. However, the increasing complexity of children and young people and growing dependence on technology mean that this is no longer effective. AIM: To develop a dependency tool that enables the hospice to safely and effectively manage the use of beds for planned short breaks (respite care), preserving capacity for children requiring symptom management and end-of-life care. METHODS: A comprehensive literature review and existing tools were used to inform the development of the Martin House Dependency Tool Framework. Training was provided to staff and the tool was piloted before applying it across the hospice caseload. FINDINGS: The tool has been used on 431 children (93.1% of caseload). The tool enabled consistency of assessment and more effective management of resources, due to a contemporaneous understanding of the clinical needs of those on the caseload. CONCLUSION: The tool has enabled consistent and transparent assessment of children, improving safety, effectiveness and responsiveness, and the management of the workforce and resources.


Assuntos
Cuidados Paliativos na Terminalidade da Vida/organização & administração , Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Modelos de Enfermagem , Cuidados Paliativos/organização & administração , Ocupação de Leitos , Inglaterra , Hospitais para Doentes Terminais , Humanos , Determinação de Necessidades de Cuidados de Saúde , Alocação de Recursos , Cuidados Intermitentes/organização & administração
8.
Soc Work Health Care ; 60(1): 93-105, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33554768

RESUMO

Social workers and nurses, as members of interprofessional palliative medicine teams, faced unfamiliar challenges and opportunities as they endeavored to provide humanistic care to patients and families during the coronavirus (COVID-19) pandemic. Typical methods for engaging patients and families in medical decision-making became thwarted by visitation restrictions and patients' dramatic health declines. This paper presents an innovative social work and nursing intervention aimed at enhancing humanistic patient/family care and advanced directive dialogs. Through incorporating a narrative synthesis of the teams' reflective journals from COVID-19, the paper chronicles the intervention implementation, patient/family responses, and team members' personal and professional meaning-making processes.


Assuntos
/epidemiologia , Recursos Humanos de Enfermagem no Hospital/organização & administração , Cuidados Paliativos/organização & administração , Serviço Social/organização & administração , Centros de Traumatologia/organização & administração , Humanos , Pandemias
9.
Soc Work Health Care ; 60(1): 49-61, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33557718

RESUMO

The COVID-19 pandemic has exposed the systemic inequities in our health care system and society has called for actions to meet the clinical, psychosocial and educational needs in health care settings and communities. In this paper we describe how an organized Department of Health Social Work in a medical school played a unique role in responding to the challenges of a pandemic with community, clinical, and educational initiatives that were integral to our community's health.


Assuntos
/epidemiologia , Liderança , Faculdades de Medicina/organização & administração , Serviço Social/organização & administração , Fadiga por Compaixão/epidemiologia , Abastecimento de Alimentos/métodos , Nível de Saúde , Linhas Diretas/organização & administração , Humanos , Capacitação em Serviço/organização & administração , Saúde Mental , Cuidados Paliativos/organização & administração , Pandemias , Telemedicina/organização & administração , Estados Unidos/epidemiologia
10.
Soc Work Health Care ; 60(1): 62-77, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33588694

RESUMO

The Mount Sinai Hospital in New York City was in the epicenter of the COVID-19 pandemic and had to transform from a tertiary to crisis care hospital and increase its bed capacity by 50 percent to care for COVID-19 patients. The size, scope, complexity and uncertainty of this crisis was unparalleled. This article describes the comprehensive response of the Department of Social Work Services, one of the largest hospital social work departments in the country. The response was informed by four Departmental principles, as well as crisis intervention strategies. This article describes organizational structures, practice models, policies, and protocols developed to respond quickly and effectively, given infection prevention mandates, to patient, population and workforce needs. Finally, it includes how social workers addressed COVID-19 related physical and psychosocial needs and applied and modified interprofessional communication and collaboration. Lessons learned and clinical and administrative changes that will assist in navigating "new normal" operations are discussed.


Assuntos
/epidemiologia , Liderança , Serviço Hospitalar de Assistência Social/organização & administração , Serviço Social/organização & administração , Comunicação , Comportamento Cooperativo , Serviço Hospitalar de Emergência/organização & administração , Humanos , Unidades de Terapia Intensiva/organização & administração , Relações Interprofissionais , Cidade de Nova Iorque/epidemiologia , Saúde do Trabalhador , Cuidados Paliativos/organização & administração , Pandemias , Populações Vulneráveis
11.
JCO Glob Oncol ; 7: 162-172, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33529077

RESUMO

PURPOSE: The COVID-19 pandemic has affected healthcare systems globally, leading to reorganization of medical activities. We performed an international survey aimed to investigate the medium- and long-term impact on oncology units. MATERIALS AND METHODS: An 82-item survey was distributed from June 17 to July 14, 2020 among medical oncologists worldwide. RESULTS: One hundred nine medical oncologists from 18 countries in Europe (n = 93), United States (n = 5), and Latin America (n = 11) answered the survey. A systematic tracing of COVID-19-positive patients was continued in the postacute phase by 77.1% of the centers; 64.2% of the respondents participated in a local registry and 56% in international or national registries of infected patients. Treatment adaptations were introduced, and surgery was the most affected modality being delayed or canceled in more than 10% of patients in 34% of the centers, whereas early cessation of palliative treatment was reported in 32.1% of the centers; 64.2% of respondents reported paying attention to avoid undertreatments. The use of telemedicine has been largely increased. Similarly, virtual tools are increasingly used particularly for medical education and international or national or multidisciplinary meetings. 60.6% of the participants reduced clinical activity, and 28.4% compensated by increasing their research activity. Significant reduction of clinical trial activities is expected in 37% of centers this year. The well-being of healthcare staff would not recover by the end of the year according to 18% of the participants. CONCLUSION: The COVID-19 outbreak has had a major impact on oncologic activity, which will persist in the future, irrespective of geographical areas.


Assuntos
/epidemiologia , Oncologia/tendências , Neoplasias/terapia , Pandemias , Adulto , Ensaios Clínicos como Assunto , Europa (Continente)/epidemiologia , Feminino , Geografia , Humanos , Comunicação Interdisciplinar , Internet , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/organização & administração , Sistema de Registros , Inquéritos e Questionários , Telemedicina , Estados Unidos/epidemiologia
12.
Ann Hematol ; 100(3): 601-606, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33388859

RESUMO

While recent medical advances have led to cure, remission, or long-term disease control for patients with hematologic malignancy, many still portend poor prognoses, and frequently are associated with significant symptom and quality of life burden for patients and families. Patients with hematological cancer are referred to palliative care (PC) services less often than those with solid tumors, despite higher inpatient mortality and shorter interval between first consultation and death. The complexity of individual prognostication, ongoing therapeutic goals of cure, the technical nature and complications of treatment, the intensity of medical care even when approaching end of life, and the speed of change to a terminal event all pose difficulties and hinder referral. A modified palliative care model is an unmet need in hemato-oncology, where PC is introduced early from the diagnosis of hematological malignancy, provided alongside care of curative or life-prolonging intent, and subsequently leads to death and bereavement care or cure and survivorship care depending on disease course. From current evidence, the historical prioritization of cancer care at the center of palliative medicine did not guarantee that those diagnosed with a hematological malignancy were assured of referral, timely or otherwise. Hopefully, this article can be a catalyst for debate that will foster a new direction in integration of clinical service and research, and subspecialty development at the interface of hemato-oncology and palliative care.


Assuntos
Prestação Integrada de Cuidados de Saúde , Neoplasias Hematológicas/terapia , Oncologia , Cuidados Paliativos , Equipe de Assistência ao Paciente/organização & administração , Continuidade da Assistência ao Paciente/organização & administração , Continuidade da Assistência ao Paciente/normas , Prestação Integrada de Cuidados de Saúde/métodos , Prestação Integrada de Cuidados de Saúde/organização & administração , Prestação Integrada de Cuidados de Saúde/normas , Humanos , Comunicação Interdisciplinar , Oncologia/métodos , Oncologia/organização & administração , Oncologia/normas , Cuidados Paliativos/métodos , Cuidados Paliativos/organização & administração , Cuidados Paliativos/normas , Equipe de Assistência ao Paciente/normas , Encaminhamento e Consulta/organização & administração , Encaminhamento e Consulta/normas
13.
Support Care Cancer ; 29(4): 1713-1718, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33484357

RESUMO

This paper chronicles the third decade of MASCC from 2010. There was a generational change in this decade, building on the solid foundation of the founders. It included the first female President, and a new Executive Director with a background in strategy and business development and operations as applied to healthcare. The headquarters moved from Copenhagen to Toronto. The first meeting to be held outside of Europe or North America was held in Adelaide, Australia, and the membership in the Asia Pacific region expanded. A program of international affiliates saw national supportive care organisations formally link with MASCC. In cancer supportive care, there was a raft of new toxicities to manage as immunotherapies were added to conventional cytotoxic treatment. There was also a greater emphasis on the psychosocial needs of patients and families. New MASCC groups were formed to respond to this evolution in cancer management. The MASCC journal, Supportive Care in Cancer, continued to grow in impact, and MASCC published two editions of a textbook of supportive care and survivorship. The decade ended with the challenge of the COVID-19 pandemic, but that served to highlight the importance of good supportive care to patients with cancer.


Assuntos
Neoplasias/terapia , Cuidados Paliativos/história , Cuidados Paliativos/tendências , Sociedades Médicas/história , /epidemiologia , Congressos como Assunto/história , Congressos como Assunto/tendências , Conselho Diretor/história , Conselho Diretor/tendências , História do Século XX , História do Século XXI , Humanos , Agências Internacionais/história , Agências Internacionais/organização & administração , Agências Internacionais/normas , Agências Internacionais/tendências , Cooperação Internacional/história , Neoplasias/história , Cuidados Paliativos/organização & administração , Pandemias , Publicações/história , Publicações/tendências , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Sociedades Médicas/tendências
14.
Pan Afr Med J ; 35(Suppl 2): 130, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33193945

RESUMO

The COVID-19 pandemic has strained health care systems beyond capacity resulting in many people not having access to life-sustaining measures even in well-resourced countries. Palliative and end-of-life care are therefore essential to alleviate suffering and ensure a continuum of care for patients unlikely to survive. This is challenging in sub-Saharan Africa where lack of trained teams on basic palliative care and reduced access to opioids limit implementation of palliative and end-of-life care. At the same time, health care providers have to cope with local cultural conceptions of death and absence of advance care directives.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Cuidados Paliativos/organização & administração , Pandemias , Pneumonia Viral/terapia , Assistência Terminal/organização & administração , Diretivas Antecipadas , África ao Sul do Saara/epidemiologia , Analgésicos Opioides/provisão & distribução , Analgésicos Opioides/uso terapêutico , Atitude Frente a Morte , Barreiras de Comunicação , Continuidade da Assistência ao Paciente , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Cultura , Acesso aos Serviços de Saúde , Humanos , Cuidados Paliativos/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Relações Profissional-Paciente , Insuficiência Respiratória/tratamento farmacológico , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/mortalidade , Estigma Social , Assistência Terminal/psicologia
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