Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · Nov 2018
Comparative Study Observational StudyA pragmatic comparative study of palliative care clinician's reports of the degree of shadowing visible on plain abdominal radiographs.
The assessment of constipation symptoms is based on history and physical examination. However, the experience is highly subjective perhaps explaining why palliative medicine doctors continue to use plain abdominal radiographs as part of routine assessment of constipation. Previous studies have demonstrated poor agreement between clinicians with this work in palliative care, limited further by disparity of clinicians' experience and training. ⋯ As it remains challenging in palliative care to objectively assess and diagnose constipation by history and imaging, uniform and objective assessment and diagnostic criteria are required. It is likely that any agreed criteria will include a combination of imaging and history. The results suggest the use of radiographs alone to diagnose and assess constipation in palliative care represents low value care.
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Support Care Cancer · Nov 2018
Prehabilitation for surgical oncology patients: empowering patient volition.
Prehabilitation is the improvement of patient health in anticipation of a physiological stressor, such as major surgery. Prehabilitation optimizes health by taking a proactive approach to promoting exercise, nutrition, and lifestyle modifications. Engaging patients in the pre-operative phase provides an opportunity to positively impact their recovery and return to functional baseline by reducing post-operative deconditioning. ⋯ The program was initiated in January 2015 and assesses approximately 3-5 patients/week (with a total of over 250 patients so far). This program offers patients individualized pre-operative assessments, including medical optimization, functional, and nutritional assessments, as well as counseling for mood-related issues, smoking/alcohol cessation, and preparing for surgery (such as ensuring adequate home supports/functional equipment prior to surgery). By providing holistic, person-centered, individualized pre-operative optimization strategies, patients and families feel empowered, motivated, and in control of their own health.
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Support Care Cancer · Nov 2018
Clinical TrialUsing patient-reported outcome measures to deliver enhanced supportive care to people with lung cancer: feasibility and acceptability of a nurse-led consultation model.
Developing new supportive/palliative care services for lung cancer should encompass effective ways to promptly identify and address patients' healthcare needs. We examined whether an in-clinic, nurse-led consultation model, which was driven by use of a patient-reported outcomes (PRO) measure, was feasible and acceptable in the identification of unmet needs in patients with lung cancer. ⋯ Nurse-led PRO-measures-driven consultations are acceptable and conditionally feasible to holistically identify and effectively manage patient needs in modern lung cancer care. PRO data should be systematically collected and audited to assist in the provision of supportive care to people with lung cancer.
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Support Care Cancer · Nov 2018
Factors associated with discharge disposition on an acute palliative care unit.
Acute palliative care units (APCUs) admit patients with cancer for symptom control, transition to community palliative care units or hospice (CPCU/H), or end-of-life care. Prognostication early in the course of admission is crucial for decision-making. We retrospectively evaluated factors associated with patients' discharge disposition on an APCU in a cancer center. ⋯ Age, reason for admission, and the FDSA symptom cluster on admission are variables that can inform clinicians about probable discharge disposition on an APCU.
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Support Care Cancer · Nov 2018
Associated factors and costs of avoidable visits to the emergency department among cancer patients: 1-year experience in a tertiary care hospital in South Korea.
Patients receiving palliative care make avoidable emergency department visits (AvED), which may increase economic and social costs. However, the proportion of AvED among all patients, including cancer patients after curation, and the resulting costs are unknown in Asia. This study aimed to investigate the proportion, characteristics, and costs regarding factors associated with AvED among cancer patients. ⋯ Our study showed that 55.7% of all ED visits by cancer patients visiting the ED of a tertiary care hospital were avoidable, and several factors were associated with AvED.