Search results for " palliative care"
showing 10 items of 53 documents
The acrobatics of dying: A psychodynamic framework for palliative care
2017
This article aims at summing up the reflections of a small group of psychologists who work in the domain of palliative treatment. The theory and methodology supporting it are borrowed by a group analysis approach; the group's purpose is a research based on the workers' experience elaboration, which aims at finding out both the specificities of the work apparatus with the people accompanied to the conclusion of their lives, and the main thematic areas of the relationship between healthcare team, patients, and families. The work we present aims at introducing the most meaningful themes that emerged during group meetings: first of all, some service criticalities examined in the area of termina…
Opioid use and effectiveness of its prescription at discharge in an acute pain relief and palliative care unit
2013
The aim of this study was to present how opioids are used in an acute pain relief and palliative care unit (APRPCU), where many patients with difficult pain conditions are admitted from GPs, home palliative care programs, oncology departments, other hospitals or emergency units, and other regional places. From a consecutive sample of cancer patients admitted to an APRPCU for a period of 6 months, patients who had been administered opioids were included in this survey. Basic information was collected as well as opioid therapy prescribed at admission and, subsequently, during admission and at time of discharge. Patients were discharged once stabilization of pain and symptoms were obtained and…
Frequency, indications, outcomes, and predictive factors of opioid switching in an acute palliative care unit.
2007
The aim of this study was to prospectively evaluate the frequency, indications, outcomes, and predictive factors associated with opioid switching, using a protocol that had been clinically applied and viewed as effective for many years. A prospective study was carried out on a cohort of consecutive cancer patients who were receiving opioids but had an unacceptable balance between analgesia and adverse effects, despite symptomatic treatment of side effects. The initial conversion ratio between opioids and routes was as follows (mg/day): oral morphine 100=intravenous morphine 33=transdermal fentanyl 1=intravenous fentanyl 1=oral methadone 20=intravenous methadone 16=oral oxycodone 70=transder…
Pattern of symptoms and symptomatic treatment in adults and the aged population: a retrospective analysis of advanced cancer patients followed at hom…
2016
Context Data regarding symptom burden and symptomatic drugs in palliative population in different classes of age are lacking. Objective The aim of this retrospective study was to assess the symptom burden, and the profile of symptomatic drugs in the last four weeks of life in adults and older cancer patients followed at home. Methods Charts of 412 patients were retrospectively analyzed by using a backward analysis. Patients were divided into three groups: adults (<65 years, A), old (65-74 years, O1), very old (75-84 years, O2), and the oldest (≥85 years, O3). Results At -4W Karnofsky status was significantly lower for older people (p = 0.03). No significant effect of age on the vector of sy…
Palliative Sedation in Patients With Advanced Cancer Followed at Home: A Prospective Study
2014
Abstract Context Home care programs in Italy. Objectives The aim of this study was to assess a protocol for palliative sedation (PS) performed at home. Methods A total of 219 patients were prospectively assessed to evaluate a PS protocol in patients with advanced cancer followed at home by two home care programs with different territorial facilities. The protocol was based on stepwise administration of midazolam. Results A total of 176 of the patients died at home, and PS was performed in 24 of these patients (13.6%). Younger patients received the procedure more frequently than older patients (P = 0.012). The principal reasons to start PS were agitated delirium (n = 20) and dyspnea (n = 4).…
Time expenditure in patient-related care provided by specialist palliative care nurses in a community hospice service
2004
Although the importance of specialist palliative care in home care programmes for terminally ill patients is well known, German community hospice services did not begin to employ nurses who had specialized in palliative care until the early 1990s. The general tasks of these nurses are sufficiently well defined, but no comprehensive data of their daily workload are available in Germany to date. The present article examines time expenditure in direct patient-related care at the community-based hospice service in Mainz, Germany, by analysing time registration sheets concerning 351 patients who received care from January 2000 until December 2002. Fifty-five per cent of care time spent on each …
Attitudes towards end-of-life issues in intensive care unit among Italian anesthesiologists: a nation-wide survey
2018
Background: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). Methods: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. Results: Eight hundred and five persons responded to the full list of questions. The highest proportion of respondents was of 36â45 years of age (34%) and catholic (66%). Almost 70% of responders declared that palliative/supportive care are applied …
Translation and Testing of the Italian Version of FAMCARE-2: Measuring Family Caregivers' Satisfaction With Palliative Care.
2017
Family satisfaction is an important outcome of palliative care and is a critical measure for health care professionals to address when assessing quality of care. The FAMCARE-2 is a widely used measure of family satisfaction with the health care received by both patient and family in palliative care. In this study, a team of Italian researchers culturally adapted the FAMCARE-2 to the Italian language and psychometrically tested the instrument by measuring satisfaction of 185 family caregivers of patients admitted into two palliative care services. FAMCARE-2 showed excellent levels of internal consistency (Cronbach’s α coefficient = .96) and test–retest reliability ( r = .98, p < .01). Th…
Personalized Goal for Dyspnea and Clinical Response in Advanced Cancer Patients
2018
Abstract Background The clinical response after comprehensive symptom management is difficult to determine in terms of a clinically important difference. Moreover, therapies should try to reach the threshold perceived by the individual patient for the determination of a favorable response to a treatment. Measures The Edmonton Symptom Assessment Score (ESAS) was measured at admission (T0), and seven days after starting palliative care (T7). Patient Global Impression and Goal Response after one week of palliative care and its relation with the Personalized Dyspnea Goal were measured at T7. Intervention Patients admitted to palliative care units underwent a comprehensive symptom assessment by …
Clinical Care Conditions and Needs of Palliative Care Patients from Five Italian Regions: Preliminary Data of the DEMETRA Project
2020
In order to plan the right palliative care for patients and their families, it is essential to have detailed information about patients&rsquo