A Comparison of Cancer and Noncancer Patients Who Receive Palliative Care Consultation Services

Hung, Yu‐Shin; Chang, Hong-Yeh; Wu, Wei-Shan; Chen, Jen‐Shi; Chou, Wen‐Chi

doi:10.1177/1049909112461842

Cited by 12 publications

(9 citation statements)

References 43 publications

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“…Emotional disturbance, disease awareness, and accommodation disturbance were reported as the most common manifestations of psychosocial distress among terminal patients with cancer in similar palliative care settings in Taiwan. 14,25 Our study reported a similar pattern and prevalence of psychosocial distress among both patients with hematologic malignancy and patients with solid cancer. In this study, the prevalence of psychosocial distress was not significantly different between the 2 groups, except for a higher prevalence of emotional disturbance among patients with hematologic malignancy than those with solid cancer.…”

Section: Discussionsupporting

confidence: 70%

Characteristics of Patients With Hematologic Malignancies Who Received Palliative Care Consultation Services in a Medical Center

Hung

Chang

et al. 2013

Am J Hosp Palliat Care

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This study aimed to compare the characteristics of patients with hematologic malignancies and solid cancers who received palliative care. A total of 124 patients with hematologic malignancy and 3032 patients with solid cancer, who received palliative care consultation services between 2006 and 2010 in a medical center in Taiwan, were retrospectively analyzed. Higher prevalence of oral stomatitis, diarrhea, and hematologic symptoms including infection, fever, severe anemia, and bleeding, and lower prevalence of constipation, abdominal distension, and pain were observed in patients with hematologic malignancies compared to that in patients with solid cancer. The interval from hospital admission to palliative care referral was longer for patients with hematologic malignancy than that for patients with solid cancer. Hematologists should refer patients earlier, and palliative care specialists should understand the specific needs of patients with hematologic malignancy.

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Section: Discussionsupporting

confidence: 70%

Characteristics of Patients With Hematologic Malignancies Who Received Palliative Care Consultation Services in a Medical Center

Hung

Chang

et al. 2013

Am J Hosp Palliat Care

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“…It leads to strengthened relationships and improved emotional stability especially concerning confrontation with death [4]. Additionally, IPCC has shown to enhance patients' awareness of the disease including its prognosis [26].…”

Section: Introductionmentioning

confidence: 99%

Impact, challenges and limits of inpatient palliative care consultations – perspectives of requesting and conducting physicians

Coym

Kanitz

Puls

et al. 2020

BMC Health Serv Res

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Background: Inpatient palliative care consultation (IPCC) teams have been established to improve care for patients with specialist palliative care (PC) needs throughout all hospital departments. The objective is to explore physicians' perceptions on the impact of IPCC, its triggers, challenges and limits, and their suggestions for future service improvements. Methods: A Qualitative study drawing on semi-structured interviews with 10 PC specialists of an IPCC team and nine IPCC requesting physicians from oncology and non-oncological departments of a university hospital. Analysis was performed using qualitative content analysis. Results: PC specialists and IPCC requesting physicians likewise considered organization of further care and symptom-burden as main reasons for IPCC requests. The main impact however was identified from both as improvement of patients' (and their caregivers') coping strategies and relief of the treating team. Mostly, PC specialists emphasized a reduction of symptom burden, and improvement of further care. Challenges in implementing IPCC were lack of time for both. PC specialists addressed requesting physicians' skepticism towards PC. Barriers for realization of IPCC included structural aspects for both: limited time, staff capacities and setting. PC specialists saw problems in implementing recommendations like disagreement towards their suggestions. All interviewees considered education in PC a sensible approach for improvement. Conclusions: IPCC show various positive effects in supporting physicians and patients, but are also limited due to structural problems, lack of knowledge, insecurity, and skepticism by the requesting physicians. To overcome some of these challenges implementation of PC education programs for all physicians would be beneficial.

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“…23 A significant increase in DNR designation after PCCS care has been reported in patients with cancers or non-cancer diseases. 5 Our previous study demonstrated that the effect of PCCS on DNR designation mainly resulted from increased patients’/families’ disease awareness and a longer duration of PCCS care. 24 To achieve a better assessment of DNR designation probabilities, medical personnel should refer patients to the PCCS earlier and for longer durations, and promote patients’/families’ awareness of cancer prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…3 Limited hospice resource was one of the major reasons for slow growth in hospice utilization. 3–5 In addition, patients’ lack of awareness of their diseases and prognoses, 6,7 philosophies of end-of-life and misinterpretations about the functions of hospice units (places for dying) also delayed growth of hospice use.…”

Section: Introductionmentioning

confidence: 99%

Impact of Palliative Care Consultation Service on Terminally Ill Cancer Patients

Shen

Kao

et al. 2016

Medicine

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The palliative care consultation service (PCCS) that has been enthusiastically promoted in Taiwan since 2005 was designed to provide comprehensive end-of-life care for terminally ill patients with qualified interdisciplinary specialists in acute care ward setting. This study aims to evaluate the impact of PCCS on terminally ill cancer patients.A total of 10,594 terminal cancer patients who were referred to PCCS from a single medical center in Taiwan between 2006 and 2014 were enrolled. The percentages of patients’ and their families’ disease awareness, do-not-resuscitate (DNR) designation, refusal and acceptance of palliative care among terminally ill cancer patients were analyzed retrospectively.At the beginning of PCCS, the percentages of disease awareness among patients and their family were increased from 25.4% to 37.9% (P = 0.007) and from 61.2% to 84.7% between 2006 and 2014 (P = 0.001), respectively. Patients’ disease awareness after PCCS referral between 2006 and 2014 was increased from 47.1% to 64.5% (P = 0.016). Family's awareness of diagnosis and prognosis after PCCS referral researched to a steady plateau, 94.1% to 97.8% in different year cohort (P = 0.34). The percentage of DNR designation rate at the beginning of PCCS (in 2006) was 15.5%, and the designation rate was increased annually and finally reached to 42.0% in 2014 (P = 0.004). The percentage of DNR consents after PCCS was also improved from 44.0% in 2006 up to 80.0% in 2014 (P = 0.005). PCCS refusal rate decreased gradually and dropped to 1.6% in 2014 (P = 0.005). The percentage of PCCS utilization was increased 5-fold during the 9-year period after the promotion of PCCSIn the program of PCCS promotion, an increasing trend of PCCS utilization, better patients’ and their families’ awareness of diagnosis and prognosis, more consent to DNR, more patients were discharged with stable condition at the end of PCCS and a decrease refusal rate of end-of-life palliative care among terminal cancer patients were observed in Taiwan between 2006 and 2014.

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A Comparison of Cancer and Noncancer Patients Who Receive Palliative Care Consultation Services

Cited by 12 publications

References 43 publications

Characteristics of Patients With Hematologic Malignancies Who Received Palliative Care Consultation Services in a Medical Center

Characteristics of Patients With Hematologic Malignancies Who Received Palliative Care Consultation Services in a Medical Center

Impact, challenges and limits of inpatient palliative care consultations – perspectives of requesting and conducting physicians

Impact of Palliative Care Consultation Service on Terminally Ill Cancer Patients

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