Advance Care Planning in Brazil

Tardelli, Natalia Rocha; Forte, Daniel Neves; Vidal, Edison Iglesias de Oliveira

doi:10.1016/j.zefq.2023.04.010

Cited by 5 publications

(1 citation statement)

References 24 publications

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“…Building upon these observations, our findings represent a critical advancement, indicating that the OPC program holds the potential to facilitate early referral by palliative care teams to home care services. The commitment of OPC teams to establishing trust, fostering discussions about EoL care, promoting prognostic awareness, and implementing advance care planning emerges as a pivotal factor, especially in a country where such discussions remain taboo, even within the field of oncology [31]. This echoes the broader societal attitudes in Brazil, as highlighted by a cross-country study in 2017.…”

Section: Discussionmentioning

confidence: 99%

Outpatient Palliative Care Program: Impact on Home Death Rate in Brazil

Gomes,

Silva,

Sorice

et al. 2024

Cancers

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While the positive impact of early palliative care on the quality of life of cancer patients is well established, there is a noticeable research gap in developing countries. This study sought to determine the impact of an outpatient palliative care (OPC) program on the location of death among patients in Brazil. This was a retrospective study including patients with cancer who died between January 2022 and December 2022 in 32 private cancer centers in Brazil. Data were collected from medical records, encompassing demographics, cancer characteristics, and participation in the OPC program. The study involved 1980 patients, of which 32.3% were in the OPC program. OPC patients were predominantly younger (average age at death of 66.8 vs. 68.0 years old, p = 0.039) and composed of women (59.4% vs. 51.3%, p = 0.019) compared to the no-OPC patients. OPC patients had more home/hospice deaths (19.6% vs. 10.4%, p < 0.001), and participation in the outpatient palliative care program strongly predicted home death (OR: 2.02, 95% CI: 1.54–2.64). Our findings suggest a significant impact of the OPC program on increasing home and hospice deaths among patients with cancer in our sample. These findings emphasize the potential of specialized OPC programs to enhance end-of-life care, particularly in low-resource countries facing challenges related to social and cultural dimensions of care and healthcare access.

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Section: Discussionmentioning

confidence: 99%

Outpatient Palliative Care Program: Impact on Home Death Rate in Brazil

Gomes,

Silva,

Sorice

et al. 2024

Cancers

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Editorial: Advance Care Planning as Key to Person Centered Care: Evidence and Experiences, Programmes and Perspectives

Krones,

Anderson,

Borenko

et al. 2023

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheit

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When and how to discuss about palliative care and advance care planning with cancer patients: A mixed-methods study

Trevizan,

Paiva,

de Almeida

et al. 2023

Pall Supp Care

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Objectives To identify the patients who are most likely to participate in discussions about palliative care (PC) and advance care planning (ACP), and to determine their preferred timing and approach of discussion. Methods The study included women aged 18–75 years diagnosed with breast cancer. In the quantitative phase, sociodemographic and clinical characteristics, knowledge, decision-making, and stigmas were evaluated. The qualitative phase included questions about patients’ understanding, timing, and method of discussing PC and ACP, which were analyzed by Bardin’s content analysis. Results In Phase 1, a total of 115 participants were included, with 53.04% completing both phases and 46.96% declining further participation. Those who completed both phases exhibited higher rates of marriage and educational attainment, while those who declined Phase 2 had a higher prevalence of advanced-stage cancer and palliative treatment. Completion of both phases was associated with a greater knowledge of reality and increased awareness of PC and ACP. Furthermore, the qualitative analysis revealed 5 convergent themes: timing, demystification, patient empowerment, misconception elimination, and open communication. These themes informed the development of a conceptual model that provides a framework for discussing PC and ACP with patients at different stages of cancer diagnosis and treatment, highlighting appropriate and inappropriate approaches and timing. Significance of results Early discussion is beneficial, but withholding information or infringing on autonomy should be avoided. The study reveals that married and highly educated individuals tend to be more receptive to these discussions. However, patients with late-stage cancer tend to decline participation. Patients value open communication, demystification of PC, and empowering discussions that eliminate misunderstandings. Efforts should be made to reach patients with limited familiarity, particularly those with late-stage cancer, to increase their receptiveness to enable well-informed decision-making.

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Advance Care Planning in Brazil

Cited by 5 publications

References 24 publications

Outpatient Palliative Care Program: Impact on Home Death Rate in Brazil

Outpatient Palliative Care Program: Impact on Home Death Rate in Brazil

Editorial: Advance Care Planning as Key to Person Centered Care: Evidence and Experiences, Programmes and Perspectives

When and how to discuss about palliative care and advance care planning with cancer patients: A mixed-methods study

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