Coming and going: predicting the discharge of cancer patients admitted to a palliative care unit: easier than thought?

Masel, Eva Katharina; Huber, Patrick; Schur, Sophie; Kierner, Katharina A.; Nemecek, Romina; Watzke, Herbert

doi:10.1007/s00520-015-2601-4

Cited by 10 publications

(6 citation statements)

References 25 publications

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“…The results of our study show that the patients could not distinguish hospices from palliative care units and lacked information about the purpose of a palliative care unit at the time of their admission. In Austria, palliative care units provide treatment ahead of discharge while hospices attend to patients in the final phase of their lives until death [ 27 ]. Some interviewees perceived the palliative care unit as a hospice or a unit where they would probably die, a few thought they were being admitted to the wrong unit, while some thought it was a unit for recuperation and symptomatic relief.…”

Section: Discussionmentioning

confidence: 99%

What Makes a Good Palliative Care Physician? A Qualitative Study about the Patient’s Expectations and Needs when Being Admitted to a Palliative Care Unit

et al. 2016

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ObjectiveThe aims of the study were to examine a) patients’ knowledge of palliative care, b) patients’ expectations and needs when being admitted to a palliative care unit, and c) patient’s concept of a good palliative care physician.MethodsThe study was based on a qualitative methodology, comprising 32 semistructured interviews with advanced cancer patients admitted to the palliative care unit of the Medical University of Vienna. Interviews were conducted with 20 patients during the first three days after admission to the unit and after one week, recorded digitally, and transcribed verbatim. Data were analyzed using NVivo 10 software, based on thematic analysis enhanced with grounded theory techniques.ResultsThe results revealed four themes: (1) information about palliative care, (2) supportive care needs, (3) being treated in a palliative care unit, and (4) qualities required of palliative care physicians. The data showed that patients lack information about palliative care, that help in social concerns plays a central role in palliative care, and attentiveness as well as symptom management are important to patients. Patients desire a personal patient-physician relationship. The qualities of a good palliative care physician were honesty, the ability to listen, taking time, being experienced in their field, speaking the patient’s language, being human, and being gentle. Patients experienced relief when being treated in a palliative care unit, perceived their care as an interdisciplinary activity, and felt that their burdensome symptoms were being attended to with emotional care. Negative perceptions included the overtly intense treatment.ConclusionsThe results of the present study offer an insight into what patients expect from palliative care teams. Being aware of patient’s needs will enable medical teams to improve professional and individualized care.

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Section: Discussionmentioning

confidence: 99%

What Makes a Good Palliative Care Physician? A Qualitative Study about the Patient’s Expectations and Needs when Being Admitted to a Palliative Care Unit

et al. 2016

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“…Most articles (n=22) did not specifically look at a certain disease population. However, when disease populations were reported, the articles included patients with cancer (Aso et al, 2022;Masel et al, 2014Masel et al, , 2015Zhang et al, 2017), chronic illness (Lenaghan, 2019), dementia (Lenaghan, 2019), or hip fracture (Nikolaus et al, 1999).…”

Section: Description Of Included Articlesmentioning

confidence: 99%

“…Subacute-to-home transitions can be distressing and logistically challenging, especially when patients are near the end of life. Problems with discharge quality, planning, and preparation contribute to poor subacute-tohome transition outcomes (Masel et al, 2014;Menzies & Hanger, 2011;Middleton et al, 2018;Robert et al, 2021;Rose et al, 2021;Zhang et al, 2017). For example, patients may not have access to appropriate resources such as information about equipment for the transition home or to support them in remaining at home (Premier's Council on Improving Healthcare and Ending Hallway Medicine, 2019).…”

Section: Introductionmentioning

confidence: 99%

Facilitating Equitable Subacute-to-Home Transitions for Patients Receiving Palliative and/or End-of-Life Care: A Literature Review

McCoy,

Al Hafi,

Downar

et al. 2023

hpj

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Introduction: As people in subacute facilities approach the end of life, the focus of their care often shifts to comfort as they seek to return home. Interventions that aim to improve hospital-to-home transitions do not generally focus on subacute care. Objective: To summarize the existing literature on subacute-to-home transitions for individuals receiving palliative care near the end of life, and to explore whether these interventions are targeted toward marginalized groups to improve their transition experience. Methods: We searched the MEDLINE, Embase, HealthSTAR, and Cochrane Library electronic databases using terms related to end of life, palliative care, and transitions from subacute facilities to home. We identified 896 records and included 29 articles, 11 of which were intervention articles. We searched the 11 intervention articles for equity stratifiers. Results: Of the 29 included articles, four addressed transitions for end-of-life populations, three discussed family caregiver perspectives, and 11 were intervention studies, including regular home visit follow-ups, individualized transition care plans, and an individualized intervention with an advanced practice nurse. Subacute-to-home interventions showed positive outcomes such as reduced risk of hospital readmissions, reduced length of stays, and improved functional status. However, study limitations included small sample sizes, inconsistent definitions of outcomes, and incompletion due to COVID-19. No studies focused on marginalized groups. Conclusion/Discussion: While there was some literature supporting targeted interventions for subacute-to-home transitions for those receiving palliative care or end-of-life care, the included interventions did not target marginalized groups. Further research in these areas is required.

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“…Masel et al beschrieben für Patienten einer Palliativstation eine Mortalität von 55 % [10]. In der vorliegenden Erhebung sind ebenfalls durchschnittlich 55 % der Patienten in den untersuchten 10 Jahren auf der Station verstorben.…”

Section: Diskussionunclassified

“…Diese Angabe konnte durch die vorliegende Arbeit bestätigt werden. Ebenfalls deckt sich die hier berichtete längere Aufenthaltsdauer der entlassenen Patienten im Vergleich zu denen, die auf der Station verstarben (12,7 vs. 9,5 Tage) mit einer Untersuchung von Masel et al (15,2 vs. 13,6 Tage) [10]. Als Erklärungen für eine verlängerte Liegedauer von in ein Hospiz verlegte Patienten kommen die limitierte Zahl der in der Region zur Verfügung stehenden Hospizplätze sowie eine verlängerte Entscheidungsdauer der Patienten und ihrer Angehörigen zugunsten einer hospizlichen Weiterversorgung in Betracht.…”

Section: Diskussionunclassified

Stationäre Palliativmedizin – Analyse der medizinischen Versorgung onkologischer und nichtonkologischer Patienten einer universitären Palliativstation

2018

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Zusammenfassung Hintergrund Palliativstationen stellen die Akutversorgung von Palliativpatienten mit besonders komplexer Symptomatik sicher. Die Anzahl der Palliativstationen hat in den vergangenen Jahren in Deutschland deutlich zugenommen. Um der wachsenden Nachfrage an Palliativbetten für die Akutversorgung adäquat zu begegnen und optimale Bedingungen für eine klinische Palliativversorgung zu gewährleisten, ist die differenzierte Analyse der aktuellen Versorgungsstrukturen zwingend erforderlich. Ziel dieser Untersuchung war es, mit den Daten einer 10 Jahre bestehenden universitären Palliativstation Diagnosen, Mortalität, Verlegungsorte und Liegedauer der auf der Station behandelten Patienten zu untersuchen. Darüber hinaus sollte geprüft werden, ob sich onkologische von nichtonkologischen Patienten bezüglich ihres Alters und des Allgemeinzustands unterscheiden. Methodik Im Rahmen einer retrospektiven epidemiologischen Untersuchung wurden Diagnosen, Mortalität, Verlegungsorte und Liegedauer der von 2007 bis 2016 auf der Station behandelten Patienten mittels deskriptiver Statistik ausgewertet. Darüber hinaus wurden Unterschiede onkologischer und nichtonkologischer Patienten in den Jahren 2015 und 2016 bezüglich ihres Alters sowie des Karnofsky- und Barthel-Index bei Klinikaufnahme betrachtet und mittels ungepaartem t-Test auf statistische Signifikanz geprüft. Ergebnisse Insgesamt konnten 2360 Patienten untersucht werden. Davon waren 94 % Tumorpatienten und 6 % Nichttumorpatienten. Die Gesamtmortalität betrug 55 %, wobei nichtonkologische eine sehr viel höhere Sterberate als onkologische Patienten hatten (73 % vs. 54 %). Nichtonkologische Patienten waren um 11,9 Jahre älter und zeigten bei Aufnahme einen 13,2 % niedrigeren Karnofsky-Index sowie einen um 23,4 Punkte erniedrigten Barthel-Index. Von den entlassenen Patienten konnten 61 % im häuslichen Umfeld weiter versorgt werden, 23 % wurden in ein Hospiz verlegt. Die mittlere Liegedauer aller Patienten betrug 11 Tage. Schlussfolgerungen Obwohl auf der untersuchten Palliativstation außerordentlich viele Tumorpatienten behandelt wurden, ist der in den letzten Jahren gestiegene Versorgungsbedarf von Nichttumorpatienten deutlich identifizierbar. Nichtonkologische Patienten benötigten eine merklich komplexere palliativmedizinische Versorgung, da diese im Vergleich zu Tumorpatienten erst in einem weitaus fortgeschritteneren Krankheitsstadium in die Palliativbetreuung integriert werden.

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Coming and going: predicting the discharge of cancer patients admitted to a palliative care unit: easier than thought?

Cited by 10 publications

References 25 publications

What Makes a Good Palliative Care Physician? A Qualitative Study about the Patient’s Expectations and Needs when Being Admitted to a Palliative Care Unit

What Makes a Good Palliative Care Physician? A Qualitative Study about the Patient’s Expectations and Needs when Being Admitted to a Palliative Care Unit

Facilitating Equitable Subacute-to-Home Transitions for Patients Receiving Palliative and/or End-of-Life Care: A Literature Review

Stationäre Palliativmedizin – Analyse der medizinischen Versorgung onkologischer und nichtonkologischer Patienten einer universitären Palliativstation

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