Continuous Care: A Home Hospice Benefit

Newman, Amy Rose; Thompson, J R; Chandler, Eloise

doi:10.1188/13.cjon.19-20

Cited by 3 publications

(4 citation statements)

References 1 publication

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“…Nevertheless, it is clinically relevant that patients who presented preoperative anxiety, probably conditioned by the diagnosis, displayed even higher anxiety levels at seven days postoperative, with a reduction in self-care activities; at 14 days postoperative, on the other hand, anxiety levels had dropped and self-care activities had increased. This seems to be in accordance with authors 10 - 11 who indicate that anxiety decreased in surgical patients with head and neck cancer at a specific point in time (fifth day postoperative). The increase in personal care, then, precedes the drop in anxiety levels.…”

Section: Discussionsupporting

confidence: 93%

“…Another aspect that stands out in total laryngectomy patients is that specific care is required, deriving from the surgery, which the patient needs to learn with a view to daily self-care. Laryngectomized patients experience different modifications, causing self-care needs and a self-care deficit, which should be solved or compensated to prevent complications, live with their disease and develop appropriately, incorporating self-care into their daily life as a fundamental tool to contribute to the maintenance of their health and improvement of their quality of life 10 - 11 .…”

Section: Introductionmentioning

confidence: 99%

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Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients

Almonacid

Ramos

Rodríguez-Borrego

2016

Rev. Latino-Am. Enfermagem

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Objective: estimate the prevalence of anxiety in laryngectomy patients in the pre and postoperative periods and its relation with the self-care level. Method: observational research of 40 patients with stage IV laryngeal cancer. Three observations took place: in the preoperative phase, at seven and at 14 days after the surgery; between June 2010 and December 2012. Two self-care levels were defined: self-sufficient and needing help for activities of daily living and treatment-related activities. To assess the anxiety levels, Zigmond's hospital anxiety scale (1983) was used. Results: in the preoperative and postoperative phases, the patients presented high levels of anxiety. Concerning self-care, on average, self-sufficient patients presented lower levels of anxiety than patients who needed help to accomplish activities of daily living and activities deriving from the surgery, without significant differences. Conclusion: anxiety is present at all times in laryngectomy patients and the reduction of the self-care deficit seems to decrease it, without putting a permanent end to it.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients

Almonacid

Ramos

Rodríguez-Borrego

2016

Rev. Latino-Am. Enfermagem

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“…Our study was not designed to identify barriers to CHC use; however, previous research has suggested that maintaining qualified nursing staff for CHC services is challenging. 23 Nursing staff providing CHC services are responsible for medication adjustments and symptom management in times of patient deterioration or crisis, 24 and are required to work a minimum of eight hours. CHC services cannot be provided by contract nurses and at least half of the hours per shift must be staffed by a registered nurse, licensed practical nurse, or licensed vocational nurse, 4 which may be difficult for some hospices to ensure and sustain.…”

Section: Discussionmentioning

confidence: 99%

Continuous Home Care Reduces Hospice Disenrollment and Hospitalization After Hospice Enrollment

Wang

Aldridge

Canavan

et al. 2016

Journal of Pain and Symptom Management

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Objectives To identify hospice and patient characteristics associated with the use of continuous home care (CHC), and to examine the associations between CHC utilization and hospice disenrollment or hospitalization after hospice enrollment. Methods Using 100% fee-for-service Medicare claims data for beneficiaries aged 66 years or older who died between July and December 2011, we identified the percentage of hospice agencies in which patients used CHC in 2011 and determined hospice and patient characteristics associated with use of CHC. Using multivariable analyses, we examined the associations between CHC utilization and hospice disenrollment and hospitalization after hospice enrollment, adjusted for hospice and patient characteristics. Results Only 42.7% of hospices (1,533 out of 3,592 hospices studied) provided CHC to at least 1 patient during the study period. Patients enrolled with for-profit, larger, and urban located hospices were more likely to use CHC (P-values < 0.001). Within these 1,533 hospices, only 11.4% of patients used CHC. Patients who were white, had cancer, and had more comorbidities were more likely to use CHC. In multivariable models, compared with patients who did not use CHC, patients who used CHC were less likely to have hospice disenrollment (adjusted odds ratio [AOR]: 0.21, 95% confidence interval [CI]: 0.19-0.23) and less likely to be hospitalized after hospice enrollment (AOR: 0.37, 95% CI: 0.34-0.40). Conclusions Although a minority of patients uses CHC, such services may be protective against hospice disenrollment and hospitalization after hospice enrollment.

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“…Several studies have suggested that palliative care provision may improve the chances of people to receive care in the final days outside hospital or at home and to die there [8] [10] [11] [12] [13]. Cancer patients are more likely to receive hospice and palliative care compared to other dying patients, both in hospital settings and at home, and their chances of achieving a chosen home death are better [14] [15] [16] [17]. Also, hospice and palliative care use were associated with home death for cancer patients in European countries [1] [11].…”

Section: Introductionmentioning

confidence: 99%

A Study on Locations of Death and Factors Associated with Death among Cancer Patients in South Korea

Rhee¹,

Tae²,

Lee³

et al. 2019

JBM

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Background: Location of death has been used to examine an indicator for good death. This study aims to examine location of death among patients with three major cancers (gastric, liver, and lung) and other factors associated with location of death in South Korea. Methods: We selected the medical and pharmacy claims data for health services and location of death among the 42,596 decedents with cancer (lung 16,632, liver 15,872, gastric 10,092) from 2009 to 2013. We used logistic regressions to identify factors associated with home death. Outcome measures are locations of death (hospital, outpatient clinics or emergency room and home). Results: Only 8.9% died at home whereas 46.5% died in hospital as inpatients. Patients with more than one comorbid cancer or receivers for any supportive care were significantly more likely to die in hospital. Female and younger than 55 years old liver cancer patients were associated with home death. Patients living in metropolitan area, or paying more insurance premium, or being public aid beneficiaries, were associated with home death. Conclusions: The supportive care service use prior to death was significantly associated with increasing odds to hospital death. Being older than 75, or having multiple cancers was significant factors associated with hospital death, whereas living in metropolitan area, lower income or emergency visit were significant factors with home death. These findings are opposite to what is found, as the palliative care and hospice is predominantly hospital-centered. The findings emphasize a need to available end-of-life care in community for dying patients.

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Continuous Care: A Home Hospice Benefit

Cited by 3 publications

References 1 publication

Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients

Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients

Continuous Home Care Reduces Hospice Disenrollment and Hospitalization After Hospice Enrollment

A Study on Locations of Death and Factors Associated with Death among Cancer Patients in South Korea

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