End-of-Life Care Matters: Palliative Cancer Care Results in Better Care and Lower Costs

Dalal, Shalini; Bruera, Éduardo

doi:10.1634/theoncologist.2016-0277

Cited by 92 publications

(63 citation statements)

References 107 publications

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“…There is a critical need to prepare family carers for the complex role they face and to focus on ways to temper the burden of caregiving (Ferrell & Wittenberg, 2017). There is also a need for palliative care delivery models that benefit both caregivers and patients (Dalal & Bruera, 2017;Kavalieratos et al, 2016). By identifying and interpreting family nursing practice that addresses complex family needs, concerns, and distress, family members´ experiences of advanced cancer can be considered in the context of the family situation (IFNA, 2017;Wright & Bell, 2009;Wright & Leahey, 2013).…”

Section: Introductionmentioning

confidence: 99%

The effectivness of a strengths‐oriented therapeutic conversation intervention on perceived support, well‐being and burden among family caregivers in palliative home‐care

Petursdottir

Svavarsdóttir

2019

Journal of Advanced Nursing

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Aims To evaluate the effectiveness of a two‐session multicomponent family strengths‐ oriented therapeutic conversation intervention among family caregivers of an individual with advanced/final stage cancer during ongoing palliative home‐care. Background Family caregivers of patients in the advanced/final phases of cancer, experience multifaceted psychological distress and morbidity. Psychosocial interventions improve the well‐being of family members who are caring for their close relative. Design A pre‐experimental design with a one‐group pre‐test/posttests measurements. Methods Forty‐eight family caregivers were assigned to receive two 60–90 min sessions of the intervention. The primary outcome was perceived emotional and cognitive support and psychological well‐being, measured at baseline (T1). Then the participants were offered the first session of the intervention. About 1 week later, the second session was administered. The participants answered the same questionnaires again (T2) and then 2–4 weeks later (T3). The guideline; Criteria for Reporting Development and Evaluation of Complex Interventions 2, guided the reporting of the study. Results Family caregivers reported significantly higher emotional and cognitive support post‐intervention (T2) and at (T3). They also reported significantly reduced stress symptoms at (T3) and reduced caregiver burden post‐intervention (T2) and at (T3). Conclusion The provision of the intervention contributed to extending knowledge about the usefulness of family conversations in the context of advanced/final stage cancer care. Impact There is a lack of knowledge about the benefit of therapeutic conversation interventions for family caregivers. The therapeutic conversation intervention offered, resulted in perceived support, decreased stress, and decreased caregiving demands among caregivers in palliative home‐care. Trial registration number: ISRCTN 21786830.

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Section: Introductionmentioning

confidence: 99%

The effectivness of a strengths‐oriented therapeutic conversation intervention on perceived support, well‐being and burden among family caregivers in palliative home‐care

Petursdottir

Svavarsdóttir

2019

Journal of Advanced Nursing

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“…Several studies indicated that hospital-based PC services increased satisfaction of patients and families [45], improved QoL [46], reduced ICU length of stay [47], and decreased costs [48,49]. In a very recent review, the authors have underlined the advantages of a PC-oriented approach in improving patient's outcomes, including symptom burden, QoL, and EoL outcomes, all achieved with lower associated costs [50].…”

Section: What Role For Inhospital Palliative Care?mentioning

confidence: 99%

“…In a recent review Dalal and Bruera have reported that the magnitude of hospital cost savings with PC involvement ranged from 9 to 32% and these savings were higher when PC team was involved earlier (within two days from patient's admission) [50]. Two recent studies [62,63]…”

Section: Which Is the Impact Of Inhospital Palliative Care Services Omentioning

confidence: 99%

Inhospital Palliative Care: Should We Need to Reconsider What Role Hospitals Should Have in Patients with End-Stage Disease or Advanced Cancer?

Cotogni¹,

Saini²,

Luca³

2017

Preprint

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“…Additionally, the Patient Protection and Affordable Care Act, often called 'Obamacare' (statute 42 U.S.C.A § 300gg-8 under PPACA Section 2709), mandates that insurance companies must cover routine care costs for trial participants. While terminal lung cancer patients have increased access to medications, evidence suggests that end of life treatment is associated with worse quality-of-life (Dalal andBruera 2017, Zhang et al 2009), and that many clinical trials and experimental treatment options fail to extend life.…”

Section: Introductionmentioning

confidence: 99%

Uncertainty and certain death: the role of clinical trials in terminal cancer care

Cortez

Halpin

2020

Sociology Health & Illness

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We consider uncertainty in relation to clinical trials for terminal non‐small cell lung cancer, which is an aggressive and difficult to treat form of cancer. Using grounded theory to analyse 85 clinical interactions between doctors, patients and family members, we argue that uncertainty is a major source of tension for terminally ill patients, with individuals confronting a choice between transitioning to palliative care or volunteering for an experimental/trial medication that might postpone death. Regardless of their efficacy, patients must also consider how such experimental treatments might impact their quality‐of‐life. We argue that clinical trials produce uncertainty through (i) discussions about the efficacy of clinical trials; (ii) the physiological consequences of clinical trial medications; and (iii) the impact clinical trials have on patient's prognostic understanding of their terminal cancer. Accordingly, while study participants encounter high prognostic certainty (i.e. they have a fatal cancer), they nonetheless experience considerable uncertainty in relation to their participation in clinical trials.

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End-of-Life Care Matters: Palliative Cancer Care Results in Better Care and Lower Costs

Abstract: This article reviews the current state of end‐of‐life care, analyzes the clinical and financial impact of palliative care, and proposes areas of future research and development.

Cited by 92 publications

References 107 publications

The effectivness of a strengths‐oriented therapeutic conversation intervention on perceived support, well‐being and burden among family caregivers in palliative home‐care

The effectivness of a strengths‐oriented therapeutic conversation intervention on perceived support, well‐being and burden among family caregivers in palliative home‐care

Inhospital Palliative Care: Should We Need to Reconsider What Role Hospitals Should Have in Patients with End-Stage Disease or Advanced Cancer?

Uncertainty and certain death: the role of clinical trials in terminal cancer care

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