Evaluation of End-of-Life Cancer Care in the ICU

Kinoshita, Satomi

doi:10.1177/1049909112446805

Cited by 12 publications

(5 citation statements)

References 26 publications

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“…Sleep deprivation is common among family members across a spectrum of clinical settings, including family members of cancer patients [1], patients with acute coronary syndrome [2], surgical candidates, and critically ill infants and adults [3]. Nearly half of intensive care unit (ICU) family decision-makers report feeling sleepy and sleep deprived [3].…”

Section: Introductionmentioning

confidence: 99%

“…In other environments, sleep deprivation results in cognitive impairment in family members of hospitalized patients [4], but it is unclear whether this occurs in family members of patients in the ICU. Since a large proportion of medical decisions in the ICU are made by surrogates—including the vast majority of decision-making at the end of life (between 90 and 94 %) performed by someone other than the patient [1, 2]—this is concerning.…”

Section: Introductionmentioning

confidence: 99%

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Half of the family members of critically ill patients experience excessive daytime sleepiness

et al. 2014

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Background Sleepiness and fatigue are commonly reported by family members of intensive care unit (ICU) patients. Sleep deprivation may result in cognitive deficits. Sleep deprivation and cognitive blunting have not been quantitatively assessed in this population. We sought to determine the proportion of family members of ICU patients that experience excessive daytime sleepiness, sleep-associated functional impairment, and cognitive blunting. Methods Multicenter, cross-sectional survey of family members of patients admitted to ICUs at the University of Maryland Medical Center, Johns Hopkins University Hospital, and Christiana Hospital. Family members of ICU patients were evaluated using the Epworth Sleepiness Scale, a validated survey assessing sleepiness in everyday situations (normal, less than 10); the Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10), a questionnaire quantifying the impact of sleepiness on daily activities (normal, at least 17.9); and psychomotor vigilance testing, a test of cognitive function, in relation to sleep deprivation (normal mean reaction time less than 500 ms). Results A total of 225 family members were assessed. Of these, 50.2 % (113/225) had Epworth scores consistent with excessive daytime sleepiness. Those with sleepiness experienced greater impairment in performing daily activities by FOSQ-10 (15.6 ± 3.0 vs 17.4 ± 2.2, p < 0.001). Cognitive blunting was found in 13.3 % (30/225) of family members and 15.1 % (14/93) of surrogate decision-makers. Similar rates of cognitive blunting as reported by mean reaction time of at least 500 ms were found among family members whether or not they reported sleepiness (15.0 % (17/113) vs. 11.6 % (13/112), p = 0.45). Conclusions Half of the family members of ICU patients suffer from excessive daytime sleepiness. This sleepiness is associated with functional impairment, but not cognitive blunting.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Half of the family members of critically ill patients experience excessive daytime sleepiness

et al. 2014

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“…This resulted in 34 papers selected for review. Among them, 19 papers were included for data integration after excluding 15 papers [8,9,[13][14][15][16][17][18][19][20][21][22][23][24][25] in which data extraction or acquisition was not possible (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Consequently, only one study with extractable measurement scores [overall rating of care was excellent: 56.6 (55.1-58.1)] was included [ 20 ]. We were unable to obtain measurement scores for two studies utilising the GDI [ 9 , 21 ].…”

Section: Reviewmentioning

confidence: 99%

Family Members’ Feedback on the “Quality of Death” of Adult Patients Who Died in Intensive Care Units and the Factors Affecting the Death Quality: A Systematic Review and Meta-Analysis

Naya,

Sakuramoto,

Aikawa

et al. 2024

Cureus

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Intensive care units (ICUs) are designed for critically ill patients who often experience high mortality rates owing to the severity of their conditions. Although the primary goal is patient recovery, it is crucial to understand the quality of death in the ICU setting. Nevertheless, there is a notable lack of systematic reviews on measured death quality and its associated factors. This study aims to conduct a quantitative synthesis of evidence regarding the quality of death in the ICU and offers a comprehensive overview of the factors influencing this quality, including its relationship with the post-intensive care syndrome-family (PICS-F). A thorough search without any language restrictions across MEDLINE, CINAHL, PsycINFO, and Igaku Chuo Zasshi databases identified relevant studies published until September 2023. We aggregated the results regarding the quality of death care for patients who died in the ICU across each measurement tool and calculated the point estimates and 95% confidence intervals. The quantitative synthesis encompassed 19 studies, wherein the Quality of Dying and Death-single item (QODD-1) was reported in 13 instances (Point estimate: 7.0, 95% CI: 6.93-7.06). Patient demographic data, including age and gender, as well as the presence or absence of invasive procedures, such as life support devices and cardiopulmonary resuscitation, along with the management of pain and physical symptoms, were found to be associated with a high quality of death. Only one study reported an association between quality of death and PICS-F scores; however, no significant association was identified. The QODD-1 scale emerged as a frequently referenced and valuable metric for evaluating the quality of death in the ICU, and factors associated with the quality of ICU death were identified. However, research gaps persist, particularly regarding the variations in the quality of ICU deaths based on cultural backgrounds and healthcare systems. This review contributes to a better understanding of the quality of death in the ICU and emphasises the need for comprehensive research in this critical healthcare domain.

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“…The importance of disease specific EOL care is becoming increasingly recognized in the care of patients dying with chronic diseases such as chronic obstructive pulmonary disease (COPD), cancer or renal disease Davison, 2010;Goodridge, Duggleby, Gjevre, & Rennie, 2009;Kinoshita & Miyashita, 2013). For example, patients with COPD place special importance on receiving disease specific education, whereas many cancer patients place more importance on social experiences, maintaining hope, or symptom management Espinoza Venegas & Sanhueza Alvarado, 2010;Kinoshita & Miyashita, 2013;Wenrich et al, 2005). Collectively, these findings imply that attention should be paid to disease-specific EOL needs of individual patients.…”

Section: Introductionmentioning

confidence: 99%

Low quality of dying and death in patients with septic shock as perceived by nurses and resident physicians

et al. 2016

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Septic shock is a disease with both high prevalence and mortality. Few studies have evaluated the quality of dying and death (QODD) in patients with septic shock. The authors compared the QODD of patients who died of septic shock versus other causes. They prospectively collected QODD surveys from nurses and residents caring for 196 patients who died in the medical intensive care unit (ICU) at an urban, university hospital. Patients were included in the analysis if either a nurse or resident returned a survey. Chart review established cause of death. The authors compared total QODD scores (on a scale of 0-100) and a single-item score (QODD-1; on a scale of 0-10) of patients who died of septic shock versus other causes. Survey response rates were 59% (n = 155) for residents and 49% (n = 129) for nurses. Nurses rated patients as having lower total QODD and QODD-1 scores for septic (Δ 7.5 points, p = 0.03, and 0.9 points, p = 0.05, respectively). Residents rated septic patients with lower QODD-1 scores than nonseptic patients (Δ 0.8 points, p = 0.03). This study shows that nurses rate patients with septic shock as having lower QODD than patients dying of other causes. These findings are important for clinicians who counsel families of patients dying of septic shock.

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Evaluation of End-of-Life Cancer Care in the ICU

Cited by 12 publications

References 26 publications

Half of the family members of critically ill patients experience excessive daytime sleepiness

Half of the family members of critically ill patients experience excessive daytime sleepiness

Family Members’ Feedback on the “Quality of Death” of Adult Patients Who Died in Intensive Care Units and the Factors Affecting the Death Quality: A Systematic Review and Meta-Analysis

Low quality of dying and death in patients with septic shock as perceived by nurses and resident physicians

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