Integration of early specialist palliative care in cancer care: Survey of oncologists, oncology nurses, and patients

Salins, Naveen; Patra, Lipika; Rani, Manisha; Lohitashva, S O; Rao, Raghavendra; Ramanjulu, Raghavendra; Vallath, Nandini

doi:10.4103/0973-1075.185030

Cited by 13 publications

(12 citation statements)

References 28 publications

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“…This may be due to multiple factors, including considerations surrounding the appropriateness of time- and resource-intensive services for patients with limited life expectancy. While palliative care and hospice at the end-of-life is generally felt to be important and effective [ 27 , 28 ], cancer rehabilitation is not as widely adopted nor understood in this patient population and may be underutilized [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

The Intersection of Oncology Prognosis and Cancer Rehabilitation

Smith

Zheng

2017

Curr Phys Med Rehabil Rep

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Purpose of reviewThis review examines the delivery of rehabilitation care to cancer patients with relation to disease prognosis. This includes the evaluation when patients are referred for rehabilitation services and the effectiveness of rehabilitation interventions across the cancer continuum.Recent findingsAlthough prognosticating life expectancy is difficult, referrals for rehabilitation interventions appear to be affected by physician attitudes towards patients with advanced disease, in part because of misconceptions about the nature of rehabilitation for oncology patients. Rehabilitation may also be underutilized in long-term survivors with no evidence of disease. Despite this, our review found that rehabilitation in advanced disease, end-of-life, geriatric cancer patients, and in long-term survivors can be beneficial. There is a relative dearth in studies on rehabilitation interventions specifically at the end-of-life.SummaryCancer rehabilitation can be helpful to patients along the spectrum of cancer prognoses. Examining more accurate ways to prognosticate life expectancy, improving communication and education between oncologists and rehabilitation team members, and modifying survivorship plans to include patient education on functional changes over time may improve the delivery of rehabilitation care.

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Section: Introductionmentioning

confidence: 99%

The Intersection of Oncology Prognosis and Cancer Rehabilitation

Smith

Zheng

2017

Curr Phys Med Rehabil Rep

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“…A survey of oncologists, oncology nurses, and patients show that integration of early specialist palliative care in a tertiary cancer center in India improves symptom control, end-of-life care, health-related communication, and continuity of care. [14,15] However, the evidence in pediatric oncology is not robust.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Need for Integrated Pediatric Palliative Care Services in a Pediatric Oncology Setting: A Retrospective Audit

Rao

Vijayasekharan

et al. 2021

IJPC

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Objectives: Early integrated palliative care has shown to improve the quality of life in patients with cancer. During the past decade, pediatric palliative care has become an established area of medical expertise, however due to scant information available regarding the triggers for referral and referral practice very few children receive a formal palliative care consult. Materials and Methods: A retrospective audit of medical case records of pediatric oncology patients over a period of 1 year from September 30, 2019, to September 30, 2020, was conducted. Demographic details, diagnosis, staging, clinical parameters, reason for referral, and palliative care plan were captured in a predesigned pro forma. Results: Among 126 children with cancer, 27 (21.4%) patients were referred to palliative care. Majority 21 (77%) referrals were inpatient consults. Symptom management 17 (44.7%) was the most common trigger for referral followed by referrals for psychosocial support 12 (14.4%). Children with solid tumors 16 (59%) were more often referred than hematological malignancies. Among those needing end of life care, 8 (88.8%) out of 9 families preferred home than hospital. Conclusion: Low incidence of palliative care referral and presence of symptoms as a trigger for palliative care referral suggests gaps in the integrated approach. The study findings prompt a review of palliative care referral criteria and referral practice in a pediatric oncology setting.

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“…As per Saraiya et al (2008), improvements in patient decision making and clinical practice can reduce the burden of symptoms for patients if clinicians gain a better understanding of patient's expectations respecting the longer-term consequences of diagnosis and treatment [ 18 ]. Early integration of palliative care in cancer improves symptom control, end-of-life care, health-related communication, and continuity of care [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

The Perspective of a Breast Cancer Patient: A Survey Study Assessing Needs and Expectations

Prakash

Sardar

Shaikh

et al. 2020

Cureus

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Background Patient satisfaction is one of the key indicators of health care quality. We aim to identify patient's needs and expectations in a breast cancer clinic to provide patient-centered care and better overall satisfaction. Methods A 17-item survey was administered to 110 patients at a breast cancer clinic. The survey was designed after a thorough literature review and approved by an oncologist and a palliative care physician. Results Self-reported knowledge about the disease was reported adequate by 90.9% of our patients yet only 55.45% of our patients could identify the stage of their cancer. More education was desired by 32.7% of patients including various treatment options (29%), common complications (24.5%), prognosis (26.3%) and risk factors (11.8%). The majority of our patients were having some form of cancer-related emotional stress and physical symptoms. The majority of our patients (57.27%) wanted their oncologist to address social/emotional issues and 25.45% felt the need for more focus on physical symptoms in their subsequent visits. End-of-life (EoL) care discussions were considered an integral component of overall care by 29% of our patients. Components of EoL care discussions that patients stated they could benefit from included prognosis (27.27%), life expectancy (29%), the treatment effect on the quality of life (22.7%), palliative care (9%), hospice (10.9%), advance directives (11.8%), and family involvement in medical decision-making (13.6%). There was a difference noted regarding their EoL care discussion based on the stage of cancer. Patients with early-stage disease wanted their oncologists to decide on the frequency of this discussion (72.7%). Patients with advanced disease wanted EoL care discussion to be done more frequently as initiated by them or their oncologist or if there's a change in the treatment plan.

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Integration of early specialist palliative care in cancer care: Survey of oncologists, oncology nurses, and patients

Cited by 13 publications

References 28 publications

The Intersection of Oncology Prognosis and Cancer Rehabilitation

The Intersection of Oncology Prognosis and Cancer Rehabilitation

Evaluating the Need for Integrated Pediatric Palliative Care Services in a Pediatric Oncology Setting: A Retrospective Audit

The Perspective of a Breast Cancer Patient: A Survey Study Assessing Needs and Expectations

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