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Biersching T, Schweda A, Oechsle K, Nauck F, Rosenbruch J, Schuler U, Hense J, Neukirchen M, Weber M, Junghanss C, Kramer T, Ostgathe C, Thuss-Patience P, Van Oorschot B, Teufel M, Schuler M, Bausewein C, Tewes M. The OUTREACH study: oncologists of German university hospitals in rotation on a palliative care unit-evaluation of attitude and competence in palliative care and hospice. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04131-w. [PMID: 35831764 DOI: 10.1007/s00432-022-04131-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The effect of the duration of an educational rotation presented at a palliative care unit on the palliative care knowledge gain and the increase of palliative care self-efficacy expectations are unclear. METHODS This national prospective multicenter pre-post survey conducted at twelve German University Comprehensive Cancer Centers prospectively enrolled physicians who were assigned to training rotations in specialized palliative care units for three, six, or twelve months. Palliative care knowledge [in %] and palliative care self-efficacy expectations [max. 57 points] were evaluated before and after the rotation with a validated questionnaire. RESULTS From March 2018 to October 2020, questionnaires of 43 physicians were analyzed. Physicians participated in a 3- (n = 3), 6- (n = 21), or 12-month (n = 19) palliative care rotation after a median of 8 (0-19) professional years. The training background of rotating physicians covered a diverse spectrum of specialties; most frequently represented were medical oncology (n = 15), and anesthesiology (n = 11). After the rotation, median palliative care knowledge increased from 81.1% to 86.5% (p < .001), and median palliative care self-efficacy expectations scores increased from 38 to 50 points (p < .001). The effect of the 12-month rotation was not significantly greater than that of the 6-month rotation. CONCLUSION An educational rotation presented in a specialized palliative care unit for at least six months significantly improves palliative care knowledge and palliative care self-efficacy expectations of physicians from various medical backgrounds.
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Affiliation(s)
- T Biersching
- West German Cancer Centre, Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany
| | - A Schweda
- West German Cancer Centre, Department of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University Hospital Essen, 45147, Essen, Germany
| | - K Oechsle
- Palliative Care Unit, Department for Oncology, Haematology and Bone Marrow Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Nauck
- Department of Palliative Medicine, University Medical Centre Göttingen, Göttingen, Germany
| | - J Rosenbruch
- Department of Palliative Medicine, LMU Munich Hospital, Ludwig-Maximilians-University, Campus Großhadern, Munich, Germany
| | - U Schuler
- University Palliative Care Centre, Carl Gustav Carus University Hospital, Dresden, Germany
| | - J Hense
- West German Cancer Centre, Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany
| | - M Neukirchen
- Interdisciplinary Centre for Palliative Medicine, University Tumor Centre Düsseldorf - Comprehensive Cancer Centre, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany.,Department of Anaesthesiology, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - M Weber
- Interdisciplinary Department for Palliative Medicine, University Medicine Mainz, Johannes-Gutenberg-University, Mainz, Germany
| | - C Junghanss
- Division of Medicine, Dept. of Haematology, Oncology and Palliative Medicine, University Medical Centre, Rostock, Germany
| | - T Kramer
- Palliative Medicine at the University Centre for Tumor Diseases (UCT), University Hospital Frankfurt, Frankfurt am Main, Germany
| | - C Ostgathe
- Palliative Medicine Department, Comprehensive Cancer Centre CCC Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - P Thuss-Patience
- University Tumor Centre, Charité University Medicine Berlin, Charité Campus Virchow-Klinikum, Berlin, Germany
| | - B Van Oorschot
- Interdisciplinary Centre for Palliative Medicine, University Hospital Würzburg, Julius-Maximilians-University, Würzburg, Germany
| | - M Teufel
- West German Cancer Centre, Department of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University Hospital Essen, 45147, Essen, Germany
| | - M Schuler
- West German Cancer Centre, Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany.,German Consortium for Translational Cancer Research (DKTK), Partner Location Essen University Hospital, Essen, Germany
| | - C Bausewein
- Department of Palliative Medicine, LMU Munich Hospital, Ludwig-Maximilians-University, Campus Großhadern, Munich, Germany
| | - M Tewes
- West German Cancer Centre, Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany.
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[Applicability of QUIKS in conservatively treated tumor inpatients]. Schmerz 2021; 36:342-349. [PMID: 34705120 PMCID: PMC9512755 DOI: 10.1007/s00482-021-00599-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 11/11/2022]
Abstract
Hintergrund „Qualitätsverbesserung im konservativen Schmerzmanagement“ (QUIKS), das Modul für nichtoperative Patienten welches an das „QUIPS“-Projekt angelehnt ist, wurde an einer Kohorte Tumorpatienten auf Anwendbarkeit getestet. Material und Methoden Prospektiv wurden stationär konservativ behandelte Patienten am Universitätsklinikum Würzburg (UKW) anhand des Ergebnisfragebogens QUIKS zur Qualität der Schmerztherapie befragt (AZ 129/17, Ethikkommission am UKW). Informationen zur Therapie und Demografie wurden dem klinikinternen Dokumentationssystem entnommen. Ergebnisse Im Erfassungszeitraum konnten 100 Tumorpatienten aus verschiedenen Kliniken eingeschlossen werden. 74 % der Patienten benötigten Unterstützung bei der Beantwortung des Fragebogens. Funktionelle Einschränkungen oder schmerztherapiebedingte Nebenwirkungen lagen bei 77 % der Patienten vor, im Durchschnitt lagen Schmerzen von 6 auf der numerischen Rating-Skala vor. Die am häufigsten benannten Schmerzentitäten waren Rücken- und Kopfschmerzen. 18 % der Patienten erhielten eine Schmerztherapie mit Opioiden, 26 % mit Nichtopioiden, eine Anpassung der Schmerztherapie erfolgte in 5 % mit Opioiden und in 44 % mit Nichtopioiden, ein Einbezug schmerzmedizinischer Spezialisten erfolgte in 9 %. Fazit Die Anwendung des Fragebogens wurde von den Patienten gut akzeptiert, war jedoch mit einem großen Maß an Unterstützung beim Ausfüllen verbunden. Es zeigte sich ein hohes Schmerzniveau während des Krankenhausaufenthalts. Eine Anpassung der Schmerztherapie oder ein Einbezug schmerzmedizinischer Spezialisten erfolgte selten. Die Interpretation bzgl. Aussagen zur Qualität des Schmerzmanagements könnte eingeschränkt sein, da andere (vorbestehende) Schmerzentitäten, wie nichttumorassoziierter Schmerz oder chronischer Tumorschmerz, nicht eindeutig abgrenzbar sind. Zusatzmaterial online Die Online-Version dieses Beitrags (10.1007/s00482-021-00599-6) enthält die QUIKS-Prozessparameter und den QUIKS-Ergebnisfragebogen.
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Erlenwein J, Petzke F. [Pain Management in Non-surgical Inpatients - Treatment Approaches and Competence for Pain Services]. Anasthesiol Intensivmed Notfallmed Schmerzther 2021; 56:614-627. [PMID: 34507384 DOI: 10.1055/a-1531-0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The number of non-surgical patients in the hospital setting with pain due to medical conditions or comorbidities and/or invasive procedures or treatments is high. Compared to perioperative pain management, the portion of patients and/or conditions that require more than an approach focused on pharmacological treatment of nociceptive pain is considerably higher. Rather, treatment often requires the differentiated use of co-analgesics, non-pharmacological treatments, physiotherapy, occupational therapy, psychological assessment and interventsions and educational approaches, ideally in the form of closely coordinated interdisciplinary treatment. The assessment and treatment of acute and especially chronic pain should follow the biopsychosocial concept of pain, especially if risk factors for chronification have been identified, if patients receive high-dose therapy with analgesics or have preexisting a chronic pain disorder.
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Berendt J, Ostgathe C, Simon ST, Tewes M, Schlieper D, Schallenburger M, Meier S, Gahr S, Schwartz J, Neukirchen M. [Cooperation between intensive care and palliative care : The status quo in German Comprehensive Cancer Centers]. Med Klin Intensivmed Notfmed 2020; 116:586-594. [PMID: 32767071 PMCID: PMC8494681 DOI: 10.1007/s00063-020-00712-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/08/2020] [Accepted: 07/04/2020] [Indexed: 12/04/2022]
Abstract
Hintergrund Die interdisziplinäre Zusammenarbeit zwischen Intensivmedizin und Palliativmedizin kann die Versorgungsqualität verbessern. Das Ausmaß dieser Zusammenarbeit ist aber bisher kaum untersucht. Ziel der Arbeit Es sollten die angebotenen und in Anspruch genommenen palliativmedizinischen Unterstützungsangebote auf den Intensivstationen deutscher onkologischer Spitzenzentren erfasst werden. Material und Methoden Durchgeführt wurde eine quantitativ-qualitative, deskriptive Umfrage an den 16 von der Stiftung Deutsche Krebshilfe geförderten Zentren. Die im quantitativen Teil erfragten Häufigkeiten werden als Mittelwert und Median mit den jeweiligen Streumaßen dargestellt, während die im qualitativen Teil erhobenen Triggerfaktoren mit einer Inhaltsanalyse nach Mayring ausgewertet wurden. Ergebnisse Von Juli bis August 2017 konnten Angaben aus 15 von 16 onkologischen Spitzenzentren (94 %) erfasst werden. Im Jahr 2016 wurden im Median 33 Intensivpatienten (Min. 0, Max. 100) palliativmedizinisch vorgestellt und 9 Patienten (Min. 1, Max. 30) auf eine Palliativstation verlegt. Regelmäßige intensivmedizinisch-palliativmedizinische Visiten sowie ein Screening-Tool zur Einbindung der spezialisierten Palliativmedizin sind an zwei onkologischen Spitzenzentren implementiert. Anhand von 23 genannten Triggern, die auf der Intensivstation eine palliativmedizinische Mitbehandlung ausgelöst haben, lassen sich nach qualitativer Analyse die drei Kategorien „Entscheidung und Einstellung des Teams“, „Zustand des Patienten“ und „Wunsch von Patienten und Angehörigen“ ableiten. Diskussion Trotz eines verfügbaren Angebots werden palliativmedizinische Ressourcen in den intensivmedizinischen Abteilungen der onkologischen Spitzenzentren immer noch selten genutzt. In die tägliche Routine integrierte Angebote wie Screening-Tools oder gemeinsame Visiten könnten die Ausnutzung der angebotenen palliativmedizinischen Ressourcen erhöhen und die Versorgungsqualität verbessern.
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Affiliation(s)
- J Berendt
- Palliativmedizinische Abteilung, Universitätsklinikum Erlangen, Comprehensive Cancer Center EMN-Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - C Ostgathe
- Palliativmedizinische Abteilung, Universitätsklinikum Erlangen, Comprehensive Cancer Center EMN-Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - S T Simon
- Zentrum für Palliativmedizin, Centrum für Integrierte Onkologie Aachen, Bonn, Köln, Düsseldorf, Uniklinik Köln, Köln, Deutschland
| | - M Tewes
- Westdeutsches Tumorzentrum, Innere Klinik (Tumorforschung), Universitätsklinikum Essen, Essen, Deutschland
| | - D Schlieper
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland
| | - M Schallenburger
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland
| | - S Meier
- Klinik für Anästhesiologie, Universitätsklinikum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - S Gahr
- Palliativmedizinische Abteilung, Universitätsklinikum Erlangen, Comprehensive Cancer Center EMN-Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - J Schwartz
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
| | - M Neukirchen
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.,Klinik für Anästhesiologie, Universitätsklinikum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
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Anxiety, depression and psychosocial needs are the most frequent concerns reported by patients: preliminary results of a comparative explorative analysis of two hospital-based palliative care teams in Germany and Japan. J Neural Transm (Vienna) 2020; 127:1481-1489. [PMID: 32419058 PMCID: PMC7578135 DOI: 10.1007/s00702-020-02186-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/30/2020] [Indexed: 11/16/2022]
Abstract
In the partnership between the medical departments of Würzburg University, Germany, and Nagasaki University, Japan, palliative care is a relevant topic. The aim of the study was to perform a comparative analysis of the hospital-based palliative care teams in Würzburg (PCT-W) and Nagasaki (PCT-N). Survey of staff composition and retrospective analysis of PCT patient charts in both PCTs were conducted. Patients self-assessed their symptoms in PCT-W and in Radiation Oncology Würzburg (RO-W). The (negative) quality indicator ‘percentage of deceased hospitalised patients with PCT contact for less than 3 days before death’ (Earle in Int J Qual Health Care 17(6):505–509, 2005) was analysed. Both PCTs follow a multidisciplinary team approach. PCT-N saw 410 cancer patients versus 853 patients for PCT-W (22.8% non-cancer patients). The Eastern Cooperative Oncology Group Performance Status at first contact with PCT-N was 3 or 4 in 39.3% of patients versus 79.0% for PCT-W. PCT-N was engaged in co-management longer than PCT-W (mean 20.7 days, range 1–102 versus mean 4.9 days, range 1–48). The most frequent patient-reported psychological symptom was anxiety (family anxiety: 98.3% PCT-W and 88.7% RO-W, anxiety 97.9% PCT-W and 85.9% RO-W), followed by depression (98.2% PCT-W and 80.3% RO-W). In 14 of the 148 deceased patients, PCT-N contact was initiated less than 3 days before death (9.4%) versus 121 of the 729 deceased PCT-W patients (16.6%). Psychological needs are highly relevant in both Germany and Japan, with more than 85% anxiety and depression in patients in the Japanese IPOS validation study (Sakurai in Jpn J Clin Oncol 49(3):257–262, 2019). This should be taken into account when implementing PCTs.
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Coym A, Oechsle K, Kanitz A, Puls N, Blum D, Bokemeyer C, Ullrich A. Impact, challenges and limits of inpatient palliative care consultations - perspectives of requesting and conducting physicians. BMC Health Serv Res 2020; 20:86. [PMID: 32019562 PMCID: PMC7001248 DOI: 10.1186/s12913-020-4936-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/27/2020] [Indexed: 11/17/2022] Open
Abstract
Background Inpatient palliative care consultation (IPCC) teams have been established to improve care for patients with specialist palliative care (PC) needs throughout all hospital departments. The objective is to explore physicians’ perceptions on the impact of IPCC, its triggers, challenges and limits, and their suggestions for future service improvements. Methods A Qualitative study drawing on semi-structured interviews with 10 PC specialists of an IPCC team and nine IPCC requesting physicians from oncology and non-oncological departments of a university hospital. Analysis was performed using qualitative content analysis. Results PC specialists and IPCC requesting physicians likewise considered organization of further care and symptom-burden as main reasons for IPCC requests. The main impact however was identified from both as improvement of patients’ (and their caregivers’) coping strategies and relief of the treating team. Mostly, PC specialists emphasized a reduction of symptom burden, and improvement of further care. Challenges in implementing IPCC were lack of time for both. PC specialists addressed requesting physicians’ skepticism towards PC. Barriers for realization of IPCC included structural aspects for both: limited time, staff capacities and setting. PC specialists saw problems in implementing recommendations like disagreement towards their suggestions. All interviewees considered education in PC a sensible approach for improvement. Conclusions IPCC show various positive effects in supporting physicians and patients, but are also limited due to structural problems, lack of knowledge, insecurity, and skepticism by the requesting physicians. To overcome some of these challenges implementation of PC education programs for all physicians would be beneficial.
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Affiliation(s)
- Anja Coym
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Karin Oechsle
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Alena Kanitz
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Nora Puls
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - David Blum
- Competence Center Palliative Care, Department of Radiation Oncology, University Hospital Zürich, Zürich, Switzerland
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, Germany
| | - Anneke Ullrich
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Delgado-Ortega L, González-Domínguez A, Borrás JM, Oliva-Moreno J, González-Haba E, Menjón S, Pérez P, Vicente D, Cordero L, Jiménez M, Simón S, Hidalgo-Vega Á, Moya-Alarcón C. The economic burden of disease of epithelial ovarian cancer in Spain: the OvarCost study. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:135-147. [PMID: 29922900 PMCID: PMC6394604 DOI: 10.1007/s10198-018-0986-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 06/06/2018] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To assess the economic burden of epithelial ovarian cancer (EOC) in incident patients and the burden by disease stage in Spain. METHODS We developed a Markov model from a social perspective simulating the natural history of EOC and its four stages, with a 10-year time horizon, 3-week cycles, 3% discount rate, and 2016 euros. Healthcare resource utilization and costs were estimated by disease stage. Direct healthcare costs (DHC) included early screening, genetic counselling, medical visits, diagnostic tests, surgery, chemotherapy, hospitalizations, emergency services, and palliative care. Direct non-healthcare costs (DNHC) included formal and informal care. Indirect costs (IC) included labour productivity losses due to temporary and permanent leaves, and premature death. Epidemiology data and resource use were taken from the literature and validated for Spain by the OvarCost group using a Delphi method. RESULTS The total burden of EOC over 10 years was 3102 mill euros: 15.1% in stage I, 3.9% in stage II, 41.0% in stage III, and 40.2% in stage IV. Annual average cost/patient was €24,111 and it was €8,641; €14,184; €33,858, and €42,547 in stages I-IV, respectively. Of total costs, 71.2% were due to DHC, 24.7% to DNHC, and 4.1% to IC. CONCLUSIONS EOC imposes a significant economic burden on the national healthcare system and society in Spain. Investment in better early diagnosis techniques might increase survival and patients' quality of life. This would likely reduce costs derived from late stages, consequently leading to a substantial reduction of the economic burden associated with EOC.
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Affiliation(s)
- Laura Delgado-Ortega
- AstraZeneca Farmacéutica Spain, Serrano Galvache, 56, Building Álamo, Madrid Spain
| | | | - Josep María Borrás
- Clinical Sciences Department, University of Barcelona, L’Hospital de Llobregat, Barcelona Spain
| | | | | | - Salomón Menjón
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Pedro Pérez
- Hospital Clínico Universitario, Madrid, Spain
| | - David Vicente
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Luis Cordero
- AstraZeneca Farmacéutica Spain, Serrano Galvache, 56, Building Álamo, Madrid Spain
| | | | - Susana Simón
- AstraZeneca Farmacéutica Spain, Serrano Galvache, 56, Building Álamo, Madrid Spain
| | | | - Carlota Moya-Alarcón
- AstraZeneca Farmacéutica Spain, Serrano Galvache, 56, Building Álamo, Madrid Spain
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Shim HY, Chang YJ, Kawk KS, Mai TTX, Choi JY, Ahn EM, Jho HJ, Park SJ. Do Korean Doctors Think a Palliative Consultation Team Would Be Helpful to Their Terminal Cancer Patients? Cancer Res Treat 2016; 49:437-445. [PMID: 27506213 PMCID: PMC5398399 DOI: 10.4143/crt.2015.495] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 07/22/2016] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Hospice and palliative care services (HPC) are not commonly utilized in Korea; however, palliative care teams (PCTs) have been found to be effective at addressing the shortcomings in HPC. In this study, we attempted to outline unmet palliative care needs of terminal cancer patients and the potential benefits of PCTs as perceived by doctors in Korea. MATERIALS AND METHODS We surveyed 474 doctors at 10 cancer-related academic conferences from June to November 2014 with a self-report questionnaire to assess their perceptions of end-of-life care needs and the expected effects of PCTs on caring for terminal cancer patients. Among those surveyed, 440 respondents who completed the entire questionnaire were analyzed. RESULTS In all domains, fewer participants reported satisfaction with palliative care services than those reporting needs (p < 0.001). The surveyed participants also reported difficulties with a shortage of time for treatment, psychological burden, lack of knowledge regarding hospice care, lengths of stay, and palliative ward availability. Multivariate logistic regression analysis revealed that female doctors (odds ratio [OR], 2.672; 95% confidence interval [CI], 1.035 to 6.892), doctors who agreed that referring my patients to a HPC means I must give up on my patient (OR, 3.075; 95% CI, 1.324 to 7.127), and doctors who had no experience with HPC education (OR, 3.337; 95% CI, 1.600 to 7.125) were associated with higher expected effectiveness of PCT activities. CONCLUSION The PCT activities were expected to fill the doctor's perceived unmet HPC needs of terminal cancer patients and difficulties in communications.
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Affiliation(s)
- Hye-Young Shim
- Department of Preventive Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Yoon Jung Chang
- Hospice & Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Kiu-Sang Kawk
- Hospice & Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Tran Thi Xuan Mai
- Hospice & Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jin Young Choi
- Hospice & Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eun Mi Ahn
- Hospice & Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hyun Jung Jho
- Hospice & Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - So-Jung Park
- Hospice & Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
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