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[The main principles of concept of development of palliative care to children and adolescents].

https://arctichealth.org/en/permalink/ahliterature263972
Source
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2015 Jan-Feb;23(1):46-50
Publication Type
Article
Author
I V Viniarskaia
N V Ustinova
A A Baranov
V Yu Albitskii
N N Savva
O V Krasko
E V Kumirova
A G Pritiko
Source
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2015 Jan-Feb;23(1):46-50
Language
Russian
Publication Type
Article
Keywords
Adolescent
Child
Humans
Palliative Care - methods - standards - statistics & numerical data
Russia
Abstract
The article substantiates actuality of elaboration of the concept of development of palliative care of children and adolescents. The analysis of legislative and normative legal base, international documents, scientific studies related to this issue are analyzed. The situation in the regions ofthe Russian Federation is examined concerning organization of palliative care of children and its forms, provision of pharmaceuticals and specialized equipment and professional training of specialists. The demand of children population in palliative care in Russia is calculated according data of 2012. The results of carried out study are used as a basis of determining measures of development of system of palliative care of children and adolescents in the Russian Federation to propose as a foundation for the National concept as a necessary condition for organization of effective and efficient service.
PubMed ID
26012280 View in PubMed
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Improving the organization of palliative care: identification of barriers and facilitators in five European countries.

https://arctichealth.org/en/permalink/ahliterature263998
Source
Implement Sci. 2014;9:130
Publication Type
Article
Date
2014
Author
Jasper van Riet Paap
Myrra Vernooij-Dassen
Frederike Brouwer
Franka Meiland
Steve Iliffe
Nathan Davies
Wojciech Leppert
Birgit Jaspers
Elena Mariani
Ragni Sommerbakk
Kris Vissers
Yvonne Engels
Source
Implement Sci. 2014;9:130
Date
2014
Language
English
Publication Type
Article
Keywords
Cross-Cultural Comparison
England - epidemiology
Focus Groups
Germany - epidemiology
Humans
Italy - epidemiology
Netherlands - epidemiology
Norway - epidemiology
Organizational Innovation
Palliative Care - organization & administration - standards - trends
Qualitative Research
Quality Improvement
Quality of Health Care - standards
Abstract
Interventions to improve palliative care encounter challenges beyond the usual implementation problems because of palliative care's complex and changing character. In this study, we explored barriers and facilitators faced by health-care professionals in five European countries (England, Germany, Italy, Norway and the Netherlands) with regard to improving the organization of their palliative care service.
Semi-structured individual and focus group interviews were conducted with purposefully selected health-care professionals. The constant comparative method was used to analyse the data.
Professionals working in hospitals, hospices, nursing homes and primary care facilities who provide palliative care to adult patients were interviewed (n =40) or participated in ten focus group interviews (n =59). Barriers and facilitators were inductively grouped into 16 categories and arranged into five themes: innovation, individual professional level, group dynamics, organizational context and local political-economic context. Although the barriers and facilitators identified differed in scope, context, strength and provenance, they were shared by professionals from different European countries.
This study identified barriers and facilitators to organizational change in palliative care. Some of these barriers and facilitators were experienced by professionals in almost all countries and are therefore prerequisites to change. Understanding the barriers to and facilitators of change will help tailor organizational improvements to the needs of individuals and organizations.
Notes
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PubMed ID
25686479 View in PubMed
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Effects of person-centred and integrated chronic heart failure and palliative home care. PREFER: a randomized controlled study.

https://arctichealth.org/en/permalink/ahliterature264278
Source
Eur J Heart Fail. 2014 Oct;16(10):1142-51
Publication Type
Article
Date
Oct-2014
Author
Margareta Brännström
Kurt Boman
Source
Eur J Heart Fail. 2014 Oct;16(10):1142-51
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Chronic Disease
Delivery of Health Care, Integrated - methods - organization & administration
Female
Heart Failure - physiopathology - psychology - therapy
Home Care Services
Hospitalization - statistics & numerical data
Humans
Male
Outcome Assessment (Health Care)
Palliative Care - methods
Patient-Centered Care - methods
Quality of Life
Sweden
Abstract
We evaluated the outcome of person-centred and integrated Palliative advanced home caRE and heart FailurE caRe (PREFER) with regard to patient symptoms, health-related quality of life (HQRL), and hospitalizations compared with usual care.
From January 2011 to October 2012, 36 (26 males, 10 females, mean age 81.9?years) patients with chronic heart failure (NYHA class III-IV) were randomized to PREFER and 36 (25 males, 11 females, mean age 76.6?years) to the control group at a single centre. Prospective assessments were made at 1, 3, and 6 months using the Edmonton Symptom Assessment Scale, Euro Qol, Kansas City Cardiomyopathy Questionnaire, and rehospitalizations. Between-group analysis revealed that patients receiving PREFER had improved HRQL compared with controls (57.6?±?19.2 vs. 48.5?±?24.4, age-adjusted P-value?=?0.05). Within-group analysis revealed a 26% improvement in the PREFER group for HRQL (P?=?0.046) compared with 3% (P?=?0.82) in the control group. Nausea was improved in the PREFER group (2.4?±?2.7 vs. 1.7?±?1.7, P?=?0.02), and total symptom burden, self-efficacy, and quality of life improved by 18% (P?=?0.035), 17% (P?=?0.041), and 24% (P?=?0.047), respectively. NYHA class improved in 11 of the 28 (39%) PREFER patients compared with 3 of the 29 (10%) control patients (P?=?0.015). Fifteen rehospitalizations (103?days) occurred in the PREFER group, compared with 53 (305?days) in the control group.
Person-centred care combined with active heart failure and palliative care at home has the potential to improve quality of life and morbidity substantially in patients with severe chronic heart failure.
NCT01304381.
PubMed ID
25159126 View in PubMed
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Predictive factors and treatment outcome of laryngeal carcinoma recurrence.

https://arctichealth.org/en/permalink/ahliterature290272
Source
Head Neck. 2017 Mar; 39(3):555-563
Publication Type
Journal Article
Date
Mar-2017
Author
Aaro Haapaniemi
Janne Väisänen
Timo Atula
Olli-Pekka Alho
Antti Mäkitie
Petri Koivunen
Author Affiliation
Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Source
Head Neck. 2017 Mar; 39(3):555-563
Date
Mar-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - complications - pathology - therapy
Chemoradiotherapy, Adjuvant - methods
Cohort Studies
Databases, Factual
Female
Finland
Hospitals, University
Humans
Kaplan-Meier Estimate
Laryngeal Neoplasms - complications - pathology - therapy
Laryngectomy - methods
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local - epidemiology - pathology - therapy
Palliative Care
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk assessment
Salvage Therapy
Sex Factors
Survival Analysis
Treatment Outcome
Abstract
Up to 30% of patients with laryngeal squamous cell carcinoma (SCC) present with recurrence after treatment. We analyzed factors associated with the risk of cancer recurrence and prognosis after recurrence.
A nationwide laryngeal SCC cohort from Finnish university hospitals during 2001 to 2005 with initial successful therapy (n = 316) was analyzed.
Laryngeal SCC recurred in 22% of patients. The median time to recurrence was 9 months, with 90% occurring within 36 months after treatment. The World Health Organization (WHO) performance status >0, neck metastasis at presentation, and nonsurgical treatment were independent prognostic factors for recurrence. Patients with local recurrence had a 5-year overall survival (OS) of 53% compared with 5% in patients with regional/distant recurrences. OS for glottic and nonglottic laryngeal SCC recurrence was 45% and 0%, respectively.
The type of treatment affected the risk of recurrence in this retrospective series. Local recurrences carried a chance for successful salvage treatment. Routine follow-up beyond 36 months remains controversial. © 2016 Wiley Periodicals, Inc. Head Neck 39: 555-563, 2017.
PubMed ID
27902867 View in PubMed
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Contemporary radiooncological management of bone metastases from breast cancer: factors associated with prescription of different fractionation regimens (short or long course) in a rural part of North Norway with long travel distance.

https://arctichealth.org/en/permalink/ahliterature290404
Source
Int J Circumpolar Health. 2017; 76(1):1270080
Publication Type
Journal Article
Date
2017
Author
Carsten Nieder
Astrid Dalhaug
Ellinor Haukland
Bård Mannsåker
Adam Pawinski
Author Affiliation
a Department of Oncology and Palliative Medicine , Nordland Hospital , Bodø , Norway.
Source
Int J Circumpolar Health. 2017; 76(1):1270080
Date
2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Bone Neoplasms - radiotherapy - secondary
Breast Neoplasms - mortality - pathology
Comorbidity
Dose Fractionation
Female
Health Services Accessibility
Health status
Humans
Middle Aged
Norway
Palliative Care - methods
Prognosis
Retrospective Studies
Rural Population
Severity of Illness Index
Transportation
Abstract
The aim of this study was to reduce barriers that prevent implementation of evidence-based recommendations about single-fraction palliative radiotherapy (PRT) and to demonstrate that single-fraction PRT yields similar outcomes as long-course treatment (=10 fractions) in patients with bone metastases from breast cancer. This retrospective study (2007-2014) included 118 Norwegian female patients. All patients received guideline-conform systemic therapy including bone-targeting agents. Median survival was 12.7 months. Long-course PRT was prescribed in 60% of patients, while 21% had PRT with a single fraction of 8 Gy to at least one target. Reirradiation rate was not significantly higher after 8 Gy (9%, compared to 5% after long-course PRT and 6% after 4 Gy x5). Patients with favorable baseline characteristics such as younger age and good performance status (PS) were significantly more likely to receive long-course PRT. Biological subtype and comorbidity did not correlate with fractionation. Prognosis was influenced by biological subtype, extra-skeletal disease extent, severe anemia and abnormal CRP. The limited need for reirradiation after single fraction PRT might encourage physicians to prescribe this convenient regimen, which would improve resource utilization. Even patients with PS3 had a median survival of 3 months, which indicates that they could experience worthwhile clinical benefit.
Notes
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PubMed ID
28452680 View in PubMed
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Age but not Philadelphia positivity impairs outcome in older/elderly patients with acute lymphoblastic leukemia in Sweden.

https://arctichealth.org/en/permalink/ahliterature290878
Source
Eur J Haematol. 2017 Aug; 99(2):141-149
Publication Type
Journal Article
Date
Aug-2017
Author
Piotr Kozlowski
Emma Lennmyr
Lucia Ahlberg
Per Bernell
Erik Hulegårdh
Holger Karbach
Karin Karlsson
Beata Tomaszewska-Toporska
Maria Åström
Heléne Hallböök
Author Affiliation
Department of Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden.
Source
Eur J Haematol. 2017 Aug; 99(2):141-149
Date
Aug-2017
Language
English
Publication Type
Journal Article
Keywords
Age Factors
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - adverse effects - therapeutic use
Comorbidity
Female
Guideline Adherence
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Palliative Care
Philadelphia Chromosome
Population Surveillance
Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology - genetics - mortality - therapy
Prognosis
Registries
Remission Induction
Survival Analysis
Sweden - epidemiology
Treatment Outcome
Abstract
Older/elderly patients with acute lymphoblastic leukemia (ALL) are poorly represented in clinical trials.
Using Swedish national leukemia registries, we investigated disease/patient characteristics, treatment choices, outcome, and the impact of an age-adapted protocol (introduced in 2009) in this population-based study of patients aged 55-85 years, diagnosed with ALL 2005-2012.
Of 174 patients, 82% had B-phenotype, 11% Burkitt leukemia (excluded), and 7% T-phenotype. Philadelphia chromosome positivity (Ph+) occurred in 35%. Of the 155 B- and T-ALL patients, 80% were treated with intensive protocols, and 20% with a palliative approach. Higher age and WHO performance status =2 influenced the choice of palliation. Intensive, palliative, and both approaches resulted in complete remission rate 83/16/70% and 3-year overall survival (OS) 32/3/26%. The age-adapted protocol did not improve outcome. With intensive treatment, platelet count =35×109 /L and age =75 years were adverse prognostic factors for OS, Ph+ was not. Male sex was an adverse prognostic factor in the 55-64 year age-group.
We report a high frequency of Ph+ in older/elderly patients, with no evidence of poorer outcome compared to Ph-negative disease. Overall prognosis for elderly patients with ALL remains dismal, despite the use of age-adapted treatment.
PubMed ID
28419558 View in PubMed
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Providing Palliative Care in a Swedish Support Home for People Who Are Homeless.

https://arctichealth.org/en/permalink/ahliterature290915
Source
Qual Health Res. 2016 Jul; 26(9):1252-62
Publication Type
Journal Article
Date
Jul-2016
Author
Cecilia Håkanson
Jonas Sandberg
Mirjam Ekstedt
Elisabeth Kenne Sarenmalm
Mats Christiansen
Joakim Öhlén
Author Affiliation
Ersta Sköndal University College, Stockholm, Sweden cecilia.hakanson@esh.se.
Source
Qual Health Res. 2016 Jul; 26(9):1252-62
Date
Jul-2016
Language
English
Publication Type
Journal Article
Keywords
Communication
Homeless Persons
Humans
Palliative Care
Qualitative Research
Sweden
Abstract
Despite high frequencies of multiple, life-limiting conditions relating to palliative care needs, people who are homeless are one of the most underserved and rarely encountered groups in palliative care settings. Instead, they often die in care places where palliative competence is not available. In this qualitative single-case study, we explored the conditions and practices of palliative care from the perspective of staff at a Swedish support home for homeless people. Interpretive description guided the research process, and data were generated from repeated reflective conversations with staff in groups, individually, and in pairs. The findings disclose a person-centered approach to palliative care, grounded in the understanding of the person's health/illness and health literacy, and how this is related to and determinant on life as a homeless individual. Four patterns shape this approach: building trustful and family-like relationships, re-dignifying the person, re-considering communication about illness and dying, and re-defining flexible and pragmatic care solutions.
PubMed ID
25994318 View in PubMed
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QOLLTI-F: measuring family carer quality of life.

https://arctichealth.org/en/permalink/ahliterature166224
Source
Palliat Med. 2006 Dec;20(8):755-67
Publication Type
Article
Date
Dec-2006
Author
Robin Cohen
Anne M Leis
David Kuhl
Cécile Charbonneau
Paul Ritvo
Fredrick D Ashbury
Author Affiliation
Department of Oncology, McGill University, Jewish General Hospital, Montreal, QC, Canada. robin.cohen@mcgill.ca
Source
Palliat Med. 2006 Dec;20(8):755-67
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Caregivers - psychology
Family
Female
Humans
Male
Middle Aged
Palliative Care
Patient satisfaction
Psychometrics - methods
Quality of Life
Questionnaires - standards
Reproducibility of Results
Abstract
The primary goal of palliative care is to optimize the quality of life (QOL) of people living with a life-threatening illness and that of their families. While there have been important advances in measurement of the QOL of palliative care patients, little attention has been paid to the QOL of their carers (family caregivers). To develop and deliver the most effective services to these carers, their QOL needs to be measured with acceptable and psychometrically sound instruments that have content validity.
This study reports three phases of the development and testing of such a measure: QOLLTI-F, Quality of Life in Life Threatening Illness--Family Carer Version, simultaneously in English and French. Participants were carers from 12 Canadian palliative care services who were asked to complete QOLLTI-F on three occasions.
The final version of QOLLTI-F consists of 16 items. It was deemed acceptable by the vast majority of carers and a longer, 24-item version was completed in a median of 12 min. Content validity was assured by inclusion of all domains reported by carers to be important to their QOL: state of carer, patient wellbeing, quality of care, outlook, environment, finances and relationships. Construct validity was demonstrated, as principal components analysis indicated that the 16 items did indeed reflect these seven domains. Furthermore, the seven domain scores predicted 53% of the variance in global QOL, although the QOLLTI-F Total score predicted less well (43%). The test-retest reliability for the QOLLTI-F Total score was 0.77-0.80 and ranged from 0.50 to 0.79 for the seven domain scores. All QOLLTI-F scores were shown to be significantly different between days the carers considered bad, average and good, demonstrating responsiveness to change, with the exception of the Financial Concerns submeasure, which did not distinguish between average and good days.
QOLLTI-F is unique in that in measuring one person's QOL (the carer's) it includes their perception of the condition of another (the patient). This attests to the close relationship between the two. It is also unique in that its content is derived from a qualitative study asking carers what is important to their own QOL, rather than focusing on the changes or burdens related to caregiving. QOLLTI-F also has the advantage of being briefer than other carer QOL measures. It contains measures of seven different domains that are determinants of carer QOL, in addition to a summary score. All these measures are valid, reliable and responsive to change in QOL.
PubMed ID
17148530 View in PubMed
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A century of progress in palliative care.

https://arctichealth.org/en/permalink/ahliterature195855
Source
Lancet. 2000 Dec;356 Suppl:s24
Publication Type
Article
Date
Dec-2000
Author
R L Fainsinger
Author Affiliation
Palliative Care Program, Royal Alexandra Hospital, Edmonton, Alberta, Canada. rfainsin@cha.ab.ca
Source
Lancet. 2000 Dec;356 Suppl:s24
Date
Dec-2000
Language
English
Publication Type
Article
Keywords
Canada
Humans
Palliative Care - organization & administration - trends
PubMed ID
11191480 View in PubMed
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1518 records – page 1 of 152.