@article{10.4103/0973-1075.185030,
title = {Integration of Early Specialist Palliative Care in Cancer Care: Survey of Oncologists, Oncology Nurses, and Patients},
author = {Salins, Naveen and Patra, Lipika and Usha Rani, MR and Lohitashva, SO and Rao, Raghavendra and Ramanjulu, Raghavendra and Vallath, Nandini},
abstract = {
Introduction:
Palliative care is usually delivered late in the course of illness trajectory. This precludes patients on active disease modifying treatment from receiving the benefit of palliative care intervention. A survey was conducted to know the opinion of oncologists, oncology nurses, and patients about the role of early specialist palliative care in cancer.
Methods:
A nonrandomized descriptive cross-sectional study was conducted at a tertiary cancer care center in India. Thirty oncologists, sixty oncology nurses, and sixty patients were surveyed.
Results:
Improvement in symptom control was appreciated by oncologists, oncology nurses, and patients with respect to pain (\textit{Z} = −4.10, \textit{P} = 0.001), (\textit{Z} = −5.84, \textit{P} = 0.001), (\textit{Z} = −6.20, \textit{P} = 0.001); nausea and vomiting (\textit{Z} = −3.75, \textit{P} = 0.001), (\textit{Z} = −5.3, \textit{P} = 0.001), (\textit{Z} = −5.1, \textit{P} = 0.001); constipation (\textit{Z} = −3.29, \textit{P} = 0.001), (\textit{Z} = −4.96, \textit{P} = 0.001), (\textit{Z} = −4.49, \textit{P} = 0.001); breathlessness (\textit{Z} = −3.57, \textit{P} = 0.001), (\textit{Z} = −5.03, \textit{P} = 0.001), (\textit{Z} = −4.99, \textit{P} = 0.001); and restlessness (\textit{Z} = −3.68, \textit{P} = 0.001), (\textit{Z} = −5.23, \textit{P} = 0.001), (\textit{Z} = −3.22, \textit{P} = 0.001). Improvement in end-of-life care management was appreciated by oncologists and oncology nurses with respect to communication of prognosis (\textit{Z} = −4.04, \textit{P} = 0.001), (\textit{Z} = −5.20, \textit{P} = 0.001); discussion on limitation of life-sustaining treatment (\textit{Z} = −3.68, \textit{P} = 0.001), (\textit{Z} = −4.53, \textit{P} = 0.001); end-of-life symptom management (\textit{Z} = −4.17, \textit{P} = 0.001), (\textit{Z} = −4.59, \textit{P} = 0.001); perimortem care (\textit{Z} = −3.86, \textit{P} = 0.001), (\textit{Z} = −4.80, \textit{P} = 0.001); and bereavement support (\textit{Z} = −3-80, \textit{P} = 0.001), (\textit{Z} = −4.95, \textit{P} = 0.001). Improvement in health-related communication was appreciated by oncologists, oncology nurses, and patients with respect to communicating health related information in a sensitive manner (\textit{Z} = −3.74, \textit{P} = 0.001), (\textit{Z} = −5.47, \textit{P} = 0.001), (\textit{Z} = −6.12, \textit{P} = 0.001); conducting family meeting (\textit{Z} = −3.12, \textit{P} = 0.002), (\textit{Z} = −4.60, \textit{P} = 0.001), (\textit{Z} = −5.90, \textit{P} = 0.001); discussing goals of care (\textit{Z} = −3.43, \textit{P} = 0.001), (\textit{Z} = −5.49, \textit{P} = 0.001), (\textit{Z} = −5.61, \textit{P} = 0.001); maintaining hope (\textit{Z} = −3.22, \textit{P} = 0.001), (\textit{Z} = −4.85, \textit{P} = 0.001), (\textit{Z} = −5.61, \textit{P} = 0.001); and resolution of conflict (\textit{Z} = −3.56, \textit{P} = 0.001), (\textit{Z} = −5.29, \textit{P} = 0.001), (\textit{Z} = −5.28, \textit{P} = 0.001). Patients appreciated improvement in continuity of care with respect to discharge planning (\textit{Z} = −6.12, \textit{P} = 0.001), optimal supply of essential symptom control medications on discharge (\textit{Z} = −6.32, \textit{P} = 0.001), follow-up plan (\textit{Z} = −6.40, \textit{P} = 0.001), after hours telephonic support (\textit{Z} = −6.31, \textit{P} = 0.001), and preferred place of care (\textit{Z} = −6.28, \textit{P} = 0.001).
Conclusion:
Oncologists, oncology nurses, and patients felt that integration of early specialist palliative care in cancer improves symptom control, end-of-life care, health-related communication, and continuity of care. The perceptions of benefit of the palliative care intervention in the components surveyed, differed among the three groups.
},
volume = 22,
issn = {0973-1075},
issn = {1998-3735},
url = {https://doi.org/10.4103/0973-1075.185030},
doi = {10.4103/0973-1075.185030}
}