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Supportive Care in Cancer

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01.03.2018 | Original Article

Early integration of palliative cancer care: patients’ and caregivers’ challenges, treatment preferences, and knowledge of illness and treatment throughout the cancer trajectory

verfasst von: Martina Preisler, Silke Heuse, Manuel Riemer, Friederike Kendel, Anne Letsch

Erschienen in: Supportive Care in Cancer | Ausgabe 3/2018

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Abstract

Purpose

Early integration of palliative care (EIPC) into oncology is beneficial for cancer patients and their caregivers. Best practice models of EIPC throughout the course of cancer treatment aim to support patients and caregivers in meeting their individual needs. So far, we know little about whether EIPC offers should be phase-specific or patient-centered. This study investigated patients’ and caregivers’ needs considering individual challenges, treatment preferences, and knowledge over the cancer trajectory.

Methods

Semi-structured qualitative interviews and pre-interview questionnaires were conducted with 11 cancer patients and 9 caregivers. A modified grounded theory approach was used to analyze the interview data applying thematic analysis and reflective principles by using MAXQDA.

Results

Our data showed no clearly distinct pattern of illness-phase-specific needs of patients and caregivers. Support needs were dependent on the significance and interpretation of events by patients and caregivers. Mastering challenges was highly individual and influenced by personal and contextual factors. Our results showed that subjective theories of illness significantly influenced experience, information requirements, treatment preferences, and the feeling of patients and caregivers “to be in good hands.” The physician-patient relationship was of central relevance and has a major gatekeeper function for EIPC. Access to the medical care system, resources, and information appeared to be based on chance.

Conclusions

For optimal EIPC, it is necessary to improve structural conditions such as more structured information about resources and procedures. Subjective theories of illness need to be continuously considered by practitioners in order to recognize the individual need for support.

Temel JS, Greer JA, Muzikansky A et al (2013) Early palliative care for patients with metastatic non–small-cell lung cancer. N Engl J Med 363:733–742. https://doi.org/10.1056/NEJMoa1000678

Zimmermann C, Swami N, Krzyzanowska M et al (2014) Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet 383:1721–1730. https://doi.org/10.1016/S0140-6736(13)62416-2 CrossRefPubMed

Bakitas M, Lyons KD, Hegel MT, Bakitas M (2009) Effects of a palliative care intervention. doi: https://doi.org/10.1001/jama.2009.1198

Greer JA, Pirl WF, Jackson VA et al (2012) Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non–small-cell lung cancer. J Clin Oncol 30:394–400. https://doi.org/10.1200/JCO.2011.35.7996 CrossRefPubMed

Kavalieratos D, Corbelli J, Zhang D et al (2016) Association between palliative care and patient and caregiver outcomes. JAMA 316:2104. https://doi.org/10.1001/jama.2016.16840 CrossRefPubMedPubMedCentral

Rugno FC, Paiva BSR, Paiva CE (2014) Early integration of palliative care facilitates the discontinuation of anticancer treatment in women with advanced breast or gynecologic cancers. Gynecol Oncol 135:249–254. https://doi.org/10.1016/j.ygyno.2014.08.030 CrossRefPubMed

Smith TJ, Temin S, Alesi ER et al (2012) American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol 30:880–887. https://doi.org/10.1200/JCO.2011.38.5161 CrossRefPubMed

Cherny N, Catane R, Schrijvers D et al (2010) European Society for Medical Oncology (ESMO) program for the integration of oncology and palliative care: a 5-year review of the designated centers’ incentive program. Ann Oncol 21:362–369. https://doi.org/10.1093/annonc/mdp318 CrossRefPubMed

Ferrell BR, Temel JS, Temin S et al (2016) Integration of palliative care into standard oncology care: american society of clinical oncology clinical practice guideline update. J Clin Oncol. https://doi.org/10.1200/JCO.2016.70.1474

10.

World Health Organization (2012) WHO definition of palliative care. In: WHO. http://www.who.int/cancer/palliative/definition/en/. Accessed 13 Apr 2017

11.

Ramchandran K, Tribett E, Dietrich B, Von Roenn J (2015) Integrating palliative care into oncology: a way forward. Cancer Control 22:386–395CrossRefPubMed

12.

Hui D, Bruera E (2016) Integrating palliative care into the trajectory of cancer care. Nat Rev Clin Oncol 13:159–171. https://doi.org/10.1038/nrclinonc.2015.201 CrossRefPubMed

13.

Hui D, Bansal S, Strasser F et al (2015) Indicators of integration of oncology and palliative care programs: an international consensus. Ann Oncol 26:1953–1959. https://doi.org/10.1093/annonc/mdv269 CrossRefPubMedPubMedCentral

14.

Hui D, Kim YJ, Park JC et al (2015) Integration of oncology and palliative care: a systematic review. Oncologist 20:77–83. https://doi.org/10.1634/theoncologist.2014-0312 CrossRefPubMed

15.

Zhi WI, Smith TJ (2015) Early integration of palliative care into oncology: evidence, challenges and barriers. Ann Palliat Med 4:122–131. https://doi.org/10.3978/j.issn.2224-5820.2015.07.03 PubMed

16.

Peppercorn JM, Smith TJ, Helft PR et al (2011) American Society of Clinical Oncology Statement: toward individualized care for patients with advanced cancer. J Clin Oncol 29:755–760. https://doi.org/10.1200/JCO.2010.33.1744 CrossRefPubMed

17.

Ford E, Catt S, Chalmers A, Fallowfield L (2012) Systematic review of supportive care needs in patients with primary malignant brain tumors. Neuro-Oncology 14:392–404. https://doi.org/10.1093/neuonc/nor229 CrossRefPubMedPubMedCentral

18.

Schenker Y, Park SY, Maciasz R, Arnold RM (2014) Do patients with advanced cancer and unmet palliative care needs have an interest in receiving palliative care services? J Palliat Med 17:667–672. https://doi.org/10.1089/jpm.2013.0537 CrossRefPubMedPubMedCentral

19.

Hara REO, Hull JG, Lyons KD et al (2010) Impact on caregiver burden of a patient-focused palliative care intervention for patients with advanced cancer. Palliat Support Care 8:395–404. https://doi.org/10.1017/S1478951510000258.Impact CrossRef

20.

Given BA, Given CW, Sherwood PR (2012) Family and caregiver needs over the course of the cancer trajectory. J Support Oncol 10:57–64. https://doi.org/10.1016/j.suponc.2011.10.003 CrossRefPubMed

21.

Glajchen M (2004) The emerging role and needs of family caregivers in cancer care. J Support Oncol 2:145–155PubMed

22.

Hudson PL, Aranda S, Kristjanson LJ (2004) Meeting the supportive needs of family caregivers in palliative care: challenges for health professionals. J Palliat Med 7:19–25. https://doi.org/10.1089/109662104322737214 CrossRefPubMed

23.

Fried TR, Bradley EH, Towle VR, Allore H (2002) Understanding the treatment preferences of seriously ill patients. N Engl J Med 346:1061–1066. https://doi.org/10.1056/NEJMsa012528 CrossRefPubMed

24.

Hinchey J, Goldberg J, Linsky S et al (2016) Knowledge of cancer stage among women with nonmetastatic breast cancer. J Palliat Med 19:314–317. https://doi.org/10.1089/jpm.2015.0133 CrossRefPubMed

25.

Soylu C, Babacan T, Sever AR, Altundag K (2016) Patients’ understanding of treatment goals and disease course and their relationship with optimism, hope, and quality of life: a preliminary study among advanced breast cancer outpatients before receiving palliative treatment. Support Care Cancer 24:3481–3488. https://doi.org/10.1007/s00520-016-3182-6 CrossRefPubMed

26.

Bauman JR, Temel JS (2014) The integration of early palliative care with oncology care: The time has come for a new tradition. JNCCN J Natl Compr Cancer Netw 12:1763–1771CrossRef

27.

Muckel P (2011) Die Entwicklung von Kategorien mit der Methode der Grounded Theory. In: Historical Social Research, Supplement, 19, p 211–231. http://nbn-resolving.de/urn:nbn:de:0168-ssoar-288620

28.

Corbin JM, Strauss AL (2014) Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Sage Publications Ltd. 4th Edition. Revised

29.

Strauss AL, Corbin JM (1996) Grounded theory: Grundlagen qualitativer Sozialforschung. PsychologieVerlagsUnion, Beltz

30.

Gaertner J, Wolf J, Hallek M et al (2011) Standardizing integration of palliative care into comprehensive cancer therapy—a disease specific approach. Support Care Cancer 19:1037–1043. https://doi.org/10.1007/s00520-011-1131-y CrossRefPubMed

31.

Corbin JM, Strauss AL (2004) Weiterleben lernen : Verlauf und Bewältigung chronischer Krankheit. Verlag Hans Huber

32.

Kaasa S, Knudsen AK, Lundeby T, Loge JH (2017) Integration between oncology and palliative care: a plan for the next decade? Tumori J 103. doi: https://doi.org/10.5301/tj.5000602

33.

Ferrell BR, Temel JS, Temin S, et al (2016) Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 35. doi: https://doi.org/10.1200/JCO.2016.70.1474

34.

Verres R (1986) Subjektive Krankheitstheorie und Angst. In: Krebs und Angst (ed) Spezielle Aspekte bezüglich der Krebsvorsorge und Krebsfrüherkennung. Springer, Berlin, pp 50–56

35.

Flick U (1998) Subjektive Vorstellungen von Gesundheit und Krankheit: Überblick und Einleitung. In: Flick, U (ed): Wann fühlen wir uns gesund? Subjektive Vorstellungen von Gesundheit und Krankheit. Weinheim:Juventa Verlag, p 7–30. http://nbn-resolving.de/urn:nbn:de:0168-ssoar-39918

36.

Parsons T (1951) The social system. Free Press, New York

37.

Berglund M, Westin L, Svanström R, Sundler AJ (2012) Suffering caused by care-patients’ experiences from hospital settings. Int J Qual Stud Health Well Being 7:1–9. https://doi.org/10.3402/qhw.v7i0.18688 CrossRefPubMed

38.

Case DO, Andrews JE, Johnson JD, Allard SL (2005) Avoiding versus seeking: the relationship of information seeking to avoidance, blunting, coping, dissonance, and related concepts. J Med Libr Assoc 93:353–362PubMedPubMedCentral

39.

Murray SA, Kendall M, Mitchell G et al (2017) Palliative care from diagnosis to death. BMJ 356:1–5. https://doi.org/10.1136/bmj.j878

40.

Rohrmoser A, Preisler M, Bär K et al (2017) Early integration of palliative/supportive cancer care—healthcare professionals’ perspectives on the support needs of cancer patients and their caregivers across the cancer treatment trajectory. Support Care Cancer 25:1621–1627. https://doi.org/10.1007/s00520-017-3587-x CrossRefPubMed

41.

Kaba R, Sooriakumaran P (2007) The evolution of the doctor-patient relationship. Int J Surg 5:57–65. https://doi.org/10.1016/j.ijsu.2006.01.005 CrossRefPubMed

42.

Munhoz BA, Paiva HS, Abdalla BMZ et al (2014) From one side to the other: what is essential? Perception of oncology patients and their caregivers in the beginning of oncology treatment and in palliative care. Einstein (São Paulo) 12:485–491. https://doi.org/10.1590/S1679-45082014RC3091 CrossRef

43.

German guideline program in oncology evidenced-based guideline: palliative care for patients with incurable cancer. Short version. May 2015, URL: http://leilinienprogramm-onkologie.de/uploads/media/Guideline_Palliative_Care_Short_Version_01.pdf. February 2017 Awmf 1–268

44.

Arora NK (2003) Interacting with cancer patients: the significance of physicians’ communication behavior. Soc Sci Med 57:791–806. https://doi.org/10.1016/S0277-9536(02)00449-5 CrossRefPubMed

45.

Hui D, Park M, Liu D et al (2015) Attitudes and beliefs toward supportive and palliative care referral among hematologic and solid tumor oncology specialists. Oncologist 20:1–7. https://doi.org/10.1634/theoncologist.2015-0240 CrossRef

Titel: Early integration of palliative cancer care: patients’ and caregivers’ challenges, treatment preferences, and knowledge of illness and treatment throughout the cancer trajectory
verfasst von: Martina Preisler
Silke Heuse
Manuel Riemer
Friederike Kendel
Anne Letsch
Publikationsdatum: 01.03.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 3/2018
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-3911-5

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Early integration of palliative cancer care: patients’ and caregivers’ challenges, treatment preferences, and knowledge of illness and treatment throughout the cancer trajectory

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Purpose

Methods

Results

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Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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