Hemmingsenebbesen7556
High costs of cancer, and especially the increase in treatment costs, have raised concerns about the financial sustainability of publicly funded health care systems around the world. As cancers get more prevalent with age, treatment costs are expected to keep rising with aging populations. The objective of the study is to analyze the changes in cost of cancer care broken down into separate cost components and outcomes of cancer treatment in the Nordic countries 2012-2017.
We estimated direct costs of cancer based on retrospective data from national registers outpatient care and inpatient care in primary care and specialized care as well as medicine costs. The number of cancer cases and survival data was obtained from NORDCAN. Cancer was defined as ICD-10 codes C00-C97.
Healthcare costs of cancer in real terms increased in all countries CAGR was between 1 and 6% depending on the country. Medicine costs have increased rapidly (37-125%) in all countries during the observation period. In Finland and Denmarknally on a detailed level to understand the reasons for cost development. The registration of cost data, especially medicine costs, should be more standardized to enable better cost and outcomes comparisons between countries in the future.
To provide an evaluation of predictors of 6-month mortality in incident
bacteraemia cases.
A retrospective population-based study of 541 adult residents of Olmsted County, MN with monomicrobial
bacteraemia from 1 January 2006 through 31 December 2020. Multivariable Cox regression was used to investigate risk factors of 6-month mortality.
The median (interquartile range [IQR]) age of 541 patients with
bacteraemia was 66.8 (54.4-78.5) years and 39.6% were female. PF-05221304 The median (IQR) Charlson Comorbidity Index was 6 (3-9). Overall, 144 patients died during the six-month period following their initial episode (30-day and 6-month mortality = 16.5% and 26.7%, respectively). In a multivariable analysis, older age, ICU admission, and unknown source of infection were significant predictors of increased 6-month mortality. In contrast, having an infectious diseases (ID) consultation was associated with reduced mortality in the first 2 weeks of follow-up. Secondary analyses revealed an early benefit of ID consultation during the first 30 days of follow-up and that infective endocarditis was an additional predictor of 6-month mortality.
To our knowledge, this investigation represents the only US population-based study evaluating predictors of mortality in patients with
bacteraemia. The finding of a short-term survival benefit associated with early ID consultation may be due to more extensive diagnostic efforts.
To our knowledge, this investigation represents the only US population-based study evaluating predictors of mortality in patients with S. aureus bacteraemia. The finding of a short-term survival benefit associated with early ID consultation may be due to more extensive diagnostic efforts.Sexual dysfunction, which is defined as 'difficulty during any stage of the sexual encounter that prevents or impairs the individual or couple from enjoying sexual activity', is globally prevalent in males with prediabetes and diabetes. It is an early harbinger of cardiovascular diseases and has a profound impact on one's physical, mental, and social health. Among patients with either prediabetes or diabetes, the most common male sexual dysfunctions are hypogonadism, erectile dysfunction, and premature ejaculation. In Asia, although sexual health is an important factor of men's health, it is rarely discussed freely in real-life practice. Addressing sexual health in Asian males has always been challenging with multiple barriers at the levels of patients and health care providers. Therefore, the assessment and management of sexual dysfunction in routine clinical practice should involve a holistic approach with effective patient-provider communication. In this review, we discuss the epidemiology, pathophysiology, and the management of hypogonadism, erectile dysfunction, and premature ejaculation among males with either prediabetes or diabetes (type 1 and type 2), as well as the evidence gaps across Asia.
The use of the standardised nursing language aims to accurately represent clinical practice, contributing to proper documentation and the creation of evidence-based practice.
To validate nursing interventions (NI) for patients in palliative care, structuring these using the Dignity-Conserving Care Model.
A methodological study was conducted, developed according to the recommendations of the International Council of Nurses (ICN) and anchored in the Dignity-Conserving Care Model. The NI were developed in four stages 1) construction of NI, based in the International Standards Organisation's standard (18.1042014); 2) content validation by 26 expert nurses; 3) cross-mapping with the NIs contained in the International Classification for Nursing Practice (ICNP
) catalogue, Palliative Care for Dignified Dying, to identify those already existing in the catalogue; and 4) structuring the NI based on the concepts of the Dignity-Conserving Care Model.
209 NI were validated and grouped into categories, namely illness-related concerns; dignity-conservation repertoire; social dignity inventory. Of these, 183 were new and 26 already existed in the ICNP
Catalogue.
The study presents new insights into palliative care in Brazil and presents 183 new NI in addition to those already published by the ICN.
The study presents new insights into palliative care in Brazil and presents 183 new NI in addition to those already published by the ICN.
In the US, rising rates of opioid abuse has led to regulatory policies designed to curb opioid prescribing. While these policies generally exclude hospice and palliative care from prescribing restrictions, it is not known if these policies have had unintended consequences that affect opioid prescribing within hospice and palliative care.
A qualitative, descriptive design, guided by the Theory of Planned Behaviour, was utilised to conduct a study to answer the following two research questions 1) How has the opioid epidemic and related policies affected opioid prescribing practises among hospice and palliative care clinicians? and 2) How do hospice and palliative care clinicians perceive patients' end-of-life care has been impacted by the opioid epidemic and related policies?
Ten clinicians, comprising physicians and nurse practitioners working in hospice and palliative care settings, were directly interviewed one-on-one. Data analysis revealed that the opioid epidemic and related policies have had an impact on the patient, clinician, nursing and hospice and palliative care speciality.
As the broader medical community shifts away from opioid prescribing, care must be taken to ensure that hospice and palliative care patients still receive access to needed medications. Education is needed to assure that the relief of human suffering at end of life is prioritised.
As the broader medical community shifts away from opioid prescribing, care must be taken to ensure that hospice and palliative care patients still receive access to needed medications. Education is needed to assure that the relief of human suffering at end of life is prioritised.
Understanding family members' (FMs) perceptions of the care provided by nurses is crucial to facilitating positive outcomes for FMs.
To better understand how bereaved FMs perceive the care nurses provide in an inpatient hospice palliative care unit.
An exploratory study was conducted, with an interpretive description methodology. It was guided by the question 'How do bereaved FMs perceive nursing care in our unit, and how does this influence their bereavement experiences?' A total of 10 FMs-or close friends-who had a significant other die on a palliative care unit were interviewed.
Findings support the belief that positive relationships and interactions with nurses impact families' perceptions of end of life. Nurses create a therapeutic environment, building a sense of ease and meaning for patients and families.
Participation of nurses in rituals and patient-honouring practices after death may help families to cope and create positive memories during their grieving process.
Participation of nurses in rituals and patient-honouring practices after death may help families to cope and create positive memories during their grieving process.
Palliative care (PC) education should be an important part of both the graduate and undergraduate nursing curriculum. Nursing's philosophy of holistic care, which aims to improve the quality of life of patients and families, aligns with the primary objective of PC, positioning nurses to take the lead in expanding and improving PC delivery to all patients with a life-threatening diagnosis. The best way to facilitate this level of care is when staff nurses and advanced practice nurses work collaboratively.
To establish a new standard for nursing education that emphasises intradisciplinary care.
To fill the gap in PC education for nursing students, a dedicated elective PC class was developed for undergraduate and graduate students at a large midwestern University in the United States.
Through an interactive approach to learning, both groups were able to experience and more fully understand how they would work collaboratively with each other to provide high-quality PC.
Intradisciplinary PC education is an opportunity for students to learn the precepts of PC in an environment that will mirror their post-graduation practice environment.
Intradisciplinary PC education is an opportunity for students to learn the precepts of PC in an environment that will mirror their post-graduation practice environment.
Pain is one of the most frequent symptoms in cancer patients and has a negative impact on their physical, emotional and functional status, as well as their quality of life (QOL). This study evaluated the effectiveness of a pain management programme on pain control and QOL among patients with metastatic cancer receiving systemic chemotherapy. The authors investigated whether a pain management programme contributes to a better pain control and improvement in QOL in the outpatient setting.
The authors conducted a randomised, single-blinded, controlled, single-centre study of metastatic cancer patients experiencing cancer pain and requiring opioid therapy. Patients were enrolled from the Medical Oncology Outpatient Clinic, Songklanagarind Hospital, Prince of Songkla University, Thailand. Participants were randomly assigned to two strategies pain assessment and management based on the programme developed by the researchers ('pain management programme' arm), and pain management by individual medical oncologistsewise, QOL measures scored higher in the pain management programme group 71.2 ±15.4 versus 58.6 ±14.5 (P = 0.002) and 71.8 ±15.5 versus 55.4 ±16.3 (P = 0.002) at visit 1 and 2, respectively. Furthermore, there was a statistically significant positive correlation between pain control and QOL improvement (P = 0.011).
The investigated pain management programme significantly improved both pain control and QOL in metastatic cancer patients receiving systemic chemotherapy in the outpatient setting.
The investigated pain management programme significantly improved both pain control and QOL in metastatic cancer patients receiving systemic chemotherapy in the outpatient setting.
