Helene Hudson Lecture: Taking an “upstream” approach in the care of dying cancer patients: The case for a palliative approach

Kelli Stajduhar, Carolyn Tayler

Abstract


Advances in technology and drug therapy have resulted in cancer patients living longer with malignant disease. However, most of these patients will face the end of life much sooner than the general population. Adopting a “palliative approach” is one innovation that has the potential to promote anticipatory planning and promote enhanced end-of-life care. Yet, in much of the western world, this upstream orientation has rarely been achieved. An emphasis on providing palliative care late in the illness trajectory has resulted in many challenges for the care of people with advanced cancer. We highlight a nursing research initiative, The Initiative for a Palliative Approach in Nursing: Evidence and Leadership (iPANEL), that aims to develop evidence to inform the integration of a palliative approach into the care of people with advancing chronic life-limiting conditions. Oncology nurses have an important role to play in facilitating a palliative approach, transforming the ways in which cancer patients are cared for within our health care system.


Full Text:

PDF

References


Bakitas, M., Byock, I.R., Ahles, T.A., Lyons, K.D., Hegel, M.T., Balan, S.,

… Tosteson, T.D. (2009). Effects of a palliative care intervention

on clinical outcomes in patients with advanced cancer: The

project ENABLE II randomized controlled trial. JAMA: The

Journal of the American Medical Association, 302(7), 741–749.

Buss, M.K., Lessen, D.S., Sullivan, A.M., Von Roenn, J., Arnold, R.M.,

& Block, S.D. (2007). A study of oncology fellows’ training in endof-

life care. The Journal of Supportive Oncology, 5(5), 237.

Canadian Association of Nurses in Oncology. (2006). Practice

Standards and Competencies for the Specialized Oncology Nurse.

Vancouver, BC: Author.

Coventry, P.A., Grande, G.E., Richards, D.A., & Todd, C.J. (2005).

Prediction of appropriate timing of palliative care for older

adults with non-malignant life-threatening disease: A systematic

review. Age and Ageing, 34(3), 218–227.

Davis, S., Kristjanson, L.J., & Blight, J. (2003). Communicating with

families of patients in an acute hospital with advanced cancer.

Cancer Nursing, 26(5), 337–345.

Ferrell, B., Virani, R. Malloy, P., & Kelly, K. (2010). The preparation of

oncology nurses in palliative care. Seminars in Oncology Nursing,

(4), 259-265.

Gattellari, M., Voigt, K.J., Butow, P.N., & Tattersall, M.H.N. (2002).

When the treatment goal is not cure: Are cancer patients

equipped to make informed decisions? Journal of Clinical

Oncology, 20(2), 503–513.

Gofton, T.E., Jog, M.S., & Schulz, V. (2009). A palliative approach to

neurological care: A literature review. The Canadian Journal of

Neurological Sciences, 36(3), 296–302.

Hardin, K.A., Meyers, F., & Louie, S. (2008). Integrating palliative

care in severe chronic obstructive lung disease. COPD: Journal of

Chronic Obstructive Pulmonary Disease, 5(4), 207–220.

Hauser, J., Harney, C., Bass, K., Rodrigue, M.K., Sileo, M., Araneta, N.,

… Thibodaux, L. (2011). Navigation and palliative care. Cancer,

(S15), 3583–3589.

Jackson, K., Mooney, C., & Campbell, D. (2009). The development

and implementation of the pathway for improving the care of

the dying in general medical wards. Internal Medicine Journal,

(10), 695–699.

Kristjanson, L.J. (2005). Directions in palliative care nursing

research: Impeccable care, timing, and complexity. The Canadian

Journal of Nursing Research, 37(2), 13–13.

Lamont, E.B., & Christakis, N.A. (2002). Physician factors in the

timing of cancer patient referral to hospice palliative care.

Cancer, 94(10), 2733–2737.

Liang, W., Burnett, C.B., Rowland, J.H., Meropol, N.J., Eggert, L.,

Hwang, Y., … Mandelblatt, J.S. (2002). Communication between

physicians and older women with localized breast cancer:

Implications for treatment and patient satisfaction. Journal of

Clinical Oncology: Official Journal of the American Society of

Clinical Oncology, 20(4), 1008–1016.

Lynn, J. (2005). Living long in fragile health: The new demographics

shape end of life care. In Improving end of life care: Why has it

been so difficult? Hastings Center Report Special Report, 35(6),

S14–S18.

Mackillop, W.J., Stewart, W.E. & Ginsberg, A.D. (1988). Cancer

patients’ perceptions of their disease and its treatment. British

Journal of Cancer Care, 58(3), 355–358.

Mathew, A., Cowley, S., Bliss, J., & Thistlewood, G. (2003). The

development of palliative care in national government policy in

England, 1986–2000. Palliative Medicine, 17(3), 270–282.

Mitra, S. & Vadivelu, N. (2013). Multidisciplinary approach and

coordination of care. In A.D. Kaye & J.M. Berger (Eds.), Essentials

of Palliative Care. New York, NY: Springer.

Morita, T., Akechi, T., Ikenaga, M., Kizawa, Y., Kohara, H.,

Mukaiyama, T….Uchitomi, Y. (2004). Communication about

ending of anticancer treatment and transition to palliative care.

Annals of Oncology, 15(10), 1551–1557.

Morrison, R.A., & Meier, D. (2004). Palliative care. New England

Journal of Medicine, 350(25), 2582–2590.

Osta, B.E., Palmer, J.L., Paraskevopoulos, T., Pei, B., Roberts, L.E.,

Poulter, V.A., … Bruera, E. (2008). Interval between first palliative

care consult and death in patients diagnosed with advanced

cancer at a comprehensive cancer center. Journal of Palliative

Medicine, 11(1), 51–57.

Ronaldson, S., & Devery, K. (2001). The experience of transition

to palliative care services: perspectives of patients and nurses.

International Journal of Palliative Nursing, 7(4), 171–177.

Saunders, C.M., Dame. (2006). Cicely Saunders: Selected writings

-2004. Oxford: Oxford University Press.

Schofield, P., Carey, M., Love, A., Nehill, C., & Wein, S. (2006). ‘Would

you like to talk about your future treatment options?’ Discussing

the transition from curative cancer treatment to palliative care.

Palliative Medicine, 20, 397–406.

Stajduhar, K.I. (2011). Chronic illness, palliative care, and the

problematic nature of dying. The Canadian Journal of Nursing

Research, 43(3), 7–15.

Stajduhar, K.I., Thorne, S.E., McGuinness, L., & Kim-Sing, C. (2010).

Patient perceptions of helpful communication in the context of

advanced cancer: Patient perceptions of helpful communication.

Journal of Clinical Nursing, 19(13–14), 2039–2047.

Statistics Canada. (2012). Seniors. In Canada Year Book 2012.

Statistics Canada Catalogue no. 89-611-XIE. Ottawa, Ontario,

–423.

Temel, J.S., Pirl, W.F., Billings, J.A., Lynch, T.J., Greer, J.A.,

Muzikansky, A., … Jacobsen, J. (2010). Early palliative care for

patients with metastatic non-small-cell lung cancer. The New

England Journal of Medicine, 363(8), 733–742.

Thorne, S.E., & Stajduhar, K.I. (2012). Patient perceptions of

communications on the threshold of cancer survivorship:

Implications for provider responses. Journal of Cancer

Survivorship: Research and Practice, 6(2), 229–237.

Waller, A., & Caroline, N.L. (2000). Handbook of palliative care in

cancer (2nd ed.). Oxford, England: Butterworth-Heinemann.

Wenrich, M., Curtis, J., Shannon, S., Carline, J., Ambrozy, D., &

Ramsey, P. (2001). Communicating with dying patients within

the spectrum of medical care from terminal diagnosis to death.

Archives of Internal Medicine, 161(6), 868–874.

Widger, K., Cadell, S., Davis, B., Siden, H., & Steele, R. (2012).

Pediatric palliative care in Canada. In C. Knapp, V. Madden & S.

Fowler-Kerry (Eds.), Pediatric Palliative Care: Global Perspectives.

New York, NY: Springer.

World Health Organization. (2014). Global Atlas of palliative care at

the end of life. Retrieved from Worldwide palliative care alliance/

World Health Organization: http://www.who.int/nmh/Global_

Atlas_of_Palliative_Care.pdf?ua=1

Zachariae, R., Pedersen, C.G., Jensen, A.B., Ehrnrooth, E., Rossen, P.B.,

& von der Maase, H. (2003). Association of perceived physician

communication style with patient satisfaction, distress, cancerrelated

self-efficacy, and perceived control over the disease.

British Journal of Cancer, 88(5), 658–665.

Zimmermann, C., Swami, N., Krzyzanowska, M., Hannon, B., Leighl,

N., Oza, A., … Lo, C. (2014). Early palliative care for patients with

advanced cancer: A cluster-randomised controlled trial. Lancet.

Advance online publication. doi:10.1016/S0140-6736(13)62416-2


Refbacks

  • There are currently no refbacks.