Effectiveness of palliative care services: A

population-based study of end-of-life care for

cancer patients

Kelompok 2
Kelas E
 Introduction

Increases in life expectancy and improvements in diagnotic and

therapeutic options for patients with chronic diseases including many
types of cancer have led to an expanded need for palliative care services.
Over the past 20 years, many efforts have been made to improve the care
of seriously ill patients through community and hospital programs
emphasizing palliation. Nonetheless, recent studies have demonstrated
that a substantial part of resourse utilization at the of life is the result of
acute hospital care and potentially excessive, intensive medical and
surgical treatments, despite evidence that high intensity treatments in
patients with advance cancer are not connected with survival differences
or improved quality of life for patients and their family

2
 Con’t..
In reccent years, the Emilia Romagna Region (RER), Italy, introduced
new care models of integrated hospital and community management. Patient
with diagnostic cancer can receive palliative care programs, home care is
typically initiated by a general practitioner which give patients access to in home
services including measuring and recording vital signs, collecting samples for
testing, performing routine laboratory test, recording food and fluid intake,
performing placement of catheters, dressing wounds, and monitoring patients
for and reporting adverse reactons, home care is provided by licensed health
professionals including nurses, physicians, and physical therapists. Patients
were classified as receiving palliative care programs if they had either a home
care episode or a hospice stay at any point in the last 6 months of life.
Otherwise, they were classified as having received no palliative care.

The Power of PowerPoint |

thepopp.com
3
 Method
In this journal data source cohort studies are used in population-based research. In the journal researchers
used retrospective, and observational in January 2013 and December 2015 RER residents died with cancer
totaling 34,357 residents. To be clearer in conducting research researchers identified patients using
outpatient diagnostic data.
In the journal explained that in palliative care in individuals registration in this palliative care uses non
palliative care controls using matching methods. This method is based on algorithms that are repeated for a
number of interactions.
Sample characteristics were evaluated through standard differences and calculated as differences in
standard deviation units. there are 25 influences Palliative care in each outcome is estimated with a
conditional logistic regression model.

The Power of PowerPoint |

thepopp.com
4
 Results
Based on the results of the journal analysis the results obtained were
that patients undergoing palliative care experienced a much lower increase
compared to all aggressive care indicators such as hospitals and other
treatments. The research conducted showed that the dominant cancer patients
were women with a presentation of 55.6% with an age of 65 years and above
about 78.9%. In 2013 and 2015 patients undergoing palliative care were around
21,108 who received palliative care over the past 6 months, and 10,933 patients
received home care, there were 5109 patients hospitalized based on facilities
only, and there were 5066 patients in both environments.
The average time spent by a patient during the palliative care process is
45 days. The level of use varies according to the stage. Multivariable analysis
shows that palliative care is associated with patient characteristics

The Power of PowerPoint |

thepopp.com
5
 Discuss
In an era that emphasizes patient centered care, our findings have relevant
implications for health systems that provide care for advanced cancer patients. In addition,
acute hospital care continues to be the chief driver of regional spending. In the present study,
palliative care services were used more frequently by elderly patients, female, and patients
who live outside of urban areas. This is most likely due to several factors. the expectation of
life of people has increased dramatically over the past 50years, however in different ways
between the sexes; in addition, a growing number of individuals live alone one person house
holds are almost one in three or separate from family. Claims based diagnoses may be
inaccurate and the number of patients dying from poor-prognosis cancers may be
underestimated. It is also possible that some people with poor prognosis cancer received in
home palliative care and were not hospitalized in the last 180 days of life. While we do not
expect that this number is large, the inclusion of these patients, had it been possible, would
have strengthened our findings of the positive impact of palliative care.

The Power of PowerPoint |

thepopp.com
6
 Application in nursing

 A nurse is also required to be able to provide excellent nursing care services, both to the
patient and to the patient's family. A nurse who is able to provide nursing care services
appropriately and is able to establish a relationship of mutual trust, so that he can intervene
that can maintain the patient's health condition and accelerate his recovery in full.
 Care services that can be provided are by examining the control of symptoms and pain felt by
cancer patients. So that if you have been able to study later analyzing nurses can directly find
out what the patient's problems are and what they are complaining about. The treatment of
patient palitivity is expected to improve the quality of life in patients and this palliative care
begins when the patient is diagnosed and until the family has finished mourning.
 As a health worker, a nurse is required to have knowledge about palliative care in patients,
how to improve the quality of life, and can help patients to die as expected. Positive treatment
also not only helps patients but also helps families like helping families in financial
management because the aim of the positive in this journal is to reduce the cost of care and

The Power of PowerPoint |

thepopp.com
7
Terima Kasih Kelompok 2

Inka Mawardi P Nuzula Eka Wardhani

Iif Adwiyatu Iffa Findasari.

Fakultas Keperawatan
8
Universitas Jember