Journal of palliative medicine
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Background: Widespread implementation of specialist palliative care screening in oncology can be facilitated by efficient screening tools. It has been shown that patient-reported outcome measures are useful as screening tools and might reduce staff effort. Short forms could further improve feasibility. ⋯ A six-item IPOS short form that included the most predictive items of each of the three IPOS dimensions identified specialist palliative care need with 87.5% sensitivity (specificity = 56.4%; area under the curve = 0.786). Conclusions: IPOS short forms can facilitate efficient screening for specialist palliative care need, and the validation results are comparable to the full version of IPOS. Results also indicate which symptoms and problems might be most relevant as red flags in routine data or staff-based screening approaches.
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Background: Gastrostomy (feeding) tubes are one way of managing swallowing impairments (dysphagia) in patients living with serious illnesses. For patients, families, and health care providers to make well-informed, preference-aligned decisions regarding gastrostomy tube placement, each group must understand the other's goals, concerns, and perspectives. Objective: Thus, the goal of this scoping review is to characterize the factors influencing gastrostomy tube placement decisions for people with serious illnesses. ⋯ Finally, health care providers prioritized decisional control (58% of studies), knowledge (53%), quality of life (47%), extending life (42%), and societal factors (42%). Conclusions: Our results highlight key factors that may help center patient preferences when making gastrostomy tube-related decisions, as well as critical areas where more research is needed to help improve decision-making surrounding gastrostomy tube placement. Providing adequate knowledge and understanding patient preferences is critical for patients to make high-quality medical decisions regarding gastrostomy tubes.
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Background: Accurate prediction of next-day survival in imminently dying patients is crucial for facilitating timely end-of-life decisions. Objectives: To develop diagnostic models for predicting next-day survival in cancer patients with a Palliative Performance Scale (PPS) score of ≤20. Design: A multicenter, prospective, observational study. ⋯ The P1d-Survival-organ system score model revealed a 95.9% survival rate for score = 0, decreasing progressively to 46.7% for score = 4. The early signs model predicted a 95.2% survival rate in patients with normal consciousness and no liquid dysphagia. Conclusions: This study successfully developed three distinct models to predict next-day survival in cancer patients with PPS ≤20, offering vital tools for informed decision making in palliative care settings.