Search

Background: Depression is a common health problem among patients with cancer. The Edmonton Symptom Assessment System (ESAS) is one of many tools that have been used to evaluate depression in these patients. Nevertheless, the diagnostic performance and the appropriate cutoff point of the ESAS for the assessment of depression in these patients have varied in the studies. Purpose: To determine the diagnostic accuracy and the optimal cutoff point for the ESAS for the assessment of depression in patients with cancer. Data Sources: PubMed, Scopus, CINAHL, and Cochrane library databases from inception to September 18, 2016. Study Selection: Paired reviewers independently screened abstracts and full-text articles for all cross-sectional studies published in English and compared these with the ESAS in the depression (ESAS-D) subscale with reference to standard tests for the assessment of depression. Data Extraction: Two reviewers serially abstracted the data and independently assessed the risk of bias by using the Quality Assessment of Diagnostic Accuracy Studies 2. Data Synthesis: A total of 6 studies were eligible for review. Our meta-analysis showed the optimal cutoff point of the ESAS-D ≥ 4, with pooled sensitivity and specificity at 53% (95% confidence interval [CI]: 38%-67%) and 90% (95% CI: 82%-94%), respectively. The positive likelihood ratio and diagnostic odds ratio of the ESAS-D ≥ 4 were 5.2 (95% CI: 3.1-8.6) and 10 (95% CI: 5-19). There was a high degree of heterogeneity between the studies (P value <.001, I2 = 96%). Conclusion: We suggest that an ESAS-D ≥ 4 could be used to detect possible cases of depression in patients with cancer. Registration: Our study protocol was registered with the International Prospective Register of Systematic Reviews on October 4, 2016, and was last updated on January 11, 2017 (registration number CRD42016048288). [ABSTRACT FROM AUTHOR]

Purpose: Many terminally ill patients would prefer to stay and die in their own homes, but unfortunately, some may not be able to do so. Although there are many factors associated with successful home deaths, receiving palliative home visits from the multidisciplinary care teams is one of the key factors that enable patients to die at home. Our study was aimed to find whether there was any association between our palliative home care program and home death. Methods: A retrospective study was conducted in the Department of Family Medicine at Ramathibodi Hospital between January 2012 and May 2014. All of the patients who were referred to multidisciplinary palliative care teams were included. The data set comprised of patient’s profile, disease status, functional status, patient’s symptoms, preferred place of death, frequency of home visits, types of team interventions, and patient’s actual place of death. Multiple logistic regression was applied in order to determine the association between the variables and the probability of dying at home. Results: A total of 142 patients were included into the study. At the end of the study, 50 (35.2%) patients died at home and 92 (64.8%) patients died in the hospital. The multivariate logistic regression analysis demonstrated a strong association between multidisciplinary home care and home death (odds ratio 6.57, 95% confidence interval [CI] 2.48-17.38). Conclusion: Palliative home care was a significant factor enabling patients who want to die at home. We encourage health policy makers to promote the development of community-based palliative care programs in Thailand. [ABSTRACT FROM AUTHOR]

Background: Palliative care evidently increases the quality of life among the patients with advanced cancer. However, there are very few studies on the aspects of the physicians' ideas, conceptions, or the effects of their ideas in palliative care quality, especially in Asian countries. This study aimed to evaluate the conception and perspective on palliative care in Thai gynecologic oncologists., Methods: The online survey was distributed to all certificated Thai gynecologic oncologists. The survey could be accessed via working email address, hyperlink, or QR code during May 2020 and January 2021. A 5-point Likert scale captured the perspectives and concepts of palliative care. The association between respondents' characteristics and their choices of content in palliative care, together with their decision making in specified clinical scenarios was analyzed., Results: A total of 207 completed surveys from 320 Thai gynecologic oncologists were received (64.69% participation rate). They prospected a willingness to give the advices to both patients and their families (85.50%), and strongly agreed to introduce palliative care in any stage of cancer at the time of diagnosis (75.80%). The numbers of their palliative cases per year were 5-20 (57.97%) and the palliative care teams were available in their hospitals. They decided to offer early palliative care and do-not-resuscitate, especially for the elders, or patients with advance stages, or recurrent disease. We found that gynecologic oncologists who previously experienced a palliative care training did not show any difference in decision making in specified clinical scenarios, compared with who did not., Conclusions: Thai gynecologic oncologists responded to the conceptions and perspectives in palliative care. Their concepts of early and willingness to offer a palliative care especially in the elders, advanced stage, or recurrent patients were proven, regardless of the experience in palliative care training.