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Bernardis A, Gonzalez-Jaramillo V, Ebneter AS, Eychmüller S. Palliative care and COVID-19: a bibliometric analysis. BMJ Support Palliat Care 2023:spcare-2022-004108. [PMID: 36702518 DOI: 10.1136/spcare-2022-004108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To assess the impact of COVID-19 on the palliative care (PC) publication trend in the last 10 years and the collaboration between countries and main topics that were discussed in the papers. METHODS We used Scopus to identify publications on PC between 2012 and 2021 and publications about PC and COVID-19 between 2020 and 2021. We used VOSviewer to assess the main topics using the keywords from the papers and to assess country collaboration. RESULTS 1937 publications resulted. An increase in publications about PC was observed during the pandemic, only partially explained by OVID-19-related publications. Cancer-related PC publications were the ones with the most marked increase. We identified six clusters in the distribution of the keywords: bioethics, cancer, nursing home/telemedicine, public health, caring and PC following the WHO definition. The countries with higher number of publications were the United States and England. CONCLUSION We showed an increase in the number of PC publications in the last 2 years that was only partially explained by COVID-19-related publications. Most of the publications increase was due to cancer-related publications, since, during the time of the pandemic, publications on cancer and PC increased markedly, while those on heart failure, lung disease and dementia, remained constant.
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Affiliation(s)
| | - Valentina Gonzalez-Jaramillo
- University Center for Palliative Care, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Andreas S Ebneter
- University Center for Palliative Care, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Steffen Eychmüller
- University Center for Palliative Care, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
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Werner L, Fischer M, van Oorschot B, Ziegaus A, Schwartz J, Reuters MC, Schallenburger M, Henking T, Neuderth S, Simon S, Bausewein C, Roch C, Neukirchen M. [Generalist palliative care in hospitals during the first wave of the COVID-19 pandemic]. Dtsch Med Wochenschr 2022; 147:e102-e113. [PMID: 36279861 PMCID: PMC9592153 DOI: 10.1055/a-1918-6407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND In the research network of German university palliative care centers (PallPan), as part of Network University Medicine (NUM), recommendations for action were developed in regard to the care provided for seriously ill and dying patients during a pandemic. For this purpose, the experiences and needs of hospital staff working closely with patients outside of specialized palliative care units during the first wave of the COVID-19 pandemic were also examined. MATERIALS AND METHODS Nationwide online survey of 8,882 physicians, nurses and therapists working in acute inpatient care in the period from December 2020 to January 2021 by means of a newly developed and piloted questionnaire on changes, burdens and cooperation with specialized palliative care. Grouping based on the changes in the number of seriously ill and dying people in the first wave of the pandemic. Due to the exploratory character of the survey, the data were analyzed descriptively. RESULTS 505/8882 completed questionnaires were evaluated (5.7 %). 167/505 (33.1 %) of the respondents reported a lower quality of care for the critically ill and dying. 464/505 (91.8 %) reported exemptions in place for visiting the dying. The most frequently mentioned stress factor was the perceived loneliness of the seriously ill and dying 437/505 (86.5 %), followed by stricter hygiene rules 409/505 (81 %), increased workload 372/505 (73.3 %) and perceived psychological stress on relatives and survivors 395/505 (78.2 %). 141/505 (27.9 %) of respondents used Tablet PCs to support patient-family communication. 310/505 (61.4 %) involved palliative care professionals in patient care, and 356/505 (70.5 %) of respondents found other palliative care services helpful. CONCLUSION Experiences and suggestions for improving palliative care in pandemic times are integrated into the PallPan recommendations for action. Family visits should be allowed and supplemented by digital offers. Palliative Care should also be integrated into both pandemic and contingency plans.
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Affiliation(s)
- Liane Werner
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Marius Fischer
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Birgitt van Oorschot
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Anke Ziegaus
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Jacqueline Schwartz
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - Marie-Christine Reuters
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - Manuela Schallenburger
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - Tanja Henking
- Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Institut für Angewandte Sozialwissenschaften (IFAS), Würzburg
| | - Silke Neuderth
- Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Institut für Angewandte Sozialwissenschaften (IFAS), Würzburg
| | - Steffen Simon
- Zentrum für Palliativmedizin und Centrum für Integrierte Onkologie Aachen Bonn Cologne Düsseldorf (CIO ABCD), Universitätsklinikum Köln, Köln, Deutschland
| | - Claudia Bausewein
- Klinik und Poliklinik für Palliativmedizin, LMU-Klinikum München, Deutschland
| | - Carmen Roch
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Martin Neukirchen
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf, Deutschland,Klinik für Anästhesie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf, Deutschland
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Krumm N, Gebel C, Kloppenburg L, Rolke R, Wedding U. Prepared to Accompany the End of Life during Pandemics in Nursing Homes. J Clin Med 2022; 11:6075. [PMID: 36294395 PMCID: PMC9604931 DOI: 10.3390/jcm11206075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic confronted nursing homes with a variety of challenges to ensure the provision of palliative care for residents. PallPan-Implement aimed to adapt the recommendations of the National Strategy for the Care of Seriously Ill, Dying Adults and their Families in Times of Pandemic (PALLPAN) in such a way that nursing facilities can use and implement them. METHODS Based on 33 PALLPAN recommendations, we developed a questionnaire, conducted a pilot implementation for selected nursing homes, and asked for qualitative feedback. RESULTS The developed questionnaire contains 22 main questions. A three-stage pilot implementation with an introductory event, processing phase, and evaluation event took place in seven facilities. The facilities evaluated the developed questionnaire as helpful. Feedback from the facilities identified three major categories: (a) requirements for facilities should be realistic to avoid frustration, (b) the creation of a pandemic plan for palliative care only is impractical, (c) measures for the psychosocial support of staff is particularly necessary, but was perceived as difficult to implement. CONCLUSIONS The practical implementation of recommendations requires a concept and material tailored to facilities and areas. The strategy of PallPan Implement developed in this project appears to be target-oriented, well-received, and can be recommended for further implementation.
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Affiliation(s)
- Norbert Krumm
- Department of Palliative Medicine, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany
| | - Cordula Gebel
- Department of Internal Medicine II, Division of Palliative Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Lars Kloppenburg
- Department of Internal Medicine II, Division of Palliative Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Roman Rolke
- Department of Palliative Medicine, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany
| | - Ulrich Wedding
- Department of Internal Medicine II, Division of Palliative Medicine, University Hospital Jena, 07747 Jena, Germany
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Schwartz J, Schallenburger M, Tenge T, Batzler YN, Schlieper D, Kindgen-Milles D, Meier S, Niegisch G, Karger A, Roderburg C, Neukirchen M. Palliative Care e-Learning for Physicians Caring for Critically Ill and Dying Patients during the COVID-19 Pandemic: An Outcome Evaluation with Self-Assessed Knowledge and Attitude. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12377. [PMID: 36231676 PMCID: PMC9564513 DOI: 10.3390/ijerph191912377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
During the COVID-19 pandemic, the care of critically ill and dying patients in isolation wards, intensive care units (ICUs), and regular wards was severely impaired. In order to support physicians in communicative and palliative care skills, an e-learning tool was developed as part of the joint project "Palliative Care in Pandemic Times" (PallPan). This study investigates the feasibility of this e-learning tool. Secondly, we aim to analyze changes in knowledge and attitude upon completion of the e-learning tool. A 38-item questionnaire-based evaluation study with assessment of global and specific outcomes including ICU and non-ICU physicians was performed. In total, 24 questionnaires were included in the anonymous analysis. Feasibility was confirmed by a very high rate of overall satisfaction (94% approval), with relevance reaching 99% approval. Overall, we detected high gains in knowledge and noticeably lower gains on the attitude plane, with the highest gain in naming reasons for incorporating palliative care. The lowest learning gain on the attitude plane was observed when the participants were confronted with their own mortality. This study shows that e-learning is a feasible tool for gaining knowledge and even changing the attitudes of physicians caring for critically ill and dying patients in a self-assessment evaluation.
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Affiliation(s)
- Jacqueline Schwartz
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Manuela Schallenburger
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Theresa Tenge
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
- Department of Anesthesiology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Yann-Nicolas Batzler
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Daniel Schlieper
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Detlef Kindgen-Milles
- Department of Anesthesiology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Stefan Meier
- Department of Anesthesiology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Günter Niegisch
- Department of Urology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - André Karger
- Institute for Psychosomatic Medicine and Psychotherapy, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Christoph Roderburg
- Department of Gastroenterology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Martin Neukirchen
- Interdisciplinary Center for Palliative Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
- Department of Anesthesiology, University Hospital Duesseldorf, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
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Gauder S, Pralong A, Rémi C, Hodiamont F, Klinger I, Heckel M, Simon ST, Bausewein C. Development of a national strategy with recommendations for the care of seriously ill and dying people and their relatives in pandemics: A modified Delphi study. Palliat Med 2022; 36:1285-1295. [PMID: 36062725 PMCID: PMC9446431 DOI: 10.1177/02692163221114536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The SARS-CoV-2 pandemic is a constant challenge for health care systems, also in Germany. Care of seriously ill and dying people and their relatives is often neglected and suffering increased due to sub-optimal symptom management, visiting restrictions and lonely dying. The project "Palliative Care in Pandemics (PallPan)" intended to develop a national strategy including evidence- and consensus-based recommendations for the care of seriously ill and dying people and their relatives during pandemic times in Germany. AIM To reach consensus on evidence-based recommendations for the care of seriously ill and dying people and their relatives in pandemics. METHODS Three-step consensus process comprising two online Delphi rounds and an expert workshop conducted from April to June 2021. One hundred twenty experts from various areas of healthcare, administration, and politics in Germany were included. RESULTS During the consensus-process, pre-formulated evidence-based recommendations were refined step-by-step. This resulted in consensus on 33 recommendations on the topics of "supporting patients and their relatives," "supporting staff," and "supporting and maintaining structures and provision of palliative care." The recommendations address professional carers and various responsibilities on a governmental, federal state and municipal level, and in healthcare facilities. CONCLUSION We provide evidence and consensus-based recommendations for the care of seriously ill and dying people and their relatives in pandemics in Germany. This is an important step towards a pandemic preparedness and hopefully improves the future palliative care response to pandemics.
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Affiliation(s)
- Sonja Gauder
- Department of Palliative Medicine, LMU Munich, Munich University Hospital, Germany
| | - Anne Pralong
- Faculty of Medicine and University Hospital, Department of Palliative Medicine and Center for Integrated Oncology, University of Cologne, Germany
| | - Constanze Rémi
- Department of Palliative Medicine, LMU Munich, Munich University Hospital, Germany
| | - Farina Hodiamont
- Department of Palliative Medicine, LMU Munich, Munich University Hospital, Germany
| | - Isabell Klinger
- Department of Palliative Medicine, University Hospital Erlangen, Germany
| | - Maria Heckel
- Department of Palliative Medicine, University Hospital Erlangen, Germany
| | - Steffen T Simon
- Faculty of Medicine and University Hospital, Department of Palliative Medicine and Center for Integrated Oncology, University of Cologne, Germany
| | - Claudia Bausewein
- Department of Palliative Medicine, LMU Munich, Munich University Hospital, Germany
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Gerlach C, Ullrich A, Berges N, Bausewein C, Oechsle K, Hodiamont F. The Impact of the SARS-CoV-2 Pandemic on the Needs of Non-Infected Patients and Their Families in Palliative Care—Interviews with Those Concerned. J Clin Med 2022; 11:jcm11133863. [PMID: 35807148 PMCID: PMC9267922 DOI: 10.3390/jcm11133863] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/26/2022] [Accepted: 07/01/2022] [Indexed: 02/05/2023] Open
Abstract
During humanitarian crises, such as a pandemic, healthcare systems worldwide face unknown challenges. This study aimed to explore and describe the effect of the SARS-CoV-2 pandemic on the needs of non-infected patients and family caregivers in specialist palliative care, using qualitative, semi-structured interviews. Data were analyzed using inductive content analysis, following the framework approach. Thirty-one interviews were conducted with patients/family caregivers (15/16) in palliative care units/specialist palliative home care (21/10) from June 2020 to January 2021. Well-known needs of patients and family caregivers at the end of life remained during the pandemic. Pandemic- dependent themes were (1) implications of the risk of contagion, (2) impact of the restriction of social interactions, (3) effects on the delivery of healthcare, and (4) changes in the relative’s role as family caregiver. Restriction on visits limited family caregivers’ ability to be present in palliative care units. In specialist palliative home care, family caregivers were concerned about the balance between preserving social contacts at the end of life and preventing infection. Specialist palliative care during a pandemic needs to meet both the well-known needs at the end of life and additional needs in the pandemic context. In particular, attention should be given to the needs and burden of family caregivers, which became more multifaceted with regards to the pandemic.
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Affiliation(s)
- Christina Gerlach
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (A.U.); (K.O.)
- Department of Palliative Care, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-(0)-6221-56-310-683
| | - Anneke Ullrich
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (A.U.); (K.O.)
| | - Natalie Berges
- Department of Palliative Medicine, LMU University Hospital, 81377 Munich, Germany; (N.B.); (C.B.); (F.H.)
| | - Claudia Bausewein
- Department of Palliative Medicine, LMU University Hospital, 81377 Munich, Germany; (N.B.); (C.B.); (F.H.)
| | - Karin Oechsle
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (A.U.); (K.O.)
| | - Farina Hodiamont
- Department of Palliative Medicine, LMU University Hospital, 81377 Munich, Germany; (N.B.); (C.B.); (F.H.)
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Klinger I, Heckel M, Shahda S, Kriesen U, Schneider C, Kurkowski S, Junghanss C, Ostgathe C. COVID-19: Challenges and solutions for the provision of care to seriously ill and dying people and their relatives during SARS-CoV-2 pandemic - perspectives of pandemic response team members: A qualitative study on the basis of expert interviews (part of PallPan). Palliat Med 2022; 36:1092-1103. [PMID: 35637612 PMCID: PMC9248004 DOI: 10.1177/02692163221099114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND During the SARS-CoV-2 pandemic's initial waves, bans on visiting and isolation measures placed limits on providing services for seriously ill and dying people and their relatives. Pandemic response teams at governmental level (macro), at federal state and municipal level (meso) and in healthcare facilities (micro) played their role in pandemic management procedures. AIM To explore pandemic-related challenges and solutions of pandemic response teams regarding the provision of care to seriously ill and dying people and their relatives. Findings were to be integrated into a national strategy (PallPan). DESIGN Semi-structured expert interviews (10/2020-2/2021) analysed via structured content analysis. SETTINGPARTICIPANTS We interviewed 41 members, who discussed the work of 43 German pandemic response teams (micro n = 23; meso n = 20; no members were available at macro level) from 14 German federal states. RESULTS Twenty-nine of 43 teams took account of the needs of seriously ill and dying. Their main challenges resulted from pandemic-related legal requirements in hospitals and long-term care facilities. The implementation of such was in the remits of the meso level. Dysfunctional or non-existent communication between the levels was reported to be challenging. To foster patient-related solutions the micro level pandemic response teams supported individual decisions to enable patient-relative contact for example, visiting and saying goodbye outside, meeting via digital solutions. CONCLUSIONS Pandemic response teams evidently struggled to find appropriate solutions to ease pandemic-related impact on the care of seriously ill and dying patients and their relatives. We recommend bringing palliative care expertise on board.
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Affiliation(s)
- Isabell Klinger
- Department of Palliative Medicine, Comprehensive Cancer Center, CCC Erlangen – EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Maria Heckel
- Department of Palliative Medicine, Comprehensive Cancer Center, CCC Erlangen – EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Maria Heckel, Department of Palliative Medicine, Comprehensive Cancer Center, CCC Erlangen – EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstr. 12, Erlangen, 91054, Germany.
| | - Sophie Shahda
- Department of Palliative Medicine, Comprehensive Cancer Center, CCC Erlangen – EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ursula Kriesen
- Department of Medicine, Clinic III – CCC Mecklenburg-Vorpommern, Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Carolin Schneider
- Department of Medicine, Clinic III – CCC Mecklenburg-Vorpommern, Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Sandra Kurkowski
- Department of Palliative Medicine, Comprehensive Cancer Center, CCC Erlangen – EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christian Junghanss
- Department of Medicine, Clinic III – CCC Mecklenburg-Vorpommern, Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Christoph Ostgathe
- Department of Palliative Medicine, Comprehensive Cancer Center, CCC Erlangen – EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Saeed S, Tousif K, Fatir CA, Basit J, Lee KY, Tahir MJ. Impact of COVID-19 on palliative care of cancer patients: Perspectives from Pakistan. Ann Med Surg (Lond) 2022; 78:103705. [PMID: 35582458 PMCID: PMC9098974 DOI: 10.1016/j.amsu.2022.103705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic has adversely affected the survival rate and palliative care of cancer patients all over the globe. In Pakistan, there are only a few institutions and organizations which provide specialized facilities for palliative care. During the pandemic, these specialized facilities were further limited. As only less than one percent of people had access to palliative care across Pakistan in the pandemic, the situation can be improved by establishing more such departments, providing telemedicine, increasing social media campaigns, and highlighting the importance of palliative care among cancer patients.
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Affiliation(s)
- Sajeel Saeed
- Holy Family Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Kashif Tousif
- Holy Family Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan
| | | | - Jawad Basit
- Holy Family Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Ka Yiu Lee
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
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Klinger I, Heckel M, Shahda S, Krisen U, Stellmacher S, Kurkowski S, Junghanß C, Ostgathe C. [COVID-19 pandemic response teams: organization, competencies, and challenges-understanding and using structural realities]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:650-657. [PMID: 35503572 PMCID: PMC9063247 DOI: 10.1007/s00103-022-03542-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 04/25/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIM Germany has a federal state system. Pandemic response teams are key instruments of pandemic management. The aim of this article is to describe the structures and powers of pandemic response teams that were explored during a study on the care of the critically ill and dying in times of a pandemic (PallPan). The focus is on health-related pandemic response teams on the national state level (macrolevel) and federal and community level (mesolevel) as well as pandemic response teams in healthcare facilities (microlevel). METHODS Members of pandemic response teams took part in qualitative semi-structured interviews (October 2020-February 2021). The evaluation was carried out by means of qualitative structuring content analysis. RESULTS Forty-two persons reported on 43 crisis teams from 14 federal states. Response teams in healthcare facilities and public administration differ primarily with regard to their competencies. Officially predetermined regulations regarding the initiation, personal composition, tasks, responsibilities, and competencies of pandemic response teams are not predefined in Germany. The macrolevel defined the legal and financial conditions for pandemic management. Meso- and microlevel pandemic response teams bear responsibility for maintaining the provision of healthcare. The defaults of local public health authorities are decisive for the pandemic response team's work. Main tasks and measures were the provision of information and the procurement and distribution of resources. DISCUSSION In terms of preparing for future pandemic situations, the knowledge gained will help to address concerns about maintaining healthcare for specific population groups, such as seriously ill and dying people, to the locally differing responsible bodies, even under pandemic conditions.
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Affiliation(s)
- Isabell Klinger
- Palliativmedizinische Abteilung, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
| | - Maria Heckel
- Palliativmedizinische Abteilung, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Deutschland
| | - Sophie Shahda
- Palliativmedizinische Abteilung, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Deutschland
| | - Ursula Krisen
- Zentrum für Innere Medizin, Medizinische Klinik III - Hämatologie, Onkologie, Palliativmedizin, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Silke Stellmacher
- Zentrum für Innere Medizin, Medizinische Klinik III - Hämatologie, Onkologie, Palliativmedizin, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Sandra Kurkowski
- Palliativmedizinische Abteilung, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Deutschland
| | - Christian Junghanß
- Zentrum für Innere Medizin, Medizinische Klinik III - Hämatologie, Onkologie, Palliativmedizin, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Christoph Ostgathe
- Palliativmedizinische Abteilung, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Deutschland
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Abstract
Die Palliativversorgung kann in der „severe acute respiratory syndrome coronavirus type 2“(SARS-CoV-2)-Pandemie mit ihrem Fachwissen, ihren Fähigkeiten und Haltungen sowohl zur Therapiezielfindung als auch zur Entscheidungsfindung bei knappen Ressourcen beitragen. Sie liefert Empfehlungen zur Kontrolle der Symptome Luftnot, Unruhe und Angst und bietet Konzepte, wie die Kommunikation mit Patienten und Angehörigen trotz der pandemiebedingten Einschränkungen gelingen kann. In dem Projekt „Nationale Strategie für Palliativversorgung in Pandemiezeiten“ (PallPan) wurden auf der Grundlage von 16 Teilstudien insgesamt 32 Handlungsempfehlungen für Patienten, Angehörige/Pflegende, Mitarbeitende und Entscheidungsträger im Gesundheitswesen vorgelegt. Dazu gehören auch Hilfestellungen zur „Trauer in besonderen Zeiten“.
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Affiliation(s)
- Lukas Radbruch
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Venusberg Campus 1, 53127 Bonn, Deutschland
- Zentrum für Palliativmedizin, Helios Krankenhaus Bonn/Rhein-Sieg, Bonn, Deutschland
| | - Claudia Bausewein
- Klinik und Poliklinik für Palliativmedizin, LMU-Klinikum München, München, Deutschland
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