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Content analysis of Advance Directives completed by patients with advanced cancer as part of an Advance Care Planning intervention : insights gained from the ACTION trial
Marieke Zwakman, Johannes JM van Delden, Glenys Caswell, Luc Deliens, F. Ingravallo, Lea J. Jabbarian, Anna Thit Johnsen, Ida Joanna Korfage, Alenka Mimič, C. Møller Arnfeldt, Urška Lunder, Branka Červ, Anja Simonič, Hana Kodba Čeh, Polona Ozbič, 2019, original scientific article

Abstract: Purpose. Writing an Advance Directive (AD) is often seen as a part of Advance Care Planning (ACP). ADs may include specific preferences regarding future care and treatment and information that provides a context for healthcare professionals and relatives in case they have to make decisions for the patient. The aim of this study was to get insight into the content of ADs as completed by patients with advanced cancer who participated in ACP conversations. Methods. A mixed methods study involving content analysis and descriptive statistics was used to describe the content of completed My Preferences forms, an AD used in the intervention arm of the ACTION trial, testing the effectiveness of the ACTION Respecting Choices ACP intervention. Results. In total, 33% of 442 patients who received the ACTION RC ACP intervention completed a My Preferences form. Document completion varied per country: 10.4% (United Kingdom), 20.6% (Denmark), 29.2% (Belgium), 41.7% (the Netherlands), 61.3% (Italy) and 63.9% (Slovenia). Content analysis showed that 'maintaining normal life' and 'experiencing meaningful relationships' were important for patients to live well. Fears and worries mainly concerned disease progression, pain or becoming dependent. Patients hoped for prolongation of life and to be looked after by healthcare professionals. Most patients preferred to be resuscitated and 44% of the patients expressed maximizing comfort as their goal of future care. Most patients preferred 'home' as final place of care. Conclusions. My Preferences forms provide some insights into patients' perspectives and preferences. However, understanding the reasoning behind preferences requires conversations with patients.
Keywords: advance care planning, psycho-oncology, medical oncology, ACTION study, cancer, end of life, dying persons
Published in DiRROS: 15.02.2021; Views: 1326; Downloads: 909
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33.
Development of an international Core Outcome Set (COS) for best care for the dying person : study protocol
Sofia C. Zambrano, Dagny Renata Faksvåg Haugen, Agnes van der Heide, Vilma A. Tripodoro, John Ellershaw, Carl-Johan Fürst, Raymond Voltz, Stephen Mason, María L. Daud, Gustavo De Simone, Urška Lunder, Hana Kodba Čeh, Miša Bakan, 2020, original scientific article

Abstract: Background: In contrast to typical measures employed to assess outcomes in healthcare such as mortality or recovery rates, it is difficult to define which specific outcomes of care are the most important in caring for dying individuals. Despite a variety of tools employed to assess different dimensions of palliative care, there is no consensus on a set of core outcomes to be measured in the last days of life. In order to optimise decision making in clinical practice and comparability of interventional studies, we aim to identify and propose a set of core outcomes for the care of the dying person. Methods: Following the COMET initiative approach, the proposed study will proceed through four stages to develop a set of core outcomes: In stage 1, a systematic review of the literature will identify outcomes measured in existing peer reviewed literature, as well as outcomes derived through qualitative studies. Grey literature, will also be included. Stage 2 will allow for the identification and determination of patient and proxy defined outcomes of care at the end of life via quantitative and qualitative methods at an international level. In stage 3, from a list of salient outcomes identified through stages 1 and 2, international experts, family members, patients, and patient advocates will be asked to score the importance of the preselected outcomes through a Delphi process. Stage 4 consists of a face-to-face consensus meeting of international experts and patient/family representatives in order to define, endorse, and propose the final Core Outcomes Set. Discussion: Core Outcome Sets aim at promoting uniform assessment of care outcomes in clinical practice as well as research. If consistently employed, a robust set of core outcomes for the end of life, and specifically for the dying phase, defined by relevant stakeholders, can ultimately be translated into best care for the dying person. Patient care will be improved by allowing clinicians to choose effective and meaningful treatments, and research impact will be improved by employing internationally agreed clinically relevant endpoints and enabling accurate comparison between studies in systematic reviews and/or in meta-analyses.
Keywords: palliative care, palliative medicine, Delphi technique, dying persons, Outcome research, last days of life, end of life
Published in DiRROS: 02.02.2021; Views: 1327; Downloads: 809
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34.
COVID-19 home confinement negatively impacts social participation and life satisfaction : a worldwide multicenter study
Achraf Ammar, Hamdi Chtourou, Omar Boukhris, Khaled Trabelsi, Liwa Masmoudi, Michael Brach, Bassem Bouaziz, Ellen Bentlage, Daniella How, Mona Ahmed, Boštjan Šimunič, Rado Pišot, Saša Pišot, 2020, original scientific article

Abstract: Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined. Therefore, an international online survey was launched in April 2020 to elucidate the behavioral and lifestyle consequences of COVID-19 restrictions. This report presents the preliminary results from more than one thousand responders on social participation and life satisfaction. Methods: Thirty-five research organizations from Europe, North-Africa, Western Asia, and the Americas promoted the survey through their networks to the general society, in 7 languages (English, German, French, Arabic, Spanish, Portuguese, and Slovenian). Questions were presented in a differential format with questions related to responses "before" and "during" confinement conditions. Results: 1047 participations (54% women) from Asia (36%), Africa (40%), Europe (21%), and others (3%) were included in the analysis. Findings revealed psychosocial strain during the enforced COVID-19 home confinement. Large decreases (p < 0.001) in the amount of social activity through family (%58%), friends/neighbors (%44.9%), or entertainment (%46.7%) were triggered by the enforced confinement. These negative effects on social participation were also associated with lower life satisfaction (%30.5%) during the confinement period. Conversely, the social contact score through digital technologies significantly increased (p < 0.001) during the confinement period with more individuals (+24.8%) being socially connected through digital technology. Conclusion: These preliminary findings elucidate the risk of psychosocial strain during the early COVID-19 home confinement period in 2020. Therefore, in order to mitigate the negative psychosocial effects of home confinement, implementation of national strategies focused on promoting social inclusion through a technology-based solution is strongly suggested.
Keywords: coronavirus, COVID-19, pandemic, public health, restrictions, isolation, home confinement, social participation, life satisfaction
Published in DiRROS: 18.12.2020; Views: 1326; Downloads: 1059
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35.
Maintaining everyday life praxis in the time of COVID-19 pandemic measures (ELP-COVID-19 survey)
Saša Pišot, Ivana Milovanović, Boštjan Šimunič, Ambra Gentile, Ksenja Bosnar, Franjo Prot, Antonino Bianco, Gianluca Lo Coco, Sunčica Bartoluci, Darko Katović, 2020, original scientific article

Abstract: Background The extreme social circumstances caused by declared COVID-19 pandemic deeply intervene people's everyday life and should not be neglected but seen through the view of social reality pinpointing the "ordinary" people. In this paper, authors explored basic segments of everyday and their subjective perception to what extent sleeping habits, physical inactivity, physical activity, nutritional habits and smoking have changed. Methods The online survey was conducted in nine European countries (Bosnia and Herzegovina, Croatia, Greece, Kosovo, Italy, Serbia, Slovakia, Slovenia and Spain) in 4108 participants, aged 15-82 years. The survey took place 30 to 40 days after WHO declared COVID-19 pandemic state, from April 15th to May 3rd, 2020. Results The results have shown 30%minutes longer sleeping time, 50% longer physical inactivity time, 65% longer screen time, 43% shorter walking time, 24% shorter sport time and 37% longer physical work time. Additionally, body mass gains (0.3%kg) could be explained in 20.6% with meals sizes, unhealthy food consumption, screen time and sport time. Further, respondents reported more regular meals (44%) and healthier meals with less alcohol consumption and less smoking, which have been positive outcomes of home confinement. Conclusion The findings draw attention to negative changes in everyday praxis (inactivity, body mass gain) after such a short period. Because of possible risk to population's health (especially of countries such as Italy and Spain with serious threat and more stringent measures), findings enable development of recommendations for maintaining healthy lifestyle habits with minimal negative health consequences in similar pandemic circumstances.
Keywords: coronavirus pandemic, COVID-19 pandemic measures, daily life praxis, physical activity, sleeping habits, eating habits, public health
Published in DiRROS: 18.12.2020; Views: 1458; Downloads: 710
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LIFE Podnebna pot 2050
Katarina Trstenjak, Boštjan Mali, 2018, popular article

Keywords: LIFE 2050, pariški podnebni sporazum, emisije, podnebje, strategije
Published in DiRROS: 13.02.2018; Views: 3465; Downloads: 695
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