Search Results for: Guida clinica per le cure palliative

Occorre garantire che ogni persona indipendentemente dall’età o dalla rarità della sua condizione riceva l’attenzione e le cure che merita: solo così potremo costruire un sistema sanitario e sociale davvero equo per tutti e sostenibile

Capacità controllo infezione in pazienti trattati dall’infanzia

Capacità controllo infezione in pazienti trattati dall’infanzia

Studio, obiettivo sarà indirizzare da subito questi pazienti verso altre cure

Consentirà di personalizzare cure sin dal momento della diagnosi

Studio su Nature Genetics, possibile scegliere subito altre cure

Objectives
Despite palliative care (PC) potentially improving quality of life, only a tiny proportion of patients with heart failure (HF) are receiving PC. Globally, PC for HF patients faces several challenges; however, a systematic assessment of the barriers and facilitators to PC of patients suffering from HF is lacking. We aimed to identify barriers and facilitators to offering PC to HF patients.

Design
The mixed-methods systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.

Data sources
PubMed, CINAHL, MEDLINE, PsycINFO, Web of Science were searched from onset of literature database to 24 March 2025.

Eligibility criteria
We included both qualitative studies and quantitative studies addressing barriers and facilitators to offering PC to patients with HF reported by healthcare providers, patients, family members and caregivers.

Data extraction and synthesis
Data extraction was done independently by two reviewers, and quality assessment was completed using the mixed-methods appraisal tool. The Capabilities-Opportunities-Motivations-Behaviour (COM-B) model and the Theoretical Domain Framework (TDF) were used to identify potential barriers and facilitators.

Results
48 studies were included out of 4168. 289 items related to barriers and 88 items related to facilitators were categorised into 72 themes. These themes were found to align with at least one of the 14 TDF domains and the COM-B model. ‘Environmental context and resources’ (eg, lack of time, human, facilities and equipment resources; 77.2% of barriers vs 22.8% of facilitators), ‘knowledge’ (eg, insufficient awareness and knowledge of PC and/or needs; 91.8% of barriers vs 8.2% of facilitators) and “‘social influences’ (eg, limited communication and collaboration between healthcare professionals; 58.7% of barriers vs 41.3% of facilitators) were the three TDF domains that encoded the largest amount of data.

Conclusions
This review identified key barriers to PC for HF patients, primarily involving resource limitations, knowledge gaps and poor interdisciplinary collaboration. Findings highlight the need for targeted interventions addressing systemic and knowledge-related challenges.

PROSPERO registration number
CRD42023484807.

39 quelle firmate dagli oncologi Aiom. Il caso delle terapie neoadiuvanti

Dagli esperti del Bambino Gesù, niente sole fino ai 6 mesi

‘Oltre 25 miliardi per cure non garantite, non è fuga da Ssn’

To the Editor A recent randomized clinical trial of palliative care initiated in the emergency department (ED) is commendable in its scale, effort, and intent. Even though its findings were null, and the authors discussed future research, the most obvious conclusion was not addressed.

In Reply We thank Dr Wong for his thoughtful review of our palliative care trial. We agree that the complexities around caring for persons with serious illness who present to the ED cannot be overstated. Also, safe ED discharge requires a team approach, including close coordination and communication between primary care clinicians, specialists, and other members of the interdisciplinary team. Two points require clarification when considering whether the ED is “the place” to integrate palliative care.

An important aspect of caring for patients with complex chronic illness, especially older adults with cancer, is understanding how treatment is tolerated. Yet barriers to seeking this information are many, including the debilitation caused by not only illness but also the adverse effects of treatment itself, which can effectively silence patients. In “Treatment Tolerability,” poetry becomes a vehicle for addressing these challenges, and imagining what patients may experience when receiving treatment (in this case, multiple transfusions). Immediately noticeable is the lack of capitalization and punctuation throughout the poem, which suggests the subordination of patients to the imperatives of urgent treatment in the quest for a cure. Adverse effects, such as confusion and weakness, are then conveyed by the haphazard rhyming in the poem; breathlessness, perhaps, is felt in the short, enjambed lines. Even the vague nursery rhyme feel of the poem seems a caution against how clinicians might infantilize and speak down to patients when attempting to assess treatment tolerability. That the poem’s speaker is not the patient but an observer seems to underscore the risk, even with the best of intentions, of supplanting the patient’s voice with our own. Finally, the speaker’s recognition of the inescapability of these concerns, and the frustration, shared by clinicians, that often accompanies them, are deftly expressed in the searching lines, “blindfolded in a fog of pain/covering everything/with a god-like fabric/because no mercy/is bright enough to pass/this fatigue onto another.”

Inaugurata struttura per cure alto livello a italiani e locali