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Background: Red blood cell (RBC) transfusion is the standard treatment for anemia in advanced cancer. Nevertheless, guidelines for managing this condition are still not exhaustive. Objective: To investigate frequency, timing, and clinical characteristics associated with RBC transfusions in patients with advanced cancer assisted by at-home oncological care service and to evaluate the association between parameters at the entry and the possibility of receiving RBC transfusions during homecare. Design: Retrospective observational study without medication. Setting/Subjects: Patients with advanced cancer entered in homecare during 2021 living in Bologna (Italy). Measurements: Gender, tumor primary site, oncological therapy, and symptoms at the entry were considered as possible factors in a binary logistic regression for the possibility of receiving at least one RBC transfusion during assistance. Data about transfusions were analyzed, and the transfusion history for each patient from the entry to death was traced. Results: Among the 1108 patients admitted, 179 (16.2%) were given at least one RBC transfusion during homecare. Genitourinary, hematological malignancies, and being still in therapy for advanced cancer are associated with a higher probability of receiving RBC transfusion during assistance (p = 0.017, p < 0.001, and p = 0.032, respectively). Half of the patients (52%) underwent RBC transfusions less than a month before death. Duration of the assistance was correlated with the period from last transfusion to death (p < 0.001). Conclusion: Hematological and genitourinary cancer and being in simultaneous care at the entry were associated with transfusion. Although the appropriateness of this treatment remains to be defined in this population, transfused patients frequently received "late in life" transfusions. [ABSTRACT FROM AUTHOR]

Objective: Virtual Reality (VR) has been demonstrated to be an effective option for integrating psychological interventions in different therapeutic settings. This randomized controlled interventional study aims to assess the effects of VR, compared to tablet controlled intervention, on anxiety, depression, pain, and short‐term psychophysical symptoms in advanced cancer patients assisted at home. Methods: Participants were provided with a VR headset or a tablet (TAB) for 4 days. On the first and last day, anxiety and depression were measured by Hospital Anxiety and Depression Scale and pain by Brief Pain Inventory. Before and after each VR and tablet session, symptoms were collected by the Edmonton Symptom Assessment Scale (ESAS). Results: Fifty‐three patients (27 VR vs. 26 TAB) completed the study. Anxiety significantly decreased in the VR group after the 4‐day intervention. The analysis of ESAS showed a significant improvement in pain (p = 0.013), tiredness (p < 0.001), and anxiety (p = 0.013) for TAB group, and a significant reduction in tiredness (p < 0.001) in the VR group. Conclusions: Technological and user‐friendly tools, such as VR and tablets, might be integrated with traditional psychological interventions to improve anxiety and cancer‐related short‐term symptoms. Further studies are needed to better consolidate the possible beneficial effects of VR. [ABSTRACT FROM AUTHOR]

Objectives: Timely, effective and personalized identification of the multidimensional needs in patients with advanced cancer are major goals of appropriate palliative care (PC) delivery. However, there is considerable variation in structures, processes, and patient demographics that might influence the intensity of end-of-life care. This study aims to characterize patterns in clinical and demographic characteristics at the inception point and their association with the intensity of care during the last month of life in advanced cancer patients assisted at home. Methods: Cancer patients entered in home PC during 2020 in Italy were considered. The association between home PC services during the last month of life (primary outcome) and demographic data, performance status (Karnofsky Performance Score [KPS]), symptoms, and therapies at the entry was explored in this retrospective study. Results: Among 1,721 consecutive patients (919 in Centre-North and 802 in Centre-South Italy), patients from Centre-South were younger (p  < 0.001), had worse KPS (p  < 0.001), and shorter survival (p  = 0.010). Patient age was inversely associated with the number of total/physician/nurses services during the last month of life (p  < 0.001, p  = 0.001, and p  = 0.008, respectively). Patients with severe symptoms (asthenia, pain, and anxiety) at inception needed more PC services at the end of life (p  = 0.026, p  = 0.008, and p  = 0.038, respectively). The distribution of workload differed according to the geographical area, with higher number of PC services provided by physicians (p  < 0.001) in Centre-North and by nurses (p  = 0.002) in Centre-South. Significance of results: These findings highlight major disparity in access and nature of PC in a country with universal access to health services. Studies aimed at comparing PC models among different countries should pay attention to the local heterogeneity within each health-care system. [ABSTRACT FROM AUTHOR]

The study shows the effects of a death education workshop with Italian high school students. Students (N = 416) from 10 high schools throughout Italy participated: 212 in the experimental group and 204 in the control group. Four weekly, two-hour workshops about the themes of death, with theoretical lessons and an experiential artistic activity of photovoice. Results show that the students in the experimental group showed significantly increased self-efficacy levels and existential anxiety levels did not increase after death education intervention. Educating youth about death could give them the skills to improve the management of death-related events and cope with negative emotions. [ABSTRACT FROM AUTHOR]

This article presents the results of an experience of death education (DE) course with bibliodrama in Italian high schools, which focused on emotions and existential themes. The research analyzed the inability to recognize or describe one's own emotions (alexithymia), fantasy-proneness, and attitudes toward death in two different groups of students: one who took a course on DE (with 113 students) and another who did not participate in it (with 114 students). The use of a mixed method allowed this study to explore the quantitative results that the students indicated in the questionnaire and the qualitative open answers to the final question about how they had profited from this DE course. The results showed that the course had a positive effect, as the DE group significantly decreased alexithymia and negative attitudes toward death, particularly in fear and avoidance of death, making their representation of death less traumatic. [ABSTRACT FROM AUTHOR]

Objective: The study examines psychophysical distress of health-care professionals providing home-based palliative care. The aim is to investigate potential correlations between dimensions of burnout and different coping strategies.Methods: The present study is an observational cross-sectional investigation. The study involved all the home palliative care teams of an Italian nonprofit organization. Of a total of 275 practitioners working for the organization, 207 (75%) decided to participate in the study and complete questionnaires. Questionnaires employed were Maslach Burnout Inventory, General Health Questionnaire 12, Psychophysiological Questionnaire of CBA 2.0, and Coping Orientation to Problems Experienced. Professionals were physicians (50%), nurses (36%), and psychologists (14%). There were no exclusion criteria. Data were processed by SPSS 23 and analyses employed were Spearman ρ, Mann-Whitney U test, and 1-way analysis of variance on ranks.Results: Among participants, a low number of professionals were emotionally exhausted (11%) or not fulfilled at work (20%), whereas most of them complained of depersonalization symptoms (67%). Emotional exhaustion and depersonalization were found to be associated with avoidance coping strategies, whereas problem-solving and positive attitude were negatively associated with emotional exhaustion and positively with personal accomplishment. Moreover, using avoidance strategies was related to a worse psychological and physical condition.Conclusions: Findings suggest the need to provide professionals training programs about coping and communication skills tailored to fit the professionals' needs according to their work experience in palliative care and aimed at improving the approach to patients and relatives. [ABSTRACT FROM AUTHOR]

Introduction Studies on the end of life have shown that patients with advanced cancer prefer to die at home, and their caregivers agree with this choice. However, many cancer patients still die in hospital. Few data are available for Southern Europe and, in particular, for Italy. This study examined the factors associated with the place of death in a cohort of Italian patients with advanced cancer who were assisted by a palliative home care team. Methods We conducted a retrospective observational study to identify the association between place of death and clinical and demographic factors in a sample of 1374 patients. To analyze the factors associated with the place of death, we used univariate analyses by nonparametric tests and multinomial regression tests. Results Five variables related to the place of death were significant in univariate analysis, but only three were retained significant in the multinomial regression test. The older patients died more frequently at home rather than in hospital (P < 0.05); a greater number of home visits by a physician in the last 30 days of home care was correlated with dying at home (P < 0.001), a greater number of hospitalizations during the last 30 days of home care was correlated with dying in hospital and in hospice (P < 0.001). Conclusions The study shows that at the end of life the frequency of home visits by the palliative care physicians and a continuous at-home palliative service could favor dying at home in a cohort of cancer patients. [ABSTRACT FROM AUTHOR]

The article offers information on physical and emotional distress of cancer patients family caregivers. It informs about a study consisting of 107 family caregivers with participants completed a battery of self-report questionnaires including the Caregiver Burden Inventory, the Psychophysiological Questionnaire and the Beck Depression Inventory. It further states that there is significant positive correlation between worry measures and physical health of the participants.