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J Hosp Palliat Nurs ; 22(6): 442-446, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-780570


This article presents the case of a mother of young children who has terminal stage IV cancer with whom providers had not discussed goals of care and prognostication. Communications about prognostication and goals of care are commonly initiated by physicians. Adolescents and young and middle-age adults with complex chronic or terminal illness often are not provided with timely, clear, complete information or palliative care support. Early palliative care for chronically ill patients facilitates discussions of prognostication and goals of care, in addition to providing symptom management. Such discussions do not diminish hope but rather allow patients to adjust hope to attain an optimal quality of life. Nurses can become active, confident advocates for patients with terminal illness of any age, and they are well positioned to assess patients and engage in goals of care and end-of-life conversations. It is especially important that palliative care nurses promote and maintain these early and comprehensive discussions during the COVID-19 pandemic because this population is at a high risk of complications from the coronavirus.

Breast Neoplasms/nursing , Coronavirus Infections/epidemiology , Nurse's Role , Palliative Care , Pneumonia, Viral/epidemiology , Professional-Family Relations , Adult , Betacoronavirus , COVID-19 , Female , Humans , Palliative Care/ethics , Pandemics , Professional-Family Relations/ethics , Prognosis , SARS-CoV-2
In Vivo ; 34(3 Suppl): 1667-1673, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-527842


BACKGROUND: COVID-19 pandemic required a marked re-allocation of healthcare resources, including at Breast Units. A patient-tailored program was developed to assess its efficacy regarding prevention of COVID-19 infection among patients with breast cancer undergoing surgery and healthcare workers (HCWs). PATIENTS AND METHODS: From March 9th to April 9th 2020, 91 patients were selected for elective surgery by means of: i) Pre-hospital screening aimed at avoiding hospitalization of symptomatic or suspicious COVID-19 patients, and ii) prioritisation of surgical procedure according to specific disease features. RESULTS: Eighty-five patients (93.4%) were fit for surgery, while five patients (5.5%) were temporarily excluded through 'telephone triage'; another two patients were excluded at in-hospital triage. A total of 71 out of 85 patients (83.5%) were diagnosed with invasive cancer, most of whom were undergoing breast-conserving surgery (61 out of 85 patients, 71.8%). The mean in-hospital stay was 2.2 days (SD=0.7 days). After hospital discharge, no patient needed re-admission due to post-operative complications; moreover, no COVID-19 infection among patients or HCWs was detected. CONCLUSION: Safe breast cancer surgery was accomplished for both patients and HCWs by means of a careful preoperative selection of patients and in-hospital preventative measures. This screening program can be transferred to high-volume Breast Units and it may be useful in implementing European Community recommendations for prevention of COVID-19 infection.

Breast Neoplasms/surgery , Carcinoma/surgery , Coronavirus Infections/prevention & control , Elective Surgical Procedures/statistics & numerical data , Infection Control/methods , Mastectomy/statistics & numerical data , Pandemics/prevention & control , Patient Selection , Pneumonia, Viral/prevention & control , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/epidemiology , Breast Neoplasms/nursing , COVID-19 , COVID-19 Testing , Carcinoma/drug therapy , Carcinoma/epidemiology , Carcinoma/nursing , Clinical Laboratory Techniques , Combined Modality Therapy , Coronavirus Infections/diagnosis , Female , Hospital Units/organization & administration , Humans , Italy/epidemiology , Length of Stay/statistics & numerical data , Lymphatic Metastasis/diagnostic imaging , Lymphoscintigraphy , Mastectomy, Segmental/statistics & numerical data , Neoadjuvant Therapy , Patient Discharge , Protective Devices , Sentinel Lymph Node Biopsy , Symptom Assessment , Telemedicine , Triage