Balaguer, A. (Albert)

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    An international consensus definition of thewish to hasten death and Its related factors
    (2016) Cuervo M. A. (Miguel Angel); Maier M. A (Markus A); Rodin G. (Gary); Monforte-Royo, C. (Cristina); Alonso-Babarro, A. (Alberto); Altisent R. (Rogelio); Breitbart W. (William); Balaguer, A. (Albert); Porta-Sales, J. (Josep); Lichtenfeld S. (Stephanie); Schroepfer T. (Tracy); Centeno, C. (Carlos); Villavicencio-Chavez C.(Christian); Tomas-Sabado J. (Joaquin); Rosenfeld B. (Barry); Materstvedt L. J. (Lars Johan); Nabal, M. (María); Voltz R. (Ramón); Deliens, L. (Luc); Trelis J. (Jordi); Bellido-Perez M. (Mercedes); Aradilla-Herrero A. (Amor); Frerich G. (Gerrit); Limonero J. T. (Joaquín T); Gastmans C. (Chris)
    Abstract Background The desire for hastened death or wish to hasten death (WTHD) that is experienced by some patients with advanced illness is a complex phenomenon for which no widely accepted definition exists. This lack of a common conceptualization hinders understanding and cooperation between clinicians and researchers. The aim of this study was to develop an internationally agreed definition of the WTHD. Methods Following an exhaustive literature review, a modified nominal group process and an international, modified Delphi process were carried out. The nominal group served to produce a preliminary definition that was then subjected to a Delphi process in which 24 experts from 19 institutions from Europe, Canada and the USA participated. Delphi responses and comments were analysed using a pre-established strategy. Findings All 24 experts completed the three rounds of the Delphi process, and all the proposed statements achieved at least 79% agreement. Key concepts in the final definition include the WTHD as a reaction to suffering, the fact that such a wish is not always expressed spontaneously, and the need to distinguish the WTHD from the acceptance of impending death or from a wish to die naturally, although preferably soon. The proposed definition also makes reference to possible factors related to the WTHD. Conclusions This international consensus definition of the WTHD should make it easier for clinicians and researchers to share their knowledge. This would foster an improved understanding of the phenomenon and help in developing strategies for early therapeutic intervention.
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    Development of a guide to multidimensional needs assessment in the Palliative Care Initial Encounter (MAP)
    (Elsevier, 2023) Goni-Fuste, B. (Blanca); Pergolizzi, D. (Denise); Monforte-Royo, C. (Cristina); Alonso-Babarro, A. (Alberto); Belar, A. (Alazne); Crespo, I. (Iris); Güell, E. (Ernest); Julià-Torras, J. (Joaquim); Moreno-Alonso, D. (Deborah); Vicuña, M.N. (Maria Nabal); Pascual, A. (Antonio); Porta-Sales, J. (Josep); Rocafort, J. (Javier); Rodríguez-Prat, A. (Andrea); Rodríguez, D. (Dulce); Sala, C. (Carmen); Serrano-Bermudez, G. (Gala); Balaguer, A. (Albert)
    Context: Ensuring patient-centered palliative care requires a comprehensive assessment of needs beginning in the initial encounter. However, there is no generally accepted guide for carrying out this multidimensional needs assessment as a first step in palliative intervention. Objectives: To develop an expert panel-endorsed interview guide that would enable proactive and systematic Multidimensional needs Assessment in the Palliative care initial encounter (MAP). Methods: A preliminary version of the MAP guide was drafted based on a published literature review, published semistructured interviews with 20 patients, 20 family carers, and 20 palliative care professionals, and a nominal group process with palliative care professionals and a representative of the national patient's association. Consensus regarding its content was obtained through a modified Delphi process involving a panel of palliative care physicians from across Spain. Results: The published systematic literature review and qualitative study resulted in the identification of 55 needs, which were sorted and grouped by the nominal group. Following the Delphi process, the list of needs was reduced to 47, linked to six domains: Clinical history and medical conditions (n = 8), Physical symptoms (n = 17), Functional and cognitive status (n = 4), Psycho-emotional symptoms (n = 5), Social issues (n = 8), and Spiritual and existential concerns (n = 5). Conclusion: MAP is an expert panel-endorsed semi-structured clinical interview guide for the comprehensive, systematic, and proactive initial assessment to efficiently assess multiple domains while adjusting to the needs of each patient. A future study will assess the feasibility of using the MAP guide within the timeframe of the palliative care initial encounter.
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    Proactive and systematic multidimensional needs assessment in patients with advanced cancer approaching palliative care: a study protocol
    (BMJ Publishing Group, 2020) Pergolizzi, D. (Denise); Crespo, I. (Iris); Balaguer, A. (Albert); Monforte-Royo, C. (Cristina); Alonso-Babarro, A. (Alberto); Arantzamendi-Solabarrieta, M. (María); Belar, A. (Alazne); Centeno, C. (Carlos); Goni-Fuste, B. (Blanca); Julià-Torras, J. (Joaquim); Martínez, M. (Marina); Mateo-Ortega, D. (Dolors); May, L. (Luis); Moreno-Alonso, D. (Deborah); Nabal, M. (María); Noguera, A. (Antonio); Pascual, A. (Antonio); Pérez-Bret, E. (Encarnación); Rocafort, J. (Javier); Rodríguez-Prat, A. (Andrea); Rodríguez, D. (Dulce); Sala, C.; Serna, J. (Judith); Porta-Sales, J. (Josep)
    Introduction The benefits of palliative care rely on how healthcare professionals assess patients’ needs in the initial encounter/s; crucial to the design of a personalised therapeutic plan. However, there is currently no evidence-based guideline to perform this needs assessment. We aim to design and evaluate a proactive and systematic method for the needs assessment using quality guidelines for developing complex interventions. This will involve patients, their relatives and healthcare professionals in all phases of the study and its communication to offer clinical practice a reliable approach to address the palliative needs of patients. Methods and analysis To design and assess the feasibility of an evidence-based, proactive and systematic Multidimensional needs Assessment in Palliative care (MAP) as a semistructured clinical interview guide for initial palliative care encounter/s in patients with advanced cancer. This is a two-phase multisite project conducted over 36 months between May 2019 and May 2022. Phase I includes a systematic review, discussions with stakeholders and Delphi consensus. The evidence gathered from phase I will be the basis for the initial versions of the MAP, then submitted to Delphi consensus to develop a preliminary guide of the MAP for the training of clinicians in the feasibility phase. Phase II is a mixed-methods multicenter feasibility study that will assess the MAP’s acceptability, participation, practicality, adaptation and implementation. A nested qualitative study will purposively sample a subset of participants to add preliminary clues about the benefits and barriers of the MAP. The evidence gathered from phase II will build a MAP user guide and educational programme for use in clinical practice.