A5035255051- Palliative Care and End-of-Life Issues
- Cancer survivorship and care
- Childhood Cancer Survivors' Quality of Life
- Family Support in Illness
- Grief, Bereavement, and Mental Health
- Health Systems, Economic Evaluations, Quality of Life
- Health and Wellbeing Research
- Multiple and Secondary Primary Cancers
- Patient Dignity and Privacy
- Health, psychology, and well-being
- Clinical practice guidelines implementation
- Patient-Provider Communication in Healthcare
- Healthcare professionals’ stress and burnout
- COVID-19 and healthcare impacts
- Economic and Financial Impacts of Cancer
- Religion, Spirituality, and Psychology
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Cancer-related cognitive impairment studies
- Machine Learning in Healthcare
- Neutropenia and Cancer Infections
- Infection Control and Ventilation
- Intensive Care Unit Cognitive Disorders
- Child Therapy and Development
- Art Therapy and Mental Health
- Pain Management and Opioid Use
National Cancer Centre Singapore
2012-2025
National University Hospital
2018-2023
Duke-NUS Medical School
2021
Academy of Medicine
2020
Ngee Ann Polytechnic
2020
National University Cancer Institute, Singapore
2018
Background: The prevalence of burnout, psychological morbidity and the use coping mechanisms among palliative care practitioners in Singapore have not been studied. Aim: We aimed to study burnout its associations with demographic workplace factors as well mechanisms. Design: This was a multi-centre, cross-sectional all providers within public healthcare sector Singapore. Setting/participants: conducted hospital services, home hospice inpatient hospices participants were doctors, nurses...
Understanding goals of care for terminally ill patients at the end life is crucial to ensure that receive consistent with their preferences.
Abstract Background The impact and consequences of cancer on the patients their family caregivers (FCs) are closely intertwined. Caregivers’ burdens can be increased due to patients’ unmet needs unresolved problems. Additionally, caregivers’ may adversely affect own well-being health outcomes. This study aims determine palliative care factors associated with these in advanced solid FCs. Methods In a cross-sectional survey, 599 tumours FCs were recruited from largest ambulatory centre...
Advanced cancer significantly impacts quality of life patients and families as they cope with symptom burden, treatment decision-making, uncertainty costs treatment. In Singapore, information about the experiences advanced financial cost incur for end-of-life care is lacking. Understanding this needed to inform practice policy ensure continuity affordability at end life. The primary objectives Cost Medical Care Patients Serious Illness in Singapore (COMPASS) cohort study are describe changes...
Informal caregivers (IC) are key to enabling home deaths, where preferred, at the end-of-life. Significant morbidity from advanced cancer can make caregiving burdensome. However, knowledge about nature of burden for in Singapore is limited. Hence, objective this study was examine impact on quality life (QOL), mental health and work capacity among local ICs. Eligible English-speaking ICs hospitalized patients were recruited through non-random sampling. The Zarit Burden Interview (ZBI),...
ABSTRACT Objective: Physicians and nurses do not assess spirituality routinely, even though spiritual care is a vital part of palliative for patients with an advanced serious illness. The aim our study was to determine whether training program healthcare professionals on the taking history would result in improved patient quality life (QoL) well-being. Method: This cluster-controlled trial doctors nurses. Three seven clinical teams (clusters) received intervention, while other four served as...
Exercise can help cancer survivors manage sequela, treatment side effects, improve overall quality of life, and is recommended for most. The purpose this study was to investigate exercise behavior factors influencing engagement among at the National Cancer Centre, Singapore (NCCS).This cross-sectional inclusive all types stages who were least 21 years age had undergone chemotherapy NCCS. Surveys utilized assess survivor barriers facilitators retrospectively physical activity behaviors 4...
Abstract Background Ex-ante identification of the last year in life facilitates a proactive palliative approach. Machine learning models trained on electronic health records (EHR) demonstrate promising performance cancer prognostication. However, gaps literature include incomplete reporting model performance, inadequate alignment formulation with implementation use-case, and insufficient explainability hindering trust adoption clinical settings. Hence, we aim to develop an explainable...
PURPOSE The Accessible Cancer Care to Enable Support for Survivors (ACCESS) program adopts a multidisciplinary supportive care model with routine distress screening triage newly diagnosed cancer survivors additional support on the basis of levels. This study aimed evaluate clinical impact ACCESS over 1 year. METHODS We performed cluster random assignment at oncologist level in 1:1 ratio receive or usual care. Participants 21 years and older, breast gynecologic cancer, receiving National...
Background Family caregivers of patients with advanced cancer have been reported to provide long hours care and be at risk for poor psychological outcomes. Although research has focused on the nature caregiving burden, little attention paid identifying protective factors that improve caregiver Aim We examined relationship between caregivers’ time spent following outcomes: anxiety, depression esteem. Subsequently, we explored main moderating effects caregiver-perceived self-competency sense...
Facing the possibility of a surge COVID-19-infected patients requiring ventilatory support in Intensive Care Units (ICU), Singapore Hospice Council and Chapter Palliative Medicine Physicians forward its position on guiding principles that ought to drive allocation ICU beds role care these their families.
Palliative surgical oncology patients represent a unique group with complex needs who often require multidisciplinary input for the provision of timely and holistic care. The authors assembled multi-disciplinary palliative intervention team evaluated its association quality discussions on goals care (GOC) among advanced cancer undergoing interventions.This prospective cohort study analyzed interventions at single urban academic center from October 2019 to March 2022. In January 2021,...
Many patients with a solid metastatic cancer are treated aggressively during their last month of life. Using data from large prospective cohort study an advanced cancer, we aimed to assess the number and predictors aggressive interventions life among its association bereaved caregivers' outcomes.We used 345 deceased 600 patients. We surveyed every 3 months until death for physical, psychological functional health, end-of-life care preference palliative use. caregivers 8 weeks after patients'...
Abstract Objectives Patients with cancer often have unmet needs (e.g., physical, psychosocial, and emotional) during their journey, putting them at risk for distress. This study aimed to identify factors associated distress investigate the association between acute health-care services utilization in a cohort of breast gynecological patients across different survivorship stages. Methods was retrospective who visited National Cancer Centre Singapore September 2019 July 2020. Distress...
Supportive care models considering inclusivity and community services to improve integrated for cancer survivors are limited. In this case study, we described the implementation of a multidisciplinary model employing routine distress screening embedded pathways integrate across disciplines sectors, while remaining inclusive multi-ethnic multilingual population in Singapore. We reported outcomes after 18 months implementation.We reviewed model's process indicators from September 2019 February...
The 59-item Comprehensive Needs Assessment Tool (CNAT) for cancer patients is an English language survey developed in South Korea. objective of this study was to validate the version CNAT advanced Singapore.
Background: Persons with advanced cancer may participate in Phase 1 clinical trials – first-in-human that are conducted the main objectives of safety and dosing. The motivations for participation not well understood include hope cure. Aim: To explore perspectives persons order to understand participating trials, experiences while being on trial views palliative care provision. Design: Qualitative study a constructivist stance, using thematic analysis based upon grounded theory approach....
Background Clinical trial evidence on the effect of palliative care models in reducing aggressive end-of-life is inconclusive. We previously reported an integrated inpatient and medical oncology co-rounding model that significantly reduced hospital bed-days postulate additional aggressiveness. Objectives To compare a vs usual receipt treatment at end-of-life. Methods Secondary analysis open-label stepped-wedge cluster-randomized comparing two within setting. The involved pooling specialist...