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Palliative Medicine

Lucy A Kernick, Karen J Hogg, Yvonne Millerick, Fliss E M Murtagh, Ayse Djahit, Miriam Johnson
BACKGROUND: People with advanced heart failure have repeated hospital admissions. Advance care planning can support patient preferences, but studies in people with heart failure have not been assessed. AIM: To evaluate the literature regarding advance care planning in heart failure. DESIGN: Systematic review and narrative analysis (PROSPERO CRD42017059190). DATA SOURCES: Electronic databases were searched (1990 to 23 March 2017): MEDLINE(R), Cochrane Library, CINAHL and Scopus...
September 20, 2018: Palliative Medicine
Kristel Paque, Robert Vander Stichele, Monique Elseviers, Koen Pardon, Tinne Dilles, Luc Deliens, Thierry Christiaens
BACKGROUND: Knowing the barriers/enablers to deprescribing in people with a life-limiting disease is crucial for the development of successful deprescribing interventions. These barriers/enablers have been studied, but the available evidence has not been summarized in a systematic review. AIM: To identify the barriers/enablers to deprescribing of medications in people with a life-limiting disease. DESIGN: Systematic review, registered in PROSPERO (CRD42017073693)...
September 19, 2018: Palliative Medicine
Suzanne Rainsford, Christine B Phillips, Nicholas J Glasgow, Roderick D MacLeod, Robert B Wiles
BACKGROUND: In rural settings, relationships between place and self are often stronger than for urban residents, so one may expect that rural people would view dying at home as a major feature of the 'good death'. AIM: To explore the concept of the 'good death' articulated by rural patients with life-limiting illnesses, and their family caregivers. DESIGN: Ethnography, utilising open-ended interviews, observations and field-notes. PARTICIPANTS: In total, 12 rural (town and farm) patients with life-limiting illnesses, 18 family caregivers and 6 clinicians, in the Snowy Monaro region of New South Wales, Australia, participated in this study over the course of the deaths of the patients...
September 19, 2018: Palliative Medicine
Maria Ec Schelin, Bengt Sallerfors, Birgit H Rasmussen, Carl Johan Fürst
BACKGROUND: There is a lack of knowledge about how the provision and availability of specialized palliative care relates to the quality of dying in hospital and community-based settings. AIM: We aimed to explore the quality of care during last week of life in relation to different levels of palliative care development. DESIGN: We investigated access to palliative care in Southern Sweden, where one region offers palliative care in accordance with European Association for Palliative Care guidelines for capacity, and the other region offers less developed palliative care...
September 19, 2018: Palliative Medicine
(no author information available yet)
No abstract text is available yet for this article.
September 5, 2018: Palliative Medicine
Cathy Payne, Sonja McIlfatrick, Philip Larkin, Lynn Dunwoody, Jackie Gracey
BACKGROUND: Limited evidence exists on the impact of palliative rehabilitation during systemic treatment of advanced cancer. AIM: To explore the experiences and perceptions of patients and healthcare professionals on the feasibility and acceptability of palliative rehabilitation during advanced lung cancer treatment. DESIGN: Qualitative design using individual semi-structured interviews transcribed verbatim and analysed thematically. SETTING/PARTICIPANTS: Eight patients and six healthcare professionals were recruited from a regional cancer centre in the United Kingdom following completion of a 6-week individualised behaviour change study which combined physical activity and nutritional guidance...
September 5, 2018: Palliative Medicine
Gunn Grande, Christine Rowland, Bernard van den Berg, Barbara Hanratty
BACKGROUND: Family carers provide vital support for patients towards end-of-life, but caregiving has considerable impact on carers' own health. The scale of this problem is unknown, as previous research has involved unrepresentative samples or failed to fully capture caregiving close to death. AIM: To quantify level of psychological morbidity and general health among a census sample of carers of people with cancer at end-of-life, compared to population reference data...
August 21, 2018: Palliative Medicine
Martin Schneider, François Chappuis, Sophie Pautex
BACKGROUND: Given the worldwide increase of chronic diseases, expatriate health workers on assignment with humanitarian emergency organisations can face more clinical situations that require advanced pain control or palliative care. Multiple reasons can prevent the provision of this care. AIM: To better know how health workers react to and cope with this dilemma. DESIGN: A qualitative interview study using inductive thematic analysis was performed...
August 16, 2018: Palliative Medicine
Melissa J Bloomer, Mari Botti, Fiona Runacres, Peter Poon, Jakqui Barnfield, Alison M Hutchinson
BACKGROUND: In geriatric inpatient rehabilitation settings, where the goal is to optimise function, providing end-of-life care can be challenging. AIM: The aim of this study is to explore how end-of-life care goals and decision-making are communicated in a geriatric inpatient rehabilitation setting. DESIGN: The design is a qualitative descriptive design using semi-structured individual and group interviews. SETTING/PARTICIPANTS: This study was conducted in a 154-bed facility in metropolitan Melbourne, Australia, providing geriatric inpatient rehabilitation for older patients; medical, nursing and allied health clinicians, who had cared for an inpatient who died, were recruited...
August 3, 2018: Palliative Medicine
Yolanda Wh Penders, Bregje Onwuteaka-Philipsen, Sarah Moreels, Gé A Donker, Guido Miccinesi, Tomás Vega Alonso, Luc Deliens, Lieve Van den Block
BACKGROUND: Measuring the quality of palliative care in a systematic way using quality indicators can illuminate differences between patient groups. AIM: To investigate differences in the quality of palliative care in primary care between people who died of cancer and people who died of organ failure. DESIGN: Mortality follow-back survey among general practitioners in Belgium, the Netherlands, and Spain (2013-2014), and Italy (2013-2015). A standardized registration form was used to construct quality indicators regarding regular pain measurement, acceptance of the approaching end of life, communication about disease-related topics with patient and next-of-kin; repeated multidisciplinary consultations; involvement of specialized palliative care; place of death; and bereavement counseling...
July 30, 2018: Palliative Medicine
Charlotte Pooler, Janice Richman-Eisenstat, Meena Kalluri
BACKGROUND: Idiopathic pulmonary fibrosis has an uncertain and rapid trajectory after diagnosis. Palliative care is rarely utilized, although both patients and caregivers experience a distressingly high symptom burden. Most patients die in hospital. AIM: The purpose of this study was to explore bereaved caregivers' experiences and perceptions of an early integrated palliative approach implemented at a Multidisciplinary Interstitial Lung Disease Clinic. DESIGN: A narrative approach was used, with thematic and content analysis of open-ended interviews...
July 30, 2018: Palliative Medicine
Esther Cooper, Ann Hutchinson, Zain Sheikh, Paul Taylor, Will Townend, Miriam J Johnson
BACKGROUND: Despite a fast-paced environment, the emergency clinician has a duty to meet the palliative patient's needs. Despite suggested models and interventions, this remains challenging in practice. AIM: To raise awareness of these challenges by exploring the experience of palliative care patients and their families and informal carers attending the emergency department, and of the clinicians caring for them. DESIGN: Qualitative systematic literature review and thematic synthesis...
July 1, 2018: Palliative Medicine
Natasha Lovell, Sabrina Bajwah, Matthew Maddocks, Andrew Wilcock, Irene J Higginson
BACKGROUND: Breathlessness remains a common and distressing symptom in people with advanced disease with few effective treatment options. Repurposing of existing medicines has been effective in other areas of palliative care, for example, antidepressants to treat pain, and offers an opportunity to deliver improved symptom control in a timely manner. Previous case series have shown reduced breathlessness following the use of sertraline (a selective serotonin reuptake inhibitor) in people with chronic obstructive pulmonary disease...
July 1, 2018: Palliative Medicine
Katherine E Sleeman, Javiera Leniz, Irene J Higginson, Katherine Bristowe
BACKGROUND: Prioritisation of end-of-life care by policymakers has been the subject of extensive rhetoric, but little scrutiny. In England, responsibility for improving health and care lies with 152 regional Health and Wellbeing Boards. AIM: To understand the extent to which Health and Wellbeing Boards have identified and prioritised end-of-life care needs and their plans for improvement. DESIGN: Qualitative documentary analysis of Health and Wellbeing Strategies...
July 1, 2018: Palliative Medicine
Kelly Sebring, Jo Shattuck, Julie Berk, Isabel Boersma, Stefan Sillau, Benzi M Kluger
BACKGROUND: There is increasing interest in applying palliative care approaches for patients with Parkinson's disease. Methodological studies are needed to validate palliative care outcome measures for Parkinson's disease to build this evidence base. As many patients with Parkinson's disease have cognitive and/or communication issues, proxy outcome measures may improve the inclusivity and relevance of research. AIM: To assess the validity of proxy caregiver reports for several potential palliative care outcome measures...
July 1, 2018: Palliative Medicine
Kirstine Skov Benthien, Mathilde Adsersen, Morten Aagaard Petersen, Eva Soelberg Vadstrup, Per Sjøgren, Mogens Groenvold
BACKGROUND: The use of chemotherapy in the last 14 days of life should be as low as possible. AIM: To study the factors related to the use of chemotherapy in the last 14 days of life and the factors related to concurrent antineoplastic treatment and specialized palliative care. DESIGN: This was a population-based cohort study. The data were collected from the Danish Register of Causes of Death, the Danish National Patient Register, and the Danish Palliative Care Database...
July 1, 2018: Palliative Medicine
Emily J Martin, Christina L Vaughan, Rabia Atayee, Jeremy M Hirst, Kaitlyn O'Donnell, Kyle P Edmonds
BACKGROUND: While opioid-induced myoclonus is well described, there are limited reports of opioid-induced chorea. Here we present the first case of chorea as a manifestation of opioid neurotoxicity due to hydromorphone. CASE PRESENTATION: A 20-year-old woman presenting with fevers and cutaneous lesions was diagnosed with hemophagocytic lymphohistiocytosis secondary to primary cutaneous lymphoma. Surgical resection of a cutaneous lesion was complicated by severe postoperative pain requiring rapid opioid dose escalation...
July 1, 2018: Palliative Medicine
Tinne Smets, Lara Pivodic, Ruth Piers, H Roeline W Pasman, Yvonne Engels, Katarzyna Szczerbińska, Marika Kylänen, Giovanni Gambassi, Sheila Payne, Luc Deliens, Lieve Van den Block
BACKGROUND: The provision of high-quality palliative care in nursing homes (NHs) is a major challenge and places demands on the knowledge and skills of the staff. AIM: This study assesses the palliative care knowledge of staff in NHs in Europe. DESIGN: Cross-sectional study using structured survey Setting/participants: Nurses and care assistants working in 322 representative samples of NHs in Belgium, the Netherlands, England, Finland, Poland and Italy...
July 1, 2018: Palliative Medicine
(no author information available yet)
10th World Research Congress of the European Association for Palliative Care (EAPC). Palliative Medicine, May 2018 32:1_suppl 3-330, doi: 10.1177/0269216318769196.
July 1, 2018: Palliative Medicine
Catriona Mayland, Sheila Payne
No abstract text is available yet for this article.
September 2018: Palliative Medicine
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