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Palliative Medicine

Olli Haltia, Niilo Färkkilä, Risto Paavo Roine, Harri Sintonen, Kimmo Taari, Juha Hänninen, Juho Tuomas Lehto, Tiina Saarto
BACKGROUND: Palliative care needs are increasing as more people are dying from incurable diseases. Healthcare costs have been reported to be highest during the last year of life, but studies on the actual costs of palliative care are scarce. AIM: To explore the resource use and costs of palliative care among end-stage breast, colorectal and prostate cancer patients after termination of life-prolonging oncological treatments, that is, during the palliative care period...
September 1, 2017: Palliative Medicine
Elizabeth L Sampson, Bridget Candy, Sarah Davis, Anna Buylova Gola, Jane Harrington, Michael King, Nuriye Kupeli, Gerry Leavey, Kirsten Moore, Irwin Nazareth, Rumana Z Omar, Victoria Vickerstaff, Louise Jones
BACKGROUND: Increasing number of people are dying with advanced dementia. Comfort and quality of life are key goals of care. AIMS: To describe (1) physical and psychological symptoms, (2) health and social care service utilisation and (3) care at end of life in people with advanced dementia. DESIGN: 9-month prospective cohort study. SETTING AND PARTICIPANTS: Greater London, England, people with advanced dementia (Functional Assessment Staging Scale 6e and above) from 14 nursing homes or their own homes...
August 1, 2017: Palliative Medicine
Sigrid Dierickx, Luc Deliens, Joachim Cohen, Kenneth Chambaere
BACKGROUND: In the international debate about assisted dying, it is commonly stated that euthanasia is incompatible with palliative care. In Belgium, where euthanasia was legalized in 2002, the Federation for Palliative Care Flanders has endorsed the viewpoint that euthanasia can be embedded in palliative care. AIM: To examine the involvement of palliative care services in euthanasia practice in a context of legalized euthanasia. DESIGN: Population-based mortality follow-back survey...
August 1, 2017: Palliative Medicine
Stuart Jarvis, Lorna K Fraser
BACKGROUND: Recent estimates of the number of children and young people with life-limiting conditions derived from routine inpatient data are higher than earlier estimates using death record data. AIM: To compare routine inpatient data and death records as means of identifying life-limiting conditions in children and young people. DESIGN: Two national cohorts of children and young people with a life-limiting condition (primary cohort from England with a comparator cohort from Scotland) were identified using linked routinely collected healthcare and administrative data...
August 1, 2017: Palliative Medicine
Nishi Patel, Melanie Huddart, Helen Makins, Theresa Mitchell, Jane L Gibbins, Juan Graterol, Deborah Stevens, Paul Perkins
BACKGROUND: Intrathecal drug delivery is known to reduce pain in patients where conventional systemic analgesia has been ineffective or intolerable. However, there is little information regarding the effects of intrathecal drug delivery on quality of life and function in those with advanced, incurable cancer. AIM: Retrospective exploration of the views of bereaved carers regarding the physical and psychosocial effects of external tunnelled intrathecal drug delivery in patients with advanced incurable cancer...
August 1, 2017: Palliative Medicine
Anna K Winthereik, Peter Hjertholm, Mette Asbjoern Neergaard, Anders Bonde Jensen, Peter Vedsted
BACKGROUND: Previous studies of associations between home visits by general practitioners and end-of-life care for cancer patients have been subject to confounding. AIM: To analyse associations between general practitioners' propensity to pay home visits and the likelihood of hospitalisation and dying out of hospital among their cancer patients. DESIGN: A national register cohort study with an ecological exposure. Standardised incidence rates of general practitioner home visits were calculated as a measure for propensity...
August 1, 2017: Palliative Medicine
Harriet Mather, Ping Guo, Alice Firth, Joanna M Davies, Nigel Sykes, Alison Landon, Fliss Em Murtagh
BACKGROUND: Phase of Illness describes stages of advanced illness according to care needs of the individual, family and suitability of care plan. There is limited evidence on its association with other measures of symptoms, and health-related needs, in palliative care. AIMS: The aims of the study are as follows. (1) Describe function, pain, other physical problems, psycho-spiritual problems and family and carer support needs by Phase of Illness. (2) Consider strength of associations between these measures and Phase of Illness...
August 1, 2017: Palliative Medicine
Michael Hoerger
No abstract text is available yet for this article.
August 1, 2017: Palliative Medicine
Sharon Heng, Janet Hardy, Phillip Good
BACKGROUND: Intestinal obstruction and constipation are common conditions in patients with advanced neoplasms. Diatrizoate Meglumine has been used in the management of both these conditions without good quality evidence of its effectiveness and safety. AIM: This audit aimed to assess the usage, effectiveness and adverse effects of Diatrizoate Meglumine for intestinal obstruction and constipation in patients with advanced neoplasms. DESIGN: A retrospective chart review was undertaken...
August 1, 2017: Palliative Medicine
Amara Callistus Nwosu, Brendan Collins, Stephen Mason
No abstract text is available yet for this article.
August 1, 2017: Palliative Medicine
Lionel Pazart, Aurélie Godard-Marceau, Aline Chassagne, Aurore Vivot-Pugin, Elodie Cretin, Edouard Amzallag, Regis Aubry
BACKGROUND: Ensuring adequate end-of-life care for prisoners is a critical issue. In France, data investigating the impact of laws allowing release of seriously ill prisoners are lacking. AIM: To assess the number and characteristics of prisoners requiring palliative care in French prisons. DESIGN: A prospective, national survey collecting data over a 3-month period. SETTING/PARTICIPANTS: All healthcare units ( n = 190) providing care for prisoners in France...
July 1, 2017: Palliative Medicine
Christopher H Grossman, Joanne Brooker, Natasha Michael, David Kissane
BACKGROUND: Death anxiety is a common issue in adult patients with advanced cancer and can have a large impact on quality of life and end-of-life care. Interventions are available to assist but are scarcely used in everyday practice. AIM: To assess quantitative studies on interventions for adult patients with advanced cancer suffering from death anxiety. DATA SOURCES: MEDLINE, PsycINFO, Embase and CINAHL were searched to identify quantitative or mixed studies on death anxiety or relatable existential intervention studies in advanced cancer patients published from 1990 to December 2016...
July 1, 2017: Palliative Medicine
Kevin Brazil, Gillian Carter, Chris Cardwell, Mike Clarke, Peter Hudson, Katherine Froggatt, Dorry McLaughlin, Peter Passmore, W George Kernohan
BACKGROUND: In dementia care, a large number of treatment decisions are made by family carers on behalf of their family member who lacks decisional capacity; advance care planning can support such carers in the decision-making of care goals. However, given the relative importance of advance care planning in dementia care, the prevalence of advance care planning in dementia care is poor. AIM: To evaluate the effectiveness of advance care planning with family carers in dementia care homes...
July 1, 2017: Palliative Medicine
Lynn Bassett, Amanda F Bingley, Sarah G Brearley
BACKGROUND: In interactions between professional caregivers, patients and family members at the end of life, silence often becomes more prevalent. Silence is acknowledged as integral to interpersonal communication and compassionate care but is also noted as a complex and ambiguous phenomenon. This review seeks interdisciplinary experience to deepen understanding of qualities of silence as an element of care. AIM: To search for published papers which describe professional caregivers' experience of silence as an element of care, in palliative and other clinical, spiritual and pastoral care settings and to synthesise their findings...
July 1, 2017: Palliative Medicine
Brian Forzley, Lee Er, Helen Hl Chiu, Ognjenka Djurdjev, Dan Martinusen, Rachel C Carson, Gaylene Hargrove, Adeera Levin, Mohamud Karim
BACKGROUND: End-stage kidney disease is associated with poor prognosis. Health care professionals must be prepared to address end-of-life issues and identify those at high risk for dying. A 6-month mortality prediction model for patients on dialysis derived in the United States is used but has not been externally validated. AIM: We aimed to assess the external validity and clinical utility in an independent cohort in Canada. DESIGN: We examined the performance of the published 6-month mortality prediction model, using discrimination, calibration, and decision curve analyses...
July 1, 2017: Palliative Medicine
René Verreault, Marcel Arcand, Lucie Misson, Pierre J Durand, Edeltraut Kroger, Michèle Aubin, Maryse Savoie, Thomas Hadjistavropoulos, Sharon Kaasalainen, Annick Bédard, Annie Grégoire, Pierre-Hughes Carmichael
BACKGROUND: Improvement in the quality of end-of-life care for advanced dementia is increasingly recognized as a priority in palliative care. AIM: To evaluate the impact of a multidimensional intervention to improve quality of care and quality of dying in advanced dementia in long-term care facilities. DESIGN: Quasi-experimental study with the intervention taking place in two long-term care facilities versus usual care in two others over a 1-year period...
July 1, 2017: Palliative Medicine
Kexin Ang, Nilay Hepgul, Wei Gao, Irene J Higginson
BACKGROUND: Implementation fidelity is critical in evaluating effectiveness of interventions. AIM: Identifying and summarising strategies to improve and assess the level of reporting of implementation fidelity in randomised controlled trials of palliative care complex interventions. DESIGN: Systematic review. DATA SOURCES: Published and completed randomised controlled trials from 2000 to current evaluating effectiveness of specialised palliative care services on patient-centred outcomes in adult patients were examined...
July 1, 2017: Palliative Medicine
Jessica de Wit, Leonhard A Bakker, Annerieke C van Groenestijn, Leonard H van den Berg, Carin D Schröder, Johanna Ma Visser-Meily, Anita Beelen
BACKGROUND: Informal caregivers of patients with amyotrophic lateral sclerosis experience increased levels of caregiver burden as the disease progresses. Insight in the factors related to caregiver burden is needed in order to develop supportive interventions. AIM: To evaluate the evidence on patient and caregiver factors associated with caregiver burden in amyotrophic lateral sclerosis informal caregivers. DESIGN: A systematic review. DATA SOURCES: Four electronic databases were searched up to 2017...
July 1, 2017: Palliative Medicine
Irene J Higginson
No abstract text is available yet for this article.
September 2017: Palliative Medicine
Marco Pino, Ruth Parry, Luke Feathers, Christina Faull
BACKGROUND: Research using video recordings can advance understanding of healthcare communication and improve care, but making and using video recordings carries risks. AIM: To explore views of hospice patients, carers and clinical staff about whether videoing patient-doctor consultations is acceptable for research and training purposes. DESIGN: We used semi-structured group and individual interviews to gather hospice patients, carers and clinical staff views...
September 2017: Palliative Medicine
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