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Palliative Medicine

Lucia Macken, Deepak Joshi, Jenny Messenger, Mark Austin, Jeremy Tibble, Louise Mason, Sumita Verma
BACKGROUND: Ascites, the commonest complication of cirrhosis, leads to frequent hospitalisations. Refractory ascites confers a median survival of 6 months without liver transplantation. In many, the management remains palliative (large-volume paracentesis). Despite calls for improvement, palliative and end-of-life care is not yet integrated into end-stage liver disease. Long-term abdominal drains are a palliative strategy in malignant ascites, but not end-stage liver disease. CASE PRESENTATION: A retrospective, single centre, case series review was performed of patients undergoing long-term abdominal drain placement for refractory ascites secondary to end-stage liver disease at a large teaching hospital between August 2011 and March 2013...
October 5, 2016: Palliative Medicine
(no author information available yet)
Philip J Larkin, Fliss Murtagh, Heather Richardson, Myra Bluebond Langner and Sheila Payne (2016) Collaboration: Securing a future for palliative care research. Palliative Medicine, September 2016 30:8 709-710, doi: 10.1177/0269216316661970.
October 3, 2016: Palliative Medicine
Siobhan Fox, Alison Cashell, W George Kernohan, Marie Lynch, Ciara McGlade, Tony O'Brien, Sean S O'Sullivan, Mary J Foley, Suzanne Timmons
BACKGROUND: Palliative care is recommended for non-malignant illnesses, including Parkinson's disease. However, past research with healthcare workers highlights unmet palliative needs in this population and referral rates to Specialist Palliative Care are low. Some healthcare workers perceive a 'fear' in their patients about introducing palliative care. However, less is known about the views of people with Parkinson's disease and their carers about palliative care. AIM: (1) To explore the palliative care and related issues most affecting people with Parkinson's disease and their families and (2) to examine perceptions about/understanding of palliative care...
September 28, 2016: Palliative Medicine
Lucas Morin, Régis Aubry, Luisa Frova, Roderick MacLeod, Donna M Wilson, Martin Loucka, Agnes Csikos, Miguel Ruiz-Ramos, Marylou Cardenas-Turanzas, YongJoo Rhee, Joan Teno, Joakim Öhlén, Luc Deliens, Dirk Houttekier, Joachim Cohen
BACKGROUND: To implement the appropriate services and develop adequate interventions, detailed estimates of the needs for palliative care in the population are needed. AIM: To estimate the proportion of decedents potentially in need of palliative care across 12 European and non-European countries. DESIGN: This is a cross-sectional study using death certificate data. SETTING/PARTICIPANTS: All adults (⩾18 years) who died in 2008 in Belgium, Czech Republic, France, Hungary, Italy, Spain (Andalusia, 2010), Sweden, Canada, the United States (2007), Korea, Mexico, and New Zealand (N = 4,908,114)...
September 28, 2016: Palliative Medicine
Clare Gardiner, Christine Ingleton, Tony Ryan, Sue Ward, Merryn Gott
BACKGROUND: It is important to understand the costs of palliative and end-of-life care in order to inform decisions regarding cost allocation. However, economic research in palliative care is very limited and little is known about the range and extent of the costs that are involved in palliative care provision. AIM: To undertake a systematic review of the health and social care literature to determine the range of financial costs related to a palliative care approach and explore approaches used to measure these costs...
September 26, 2016: Palliative Medicine
Fiona Runacres, Heidi Gregory, Anna Ugalde
BACKGROUND: Palliative care patients have numerous rehabilitation needs that increase with disease progression. Palliative rehabilitation practices and perceptions of palliative medicine physicians towards the role of rehabilitation are largely unstudied. AIM: To explore palliative medicine physicians' attitudes and perceptions towards rehabilitation delivered within inpatient palliative care units. DESIGN: Qualitative study utilizing semi-structured interviews...
September 26, 2016: Palliative Medicine
Phillipa J Malpas, Anneka Anderson, Pio Jacobs, Takawai Jacobs, Danielle Luinstra, Dolly Paul, Jim Rauwhero, Julie Wade, David Wharemate
AIM: To explore kaumātua attitudes towards physician aid-in dying, to gain a clear understanding of how such attitudes may influence and shape their expectations of medical care at the end of life and to assist health professionals in Aotearoa/New Zealand to address the healthcare needs of older Māori near the end of life. DESIGN: A kaupapa Māori consistent approach was undertaken. A systematic narrative technique was employed for the qualitative data analysis...
September 26, 2016: Palliative Medicine
Briony F Hudson, Linda Jm Oostendorp, Bridget Candy, Victoria Vickerstaff, Louise Jones, Monica Lakhanpaul, Myra Bluebond-Langner, Paddy Stone
BACKGROUND: Researchers report difficulties in conducting research with children and young people with life-limiting conditions or life-threatening illnesses and their families. Recruitment is challenged by barriers including ethical, logistical and clinical considerations. AIM: To explore how children and young people (aged 0-25 years) with life-limiting conditions or life-threatening illnesses and their families were identified, invited and consented to research published in the last 5 years...
September 8, 2016: Palliative Medicine
Sabine Pleschberger, Paulina Wosko
BACKGROUND: A growing number of older people are living in single households. They form a disadvantaged group within society as regards staying at home, most likely towards the end-of-life. It is mainly non-kin-carers who try to fulfil older people's desire for a home death, but very little is known about the challenges they face during their involvement. AIM: Getting insight into the engagement of non-kin-carers in the support for older people living alone, and a better understanding of the challenges they have to manage in end-of-life care...
September 8, 2016: Palliative Medicine
Marina Martínez, María Arantzamendi, Alazne Belar, José Miguel Carrasco, Ana Carvajal, María Rullán, Carlos Centeno
BACKGROUND: Dignity therapy is psychotherapy to relieve psychological and existential distress in patients at the end of life. Little is known about its effect. AIM: To analyse the outcomes of dignity therapy in patients with advanced life-threatening diseases. DESIGN: Systematic review was conducted. Three authors extracted data of the articles and evaluated quality using Critical Appraisal Skills Programme. Data were synthesized, considering study objectives...
August 26, 2016: Palliative Medicine
Shane Sinclair, Kate Beamer, Thomas F Hack, Susan McClement, Shelley Raffin Bouchal, Harvey M Chochinov, Neil A Hagen
BACKGROUND: Compassion is considered an essential element in quality patient care. One of the conceptual challenges in healthcare literature is that compassion is often confused with sympathy and empathy. Studies comparing and contrasting patients' perspectives of sympathy, empathy, and compassion are largely absent. AIM: The aim of this study was to investigate advanced cancer patients' understandings, experiences, and preferences of "sympathy," "empathy," and "compassion" in order to develop conceptual clarity for future research and to inform clinical practice...
August 17, 2016: Palliative Medicine
Li-Shan Ke, Xiaoyan Huang, Wen-Yu Hu, Margaret O'Connor, Susan Lee
BACKGROUND: Studies have indicated that family members or health professionals may not know or predict their older relatives' or patients' health preferences. Although advance care planning is encouraged for older people to prepare end-of-life care, it is still challenging. AIM: To understand the experiences and perspectives of older people regarding advance care planning. DESIGN: A systematic review of qualitative studies and meta-synthesis was conducted...
August 11, 2016: Palliative Medicine
David Hui, Eduardo Bruera
No abstract text is available yet for this article.
August 9, 2016: Palliative Medicine
Matthew J Allsop, Suzanne Kite, Sarah McDermott, Naomi Penn, Pablo Millares-Martin, Michael I Bennett
BACKGROUND: The need to improve coordination of care at end of life has driven electronic palliative care coordination systems implementation across the United Kingdom and internationally. No approaches for evaluating electronic palliative care coordination systems use in practice have been developed. AIM: This study outlines and applies an evaluation framework for examining how and when electronic documentation of advance care planning is occurring in end of life care services...
August 9, 2016: Palliative Medicine
Rinku Sutradhar, Lisa Barbera, Hsien-Yeang Seow
BACKGROUND: Prior work shows that palliative homecare services reduce the subsequent need for hospitalizations and emergency services; however, no study has investigated whether this association is present for emergency department visits of high acuity or whether it only applies to low-acuity emergency department visits. AIM: To examine the association between palliative versus standard homecare nursing and the rate of high-acuity and low-acuity emergency department visits among cancer decedents during their last 6 months of life...
August 9, 2016: Palliative Medicine
Wendy H Oldenmenger, Carin Cd van der Rijt
BACKGROUND: For patients with cancer-related pain, the numeric rating scale is the most frequently used instrument to measure pain intensity. In the literature, it has been suggested to interpret patient-reported ratings of pain in relation to the pain intensity which is acceptable to the individual patient. AIM: We aimed to examine the feasibility and course of acceptable pain intensity. DESIGN: A secondary analysis of a randomized controlled trial that tested the effectiveness of standard care versus standard care supplemented by a pain consultation combined with a patient pain education program...
August 9, 2016: Palliative Medicine
Michelle DiGiacomo, Yutaka Hatano, Jane Phillips, Joanne Lewis, Amy P Abernethy, David C Currow
BACKGROUND: Globally, most care for people with life-limiting illnesses is provided by informal caregivers. Identifying characteristics of caregivers that may have unmet needs and negative outcomes can help provide better support to facilitate adjustment. AIM: We compared characteristics, expressed unmet needs and outcomes for spousal caregivers, with other caregivers at the end of life, by gender and age. DESIGN: The South Australian Health Omnibus is an annual, random, face-to-face, cross-sectional survey wherein respondents are asked about end-of-life care...
August 8, 2016: Palliative Medicine
Breffni Hannon, Nadia Swami, Gary Rodin, Ashley Pope, Camilla Zimmermann
BACKGROUND: Early palliative care improves quality of life and satisfaction with care and is increasingly endorsed for patients with advanced cancer. However, little is known about the experience of receiving early palliative care from a patient and caregiver perspective. AIM: The aim of this qualitative study was to determine, from a participant perspective, the experience of receiving early palliative care and elements of that care. DESIGN: Qualitative grounded theory study using individual interviews...
August 5, 2016: Palliative Medicine
Natasha Lovell, Chris Jones, Dawn Baynes, Sarah Dinning, Katie Vinen, Fliss Em Murtagh
BACKGROUND: Meeting place-of-death preferences is an important measure of the quality of end-of-life care. Systematic review shows that 42% of end-stage kidney disease patients prefer home death. Little research has been undertaken on place of death. AIM: To understand patterns of place of death in patients with end-stage kidney disease known in one UK renal unit. DESIGN: A retrospective cohort study of all patients with chronic kidney disease stage 4-5, age ⩾75 and known to one UK renal unit, who died between 2006 and 2012...
August 5, 2016: Palliative Medicine
Chen Hsiu Chen, Su Ching Kuo, Siew Tzuh Tang
BACKGROUND: No systematic meta-analysis is available on the prevalence of cancer patients' accurate prognostic awareness and differences in accurate prognostic awareness by publication year, region, assessment method, and service received. AIM: To examine the prevalence of advanced/terminal cancer patients' accurate prognostic awareness and differences in accurate prognostic awareness by publication year, region, assessment method, and service received. DESIGN: Systematic review and meta-analysis...
August 4, 2016: Palliative Medicine
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