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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
Sue Latter, Jane B Hopkinson, Elizabeth Lowson, Jane A Hughes, Jacki Hughes, Sue Duke, Sally Anstey, Michael I Bennett, Carl May, Peter Smith, Alison Richardson
BACKGROUND: Carers of people with advanced cancer play a significant role in managing pain medication, yet they report insufficient information and support to do so confidently and competently. There is limited research evidence on the best ways for clinicians to help carers with medication management. AIMS: To develop a pain medicines management intervention (Cancer Carers Medicines Management) for cancer patients' carers near the end of life and evaluate feasibility and acceptability to nurses and carers...
June 1, 2017: Palliative Medicine
Samantha M McEvedy, Jan Cameron, Eugene Lugg, Jennifer Miller, Chris Haedtke, Muna Hammash, Martha J Biddle, Kyoung Suk Lee, Justin A Mariani, Chantal F Ski, David R Thompson, Misook Lee Chung, Debra K Moser
BACKGROUND: End-of-life implantable cardioverter defibrillator deactivation discussions should commence before device implantation and be ongoing, yet many implantable cardioverter defibrillators remain active in patients' last days. AIM: To examine associations among implantable cardioverter defibrillator knowledge, patient characteristics and attitudes to implantable cardioverter defibrillator deactivation. DESIGN: Cross-sectional survey using the Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire...
June 1, 2017: Palliative Medicine
Lee Sharkey, Belinda Loring, Melanie Cowan, Leanne Riley, Eric L Krakauer
BACKGROUND: Previous estimates of global palliative care development have not been based on official country data. AIM: The World Health Organization Noncommunicable Disease Country Capacity Survey of World Health Organization member state officials monitors countries' capacities for the prevention and control of noncommunicable diseases. In 2015, for the first time, questions were included on a number of palliative care development metrics to generate baseline data for monitoring global palliative care development...
June 1, 2017: Palliative Medicine
Caroline Shulman, Briony F Hudson, Joseph Low, Nigel Hewett, Julian Daley, Peter Kennedy, Sarah Davis, Niamh Brophy, Diana Howard, Bella Vivat, Patrick Stone
BACKGROUND: Being homeless or vulnerably housed is associated with death at a young age, frequently related to medical problems complicated by drug or alcohol dependence. Homeless people experience high symptom burden at the end of life, yet palliative care service use is limited. AIM: To explore the views and experiences of current and formerly homeless people, frontline homelessness staff (from hostels, day centres and outreach teams) and health- and social-care providers, regarding challenges to supporting homeless people with advanced ill health, and to make suggestions for improving care...
June 1, 2017: Palliative Medicine
Natalia Salamanca-Balen, Jane Seymour, Glenys Caswell, David Whynes, Angela Tod
BACKGROUND: Patients with palliative care needs do not access specialist palliative care services according to their needs. Clinical Nurse Specialists working across a variety of fields are playing an increasingly important role in the care of such patients, but there is limited knowledge of the extent to which their interventions are cost-effective. OBJECTIVES: To present results from a systematic review of the international evidence on the costs, resource use and cost-effectiveness of Clinical Nurse Specialist-led interventions for patients with palliative care needs, defined as seriously ill patients and those with advanced disease or frailty who are unlikely to be cured, recover or stabilize...
June 1, 2017: Palliative Medicine
Renée McCulloch, Mohammed Sattar, Ellen M Henderson, Majella E Lane, Myra Bluebond-Langner
BACKGROUND: Children and infants with impaired swallow or compromised enteral absorption require alternative routes for administration of analgesia. Recent clinical guidance and practice for paediatric palliative care teams, who often treat such children, supports buccal morphine sulphate as a fast acting, effective and easily administered agent for pain relief. However, a consideration of the physicochemical properties and potency of morphine would suggest that it is not a suitable candidate for delivery via the transmucosal route, raising questions about its use in children and infants...
June 1, 2017: Palliative Medicine
Lesley A Henson, Irene J Higginson, Wei Gao
BACKGROUND: Emergency department visits towards the end of life by patients with cancer are increasing over time. This is despite evidence of an association with poor patient and caregiver outcomes and most patients preferring home-based care. AIM: To identify socio-demographic and clinical factors associated with end-of-life emergency department visits and determine the relationship between patients' prior emergency department use and risk of multiple (⩾2) visits in the last month of life...
June 1, 2017: Palliative Medicine
Emma Burns, Holly G Prigerson, Steve J Quinn, Amy P Abernethy, David C Currow
BACKGROUND: Providing care at end of life has consequences for caregivers' bereavement experience. 'Difficulty moving on with life' is an informative and unbiased symptom of prolonged grief disorder. Predictors of bereaved caregivers' ability to 'move on' have not been examined across the population. AIM: To identify the characteristics of bereaved hands-on caregivers who were, and were not, able to 'move on' 13-60 months after the 'expected' death of someone close...
June 1, 2017: Palliative Medicine
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