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Palliative Medicine

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https://www.readbyqxmd.com/read/28631529/use-of-buccal-morphine-in-the-management-of-pain-in-children-with-life-limiting-conditions-results-of-a-laboratory-study
#1
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
https://www.readbyqxmd.com/read/28631517/what-factors-influence-emergency-department-visits-by-patients-with-cancer-at-the-end-of-life-analysis-of-a-124-030-patient-cohort
#2
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
https://www.readbyqxmd.com/read/28627971/moving-on-factors-associated-with-caregivers-bereavement-adjustment-using-a-random-population-based-face-to-face-survey
#3
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
https://www.readbyqxmd.com/read/28627303/the-surprise-question-in-paediatric-palliative-care-a-prospective-cohort-study
#4
Kimberley Burke, Lucy Helen Coombes, Antoinette Menezes, Anna-Karenia Anderson
BACKGROUND: The question 'would you be surprised if this patient died in the next 12-months' is widely used for identifying adult patients in the last year of life. However, this has not yet been studied in children. AIM: To assess the prognostic accuracy of the surprise question when used by a multidisciplinary team to predict survival outcomes of children with life-limiting conditions over a 3 and 12 month period. DESIGN: A prospective cohort study...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28604265/a-multi-professional-educational-intervention-to-improve-and-sustain-respondents-confidence-to-deliver-palliative-care-a-mixed-methods-study
#5
Elizabeth Reed, Jennifer Todd, Sally Lawton, Robert Grant, Clair Sadler, Jane Berg, Caroline Lucas, Max Watson
BACKGROUND: Education has been highlighted as fundamental in equipping healthcare professionals with essential knowledge and skills to provide good end-of-life care. Multiprofessional educational programmes have a positive influence on knowledge, attitude and confidence but few have sought to understand the longer term impact on care delivery. The European Certificate in Essential Palliative Care is an 8-week home-study-based programme for healthcare professionals and is currently run in nine centres...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28604233/distance-education-methods-are-useful-for-delivering-education-to-palliative-caregivers-a-single-arm-trial-of-an-education-package-palliative-caregivers-education-package
#6
Liz Forbat, Rowena Robinson, Rachel Bilton-Simek, Karemah Francois, Marsha Lewis, Erna Haraldsdottir
BACKGROUND: Face-to-face/group education for palliative caregivers is successful, but relies on caregivers travelling, being absent from the patient, and rigid timings. This presents inequities for those in rural locations. AIM: To design and test an innovative distance-learning educational package (PrECEPt: PalliativE Caregivers Education Package). DESIGN: Single-arm mixed-method feasibility proof-of-concept trial (ACTRN12616000601437). The primary outcome was carer self-efficacy, with secondary outcomes focused on caregiver preparedness and carer tasks/needs...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28604232/barriers-and-facilitators-influencing-death-at-home-a-meta-ethnography
#7
Abdul Samad Wahid, Meelad Sayma, Shiraz Jamshaid, Doa'a Kerwat, Folashade Oyewole, Dina Saleh, Aaniya Ahmed, Benita Cox, Claire Perry, Sheila Payne
BACKGROUND: In many countries, achieving a home death represents a successful outcome from both a patient welfare and commissioning viewpoint. Significant variation exists in the proportion of home deaths achieved internationally, with many countries unable to meet the wishes of a large number of patients. This review builds on previous literature investigating factors influencing home death, synthesising qualitative research to supplement evidence that quantitative research in this field may have been unable to reach...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28604224/arts-based-palliative-care-training-education-and-staff-development-a-scoping-review
#8
Benjamin Mark Turton, Sion Williams, Christopher R Burton, Lynne Williams
BACKGROUND: The experience of art offers an emerging field in healthcare staff development, much of which is appropriate to the practice of palliative care. The workings of aesthetic learning interventions such as interactive theatre in relation to palliative and end-of-life care staff development programmes are widely uncharted. AIM: To investigate the use of aesthetic learning interventions used in palliative and end-of-life care staff development programmes. DESIGN: Scoping review...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28604172/opioids-combined-with-antidepressants-or-antiepileptic-drugs-for-cancer-pain-systematic-review-and-meta-analysis
#9
Chris M Kane, Matthew R Mulvey, Sophie Wright, Cheryl Craigs, Judy M Wright, Michael I Bennett
BACKGROUND: Combining antidepressant or antiepileptic drugs with opioids has resulted in increased pain relief when used for neuropathic pain in non-cancer conditions. However, evidence to support their effectiveness in cancer pain is lacking. AIM: To determine if there is additional benefit when opioids are combined with antidepressant or antiepileptic drugs for cancer pain. DESIGN: Systematic review and meta-analysis. Randomised control trials comparing opioid analgesia in combination with antidepressant or antiepileptic drugs versus opioid monotherapy were sought...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28590165/the-complex-relationship-between-household-income-of-family-caregivers-access-to-palliative-care-services-and-place-of-death-a-national-household-population-survey
#10
Miriam J Johnson, Victoria Allgar, Hong Chen, Laurie Dunn, Una Macleod, David C Currow
BACKGROUND: Previous work shows that more affluent patients with cancer are more likely to die at home, whereas those dying from non-cancer conditions are more likely to die in hospital. Family caregivers are an important factor in determining place of death. AIM: To investigate associations between family caregivers' household income, patients' access to specialist palliative care and place of patients' death, by level of personal end-of-life care. DESIGN: A cross-sectional community household population survey...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28590159/which-patients-die-in-their-preferred-place-a-secondary-analysis-of-questionnaire-data-from-bereaved-relatives
#11
Natasja Jh Raijmakers, Anke Je de Veer, Rosanne Zwaan, Jolien M Hofstede, Anneke L Francke
BACKGROUND: Previous studies on factors influencing the place of death have focused on cancer patients dying at home. However, home is not always the preferred place. AIM: To provide insight into the extent to which patients with various diseases die in their preferred place and into factors associated with dying in the preferred place. DESIGN: A secondary analysis of the data set of the evaluation study of the National Quality Improvement Programme for Palliative Care was undertaken to explore factors related to 'dying in the preferred place'...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28590157/pilot-randomised-controlled-trial-of-focused-narrative-intervention-for-moderate-to-severe-depression-in-palliative-care-patients-discern-trial
#12
Mari Lloyd-Williams, Christopher Shiels, Jacqueline Ellis, Katharine Abba, Edward Gaynor, Kenneth Wilson, Christopher Dowrick
BACKGROUND: Depression is poorly detected and sub-optimally managed in palliative care patients, and few trials of psychosocial interventions have been carried out in this group of patients. AIMS: A pilot trial to determine the effect of a focused narrative intervention on depression in palliative care patients when used in addition to usual care. DESIGN: Patients scoring 10 or higher on Patient Health Questionnaire-9 randomised to focused narrative intervention in addition to usual care or usual care only and followed up at 2, 4 and 6 weeks...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28590150/impact-of-home-based-patient-centered-support-for-people-with-advanced-illness-in-an-open-health-system-a-retrospective-claims-analysis-of-health-expenditures-utilization-and-quality-of-care-at-end-of-life
#13
Sylvia Ek Sudat, Anjali Franco, Alice R Pressman, Kenneth Rosenfeld, Elizabeth Gornet, Walter Stewart
BACKGROUND: Home-based care coordination and support programs for people with advanced illness work alongside usual care to promote personal care goals, which usually include a preference for home-based end-of-life care. More research is needed to confirm the efficacy of these programs, especially when disseminated on a large scale. Advanced Illness Management is one such program, implemented within a large open health system in northern California, USA. AIM: To evaluate the impact of Advanced Illness Management on end-of-life resource utilization, cost of care, and care quality, as indicators of program success in supporting patient care goals...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28514888/seeing-is-believing-healthcare-professionals-perceptions-of-a-complex-intervention-to-improve-care-towards-the-end-of-life-a-qualitative-interview-study
#14
Katherine Bristowe, Irene Carey, Adrian Hopper, Susanna Shouls, Wendy Prentice, Irene J Higginson, Jonathan Koffman
BACKGROUND: Methods to improve care, trust and communication are important in acute hospitals. Complex interventions aimed at improving care of patients approaching the end of life are increasingly common. While evaluating outcomes of complex interventions is essential, exploring healthcare professionals' perceptions is also required to understand how they are interpreted; this can inform training, education and implementation strategies to ensure fidelity and consistency in use. AIM: To explore healthcare professionals' perceptions of using a complex intervention (AMBER care bundle) to improve care for people approaching the end of life and their understandings of its purpose within clinical practice...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28502215/in-response-to-c-walshe-the-state-of-play
#15
Miriam J Johnson, Magnus Ekstrom, David C Currow
No abstract text is available yet for this article.
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28494643/randomised-clinical-trial-of-early-specialist-palliative-care-plus-standard-care-versus-standard-care-alone-in-patients-with-advanced-cancer-the-danish-palliative-care-trial
#16
Mogens Groenvold, Morten Aagaard Petersen, Anette Damkier, Mette Asbjoern Neergaard, Jan Bjoern Nielsen, Lise Pedersen, Per Sjøgren, Annette Sand Strömgren, Tove Bahn Vejlgaard, Christian Gluud, Jane Lindschou, Peter Fayers, Irene J Higginson, Anna Thit Johnsen
BACKGROUND: Beneficial effects of early palliative care have been found in advanced cancer, but the evidence is not unequivocal. AIM: To investigate the effect of early specialist palliative care among advanced cancer patients identified in oncology departments. SETTING/PARTICIPANTS: The Danish Palliative Care Trial (DanPaCT) (ClinicalTrials.gov NCT01348048) is a multicentre randomised clinical trial comparing early referral to a specialist palliative care team plus standard care versus standard care alone...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28494634/changing-place-of-death-in-children-who-died-after-discharge-from-paediatric-intensive-care-units-a-national-data-linkage-study
#17
Lorna K Fraser, Sarah Fleming, Roger Parslow
BACKGROUND: Although child mortality is decreasing, more than half of all deaths in childhood occur in children with a life-limiting condition whose death may be expected. AIM: To assess trends in place of death and identify characteristics of children who died in the community after discharge from paediatric intensive care unit. DESIGN: National data linkage study. SETTING/PARTICIPANTS: All children resident in England and Wales when admitted to a paediatric intensive care unit in the United Kingdom (1 January 2004 and 31 December 2014) were identified in the Paediatric Intensive Care Audit Network dataset...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28488925/strategies-to-address-the-shortcomings-of-commonly-used-advanced-chronic-heart-failure-descriptors-to-improve-recruitment-in-palliative-care-research-a-parallel-mixed-methods-feasibility-study
#18
Pauline M Kane, Fliss Em Murtagh, Karen R Ryan, Mary Brice, Niall G Mahon, Brendan McAdam, Regina McQuillan, Geraldine O'Gara, Caroline Raleigh, Cecelia Tracey, Christine Howley, Irene J Higginson, Barbara A Daveson
BACKGROUND: Recruitment challenges contribute to the paucity of palliative care research with advanced chronic heart failure patients. AIM: To describe the challenges and outline strategies of recruiting advanced chronic heart failure patients. DESIGN: A feasibility study using a pre-post uncontrolled design. SETTING: Advanced chronic heart failure patients were recruited at two nurse-led chronic heart failure disease management clinics in Ireland Results: Of 372 patients screened, 81 were approached, 38 were recruited (46...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28488923/the-effects-of-life-review-interventions-on-spiritual-well-being-psychological-distress-and-quality-of-life-in-patients-with-terminal-or-advanced-cancer-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#19
Chong-Wen Wang, Amy Ym Chow, Cecilia Lw Chan
BACKGROUND: Life review interventions have been used to alleviate psycho-spiritual distress in people near the end of life. However, their effectiveness remains inconclusive. AIM: To evaluate the effects of therapeutic life review on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer. DESIGN: A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28488922/predicting-prognosis-in-patients-with-advanced-cancer-a-prospective-study
#20
Teresa Tavares, Margarida Oliveira, João Gonçalves, Vera Trocado, Jéssica Perpétuo, Alexandra Azevedo, Firmino Machado, Vasco Barreto, Céu Rocha
BACKGROUND: Prognosis is one of the most challenging questions with which physicians are confronted. Accuracy in the prediction of survival is necessary for clinical, ethical, and organizational reasons. AIM: Evaluate young doctors' clinical prediction of survival and the aids they could get: expert opinion, Palliative Prognostic score, and Palliative Prognostic Index. DESIGN: Prospective, observational study. SETTING/PARTICIPANTS: Advanced cancer patients under observation of an inhospital palliative care team, from April to July 2014...
May 1, 2017: Palliative Medicine
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