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Palliative Medicine

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https://www.readbyqxmd.com/read/28691583/strategies-used-in-improving-and-assessing-the-level-of-reporting-of-implementation-fidelity-in-randomised-controlled-trials-of-palliative-care-complex-interventions-a-systematic-review
#1
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
https://www.readbyqxmd.com/read/28671483/caregiver-burden-in-amyotrophic-lateral-sclerosis-a-systematic-review
#2
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
https://www.readbyqxmd.com/read/28679073/supporting-carers-to-manage-pain-medication-in-cancer-patients-at-the-end-of-life-a-feasibility-trial
#3
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
https://www.readbyqxmd.com/read/28678000/implantable-cardioverter-defibrillator-knowledge-and-end-of-life-device-deactivation-a-cross-sectional-survey
#4
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
https://www.readbyqxmd.com/read/28677988/national-palliative-care-capacities-around-the-world-results-from-the-world-health-organization-noncommunicable-disease-country-capacity-survey
#5
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
https://www.readbyqxmd.com/read/28672115/end-of-life-care-for-homeless-people-a-qualitative-analysis-exploring-the-challenges-to-access-and-provision-of-palliative-care
#6
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
https://www.readbyqxmd.com/read/28655289/the-costs-resource-use-and-cost-effectiveness-of-clinical-nurse-specialist-led-interventions-for-patients-with-palliative-care-needs-a-systematic-review-of-international-evidence
#7
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
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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