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Palliative Medicine

Lisa Jane Brighton, Jonathan Koffman, Vicky Robinson, Shaheen A Khan, Rob George, Rachel Burman, Lucy Ellen Selman
BACKGROUND: Over half of all deaths in Europe occur in hospital, a location associated with many complaints. Initiatives to improve inpatient end-of-life care are therefore a priority. In England, over 78,000 volunteers provide a potentially cost-effective resource to hospitals. Many work with people who are dying and their families, yet little is known about their training in end-of-life care. AIMS: To explore hospital volunteers' end-of-life care training needs and learning preferences, and the acceptability of training evaluation methods...
January 1, 2017: Palliative Medicine
Annicka Gm van der Plas, Mariska G Oosterveld-Vlug, H Roeline W Pasman, Bregje D Onwuteaka-Philipsen
BACKGROUND: The four main diagnostic groups for palliative care provision are cancer, chronic obstructive pulmonary disease, heart failure and dementia. But comparisons of costs and care in the last year of life are mainly directed at cancer versus non-cancer or within cancer patients. AIM: Our aim is to compare the care and expenditures in their last year of life for Dutch patients with cancer, chronic obstructive pulmonary disease, heart failure or dementia. DESIGN: Data from insurance company Achmea (2009-2010) were linked to information on long-term care at home or in an institution, the National Hospital Registration and Causes of Death-Registry from Statistics Netherlands...
January 1, 2017: Palliative Medicine
Claudia Virdun, Tim Luckett, Karl Lorenz, Patricia M Davidson, Jane Phillips
BACKGROUND: Despite most expected deaths occurring in hospital, optimal end-of-life care is not available for all in this setting. AIM: To gain a richer and deeper understanding of elements of end-of-life care that consumers consider most important within the hospital setting. DESIGN: A meta-synthesis. DATA SOURCES: A systematic search of Academic Search Complete, AMED, CINAHL, MEDLINE, EMBASE, PsycINFO, PubMed, Google, Google Scholar and CareSearch for qualitative studies published between 1990 and April 2015 reporting statements by consumers regarding important elements of end-of-life hospital care...
December 8, 2016: Palliative Medicine
Sharon Twigger, Sarah J Yardley
BACKGROUND: The Liverpool Care Pathway was used in UK hospitals (late 1990s to July 2014) in an attempt to generate hospice-style high-quality end-of-life care in acute settings. Despite being widely established, there was limited research or contextual evidence regarding this approach or its impact. Growing criticism from the public, media, politicians and healthcare professionals culminated with a critical independent review (July 2013) and subsequent withdrawal of the Liverpool Care Pathway...
December 8, 2016: Palliative Medicine
Charles C Reilly, Claudia Bausewein, Rachel Garrod, Caroline J Jolley, John Moxham, Irene J Higginson
BACKGROUND: The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. AIM: To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. DESIGN: A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034)...
December 8, 2016: Palliative Medicine
Suresh Kumar Chhetri, Belinda Fay Bradley, Tahir Majeed, Robert William Lea
No abstract text is available yet for this article.
November 24, 2016: Palliative Medicine
Julia Desiree Lotz, Marion Daxer, Ralf J Jox, Gian Domenico Borasio, Monika Führer
BACKGROUND: Pediatric advance care planning is advocated by healthcare providers because it may increase the chance that patient and/or parent wishes are respected and thus improve end-of-life care. However, since end-of-life decisions for children are particularly difficult and charged with emotions, physicians are often afraid of addressing pediatric advance care planning. AIM: We aimed to investigate parents' views and needs regarding pediatric advance care planning...
November 23, 2016: Palliative Medicine
Elisabeth Brenne
No abstract text is available yet for this article.
November 23, 2016: Palliative Medicine
Sally Taylor, Matthew J Allsop, Hilary L Bekker, Michael I Bennett, Bridgette M Bewick
BACKGROUND: Poor pain assessment is a barrier to effective pain control. There is growing interest internationally in the development and implementation of remote monitoring technologies to enhance assessment in cancer and chronic disease contexts. Findings describe the development and testing of pain monitoring systems, but research identifying the needs of health professionals to implement routine monitoring systems within clinical practice is limited. AIM: To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals' needs when integrating PainCheck into routine clinical practice...
November 11, 2016: Palliative Medicine
Xavier Gómez-Batiste, Marisa Martínez-Muñoz, Carles Blay, Jordi Amblàs, Laura Vila, Xavier Costa, Joan Espaulella, Alicia Villanueva, Ramon Oller, Joan Carles Martori, Carles Constante
BACKGROUND: The Surprise Question (SQ) identifies patients with palliative care needs. The NECPAL CCOMS-ICO(©) (NECPAL) tool combines the Surprise Question with additional clinical parameters for a more comprehensive assessment. The capacity of these screening tools to predict mortality is still unknown. AIM: To explore the predictive validity of the NECPAL and SQ to determine 12- to 24-month mortality. DESIGN: Longitudinal, prospective and observational cohort study...
November 4, 2016: Palliative Medicine
Nathan Davies, Greta Rait, Laura Maio, Steve Iliffe
BACKGROUND: People with dementia have been described as the 'disadvantaged dying' with poor end-of-life care. Towards the end of life, people with dementia cannot report on the care they receive. It is therefore important to talk to caregivers; however, few have explored the views about end-of-life care from the caregivers' perspective. The majority of research on family caregivers has focussed on the burden and psychological impact of caring for a relative with dementia. AIM: This study aimed to explore the views of family caregivers about quality end-of-life care for people with dementia...
October 25, 2016: Palliative Medicine
Kate Brameld, Katrina Spilsbury, Lorna Rosenwax, Kevin Murray, James Semmens
BACKGROUND: Studies aiming to identify palliative care populations have used data from death certificates and in some cases hospital records. The size and characteristics of the identified populations can show considerable variation depending on the data sources used. It is important that service planners and researchers are aware of this. AIM: To illustrate the differences in the size and characteristics of a potential palliative care population depending on the differential use of linked hospital records and death certificate data...
October 24, 2016: Palliative Medicine
Catherine Walshe
No abstract text is available yet for this article.
January 2017: 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...
January 2017: Palliative Medicine
Jan Gaertner, Ulrike M Stamer, Constanze Remi, Raymond Voltz, Claudia Bausewein, Rainer Sabatowski, Stefan Wirz, Gabriele Müller-Mundt, Steffen T Simon, Anne Pralong, Friedemann Nauck, Markus Follmann, Lukas Radbruch, Winfried Meißner
BACKGROUND: Dipyrone (metamizole) is one of the most widely used non-opioid analgesics for the treatment of cancer pain. AIM: Because evidence-based recommendations are not yet available, a systematic review was conducted for the German Guideline Program in Oncology to provide recommendations for the use of dipyrone in cancer pain. DESIGN: First, a systematic review for clinical trials assessing dipyrone in adult patients with cancer pain was conducted...
January 2017: Palliative Medicine
Ming Ren Toh, Lita Chew
BACKGROUND: Unused medicines represent a major source of wastage in healthcare systems around the world. Previous studies have suggested the potential cost savings from recycling the waste medicines. However, issues of product safety and integrity often deter healthcare institutions from recycling donated medications. AIM: To evaluate the feasibility of medication recycling and to assess the actual cost savings from recycling waste medicines and whether reusability of waste medicines differed among various drug classes and donor sources...
January 2017: Palliative Medicine
Alastair Canaway, Hareth Al-Janabi, Philip Kinghorn, Cara Bailey, Joanna Coast
BACKGROUND: End-of-life care affects both the patient and those close to them. Typically, those close to the patient are not considered within economic evaluation, which may lead to the omission of important benefits resulting from end-of-life care. AIM: To develop an outcome measure suitable for use in economic evaluation that captures the benefits of end-of-life care to those close to the dying. DESIGN: To develop the descriptive system for the outcome measure, in-depth qualitative interviews were conducted with the participants and constant comparative analysis methods were used to develop a descriptive system for the measure...
January 2017: Palliative Medicine
Alison Giles, Nigel Sykes
BACKGROUND: Sedative drugs are used to improve comfort in dying patients but have been accused of shortening survival by reducing patients' ability to maintain nutrition and hydration. However, as part of the dying process, patients in the last days of life often have impaired conscious levels and an inability to maintain oral intake. AIM: To establish whether the decline in oral intake is related to the use of midazolam in the last week of life. DESIGN: This is a retrospective case note review...
January 2017: Palliative Medicine
Shigeo Yamashiro, Yasuyuki Hitoshi, Seiji Tajiri, Hiroki Uchikawa, Kiyotaka Ito, Akimasa Yoshida, Jun-Ichi Kuratsu
BACKGROUND: Leptomeningeal metastasis-related hydrocephalus causes distress to patients with end-stage cancer through headache and other symptoms by elevating intracranial pressure, thus reducing quality of life. Ventriculoperitoneal shunt has been used as a treatment option in palliative care. We review four cases of patients who underwent lumboperitoneal shunt for leptomeningeal metastasis-related hydrocephalus. CASES: All patients suffered from severe headache and nausea...
January 2017: Palliative Medicine
Karin Jors, Svenja Tietgen, Carola Xander, Felix Momm, Gerhild Becker
BACKGROUND/AIM: Palliative care is based on multi-professional team work. In this study, we investigated how cleaning staff communicate and interact with seriously ill and dying patients as well as how cleaning staff cope with the situation of death and dying. DESIGN: Sequential mixed methods, consisting of semi-structured interviews, focus groups, and a questionnaire. Interviews and focus group discussions were content analyzed and results were used to create a questionnaire...
January 2017: Palliative Medicine
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