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Palliative Medicine

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https://www.readbyqxmd.com/read/29343195/caring-for-a-family-member-or-friend-with-dementia-at-the-end-of-life-a-scoping-review-and-implications-for-palliative-care-practice
#1
Timothy R Broady, Freya Saich, Tom Hinton
BACKGROUND: Although people with dementia receive substantial care from informal sources, there is limited research available that investigates how these carers experience end-of-life care. AIM: This review aimed to identify what is currently known about carers' experiences of providing end-of-life care to a family member or friend with dementia and draw implications for palliative care policy and service provision. DESIGN: A scoping literature review was conducted, first using a targeted key word search, followed by assessments of eligibility based on title and then abstract content...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343186/association-between-palliative-care-and-life-sustaining-treatments-for-patients-with-dementia-a-nationwide-5-year-cohort-study
#2
Ping-Jen Chen, Fu-Wen Liang, Chung-Han Ho, Shao-Yi Cheng, Yi-Chen Chen, Yu-Han Chen, Yueh-Chun Chen
BACKGROUND: The association between palliative care and life-sustaining treatments for patients with dementia is unclear in Asian countries. AIM: To analyse the use of palliative care and its association with aggressive treatments based on Taiwanese national data. DESIGN: A matched cohort study was conducted. The association between intervention and outcome was evaluated using conditional logistic regression analyses. SETTING/PARTICIPANTS: The source population comprised 239,633 patients with dementia diagnosed between 2002 and 2013...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343173/effects-of-two-feedback-interventions-on-end-of-life-outcomes-in-nursing-home-residents-with-dementia-a-cluster-randomized-controlled-three-armed-trial
#3
Jannie A Boogaard, Henrica Cw de Vet, Mirjam C van Soest-Poortvliet, Johannes R Anema, Wilco P Achterberg, Jenny T van der Steen
BACKGROUND: Despite increased attention for palliative care in dementia, recent studies found burdensome symptoms and unmet family caregiver needs in the last phase of life. Feedback is being used to improve the quality of palliative care, but we do not know how effective it is. AIM: To assess the effect of two feedback strategies on perceived quality of end-of-life care and comfort in dying nursing home residents with dementia. METHODS: In a cluster-randomized controlled trial, the End-of-Life in Dementia-Satisfaction With Care and the End-of-Life in Dementia-Comfort Assessment in Dying scales were completed by bereaved family caregivers of residents with dementia of 18 Dutch nursing homes...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343169/patients-and-carers-perspectives-of-palliative-care-in-general-practice-a-systematic-review-with-narrative-synthesis
#4
Emilie Green, Selena Knight, Merryn Gott, Stephen Barclay, Patrick White
BACKGROUND: General practitioners have overall responsibility for community care, including towards end of life. Current policy places generalists at the centre of palliative care provision. However, little is known about how patients and carers understand the general practitioner's role. AIMS: To explore patient and carer perspectives of (1) the role of the general practitioner in providing palliative care to adult patients and (2) the facilitators and barriers to the general practitioner's capacity to fulfil this perceived role...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343167/a-cluster-randomised-feasibility-trial-of-clinically-assisted-hydration-in-cancer-patients-in-the-last-days-of-life
#5
Andrew N Davies, Melanie Waghorn, Katherine Webber, Sigurd Johnsen, Jeewaka Mendis, Julia Boyle
BACKGROUND: The provision of clinically assisted hydration at the end-of-life is one of the most contentious issues in medicine. AIM: The aim of this feasibility study was to answer the question 'can a definitive (adequately powered) study be done?' DESIGN: The study was a cluster randomised trial, with sites randomised on a one-to-one basis to intervention 'A' (regular mouth care and usual other care) or intervention 'B' (clinically assisted hydration, mouth care and usual other care)...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29323618/measuring-attitudes-towards-the-dying-process-a-systematic-review-of-tools
#6
Bernadette Groebe, Julia Strupp, Yvonne Eisenmann, Holger Schmidt, Anna Schlomann, Christian Rietz, Raymond Voltz
BACKGROUND: At the end of life, anxious attitudes concerning the dying process are common in patients in Palliative Care. Measurement tools can identify vulnerabilities, resources and the need for subsequent treatment to relieve suffering and support well-being. AIM: To systematically review available tools measuring attitudes towards dying, their operationalization, the method of measurement and the methodological quality including generalizability to different contexts...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29323617/differential-effects-of-early-palliative-care-based-on-the-age-and-sex-of-patients-with-advanced-cancer-from-a-randomized-controlled-trial
#7
Ryan D Nipp, Areej El-Jawahri, Lara Traeger, Jamie M Jacobs, Emily R Gallagher, Elyse R Park, Vicki A Jackson, William F Pirl, Jennifer S Temel, Joseph A Greer
BACKGROUND: Early palliative care interventions enhance patient outcomes, including quality of life, mood, and coping, but it remains unclear whether certain subgroups of patients are more likely to benefit from early palliative care. We explored whether age and sex moderate the improved outcomes seen with early palliative care. METHODS: We performed a secondary analysis of data from a randomized trial of 350 patients with advanced lung and non-colorectal gastrointestinal cancer...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29299957/the-cancer-home-life-intervention-a-randomised-controlled-trial-evaluating-the-efficacy-of-an-occupational-therapy-based-intervention-in-people-with-advanced-cancer
#8
Marc Sampedro Pilegaard, Karen la Cour, Lisa Gregersen Oestergaard, Anna Thit Johnsen, Line Lindahl-Jacobsen, Inger Højris, Åse Brandt
BACKGROUND: People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the 'Cancer Home-Life Intervention'. AIM: To evaluate the efficacy of the 'Cancer Home Life-Intervention' compared with usual care with regard to patients' performance of, and participation in, everyday activities, and their health-related quality of life. DESIGN AND INTERVENTION: A randomised controlled trial ( ClinicalTrials...
December 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29299954/the-impact-of-therapeutic-opioid-agonists-on-driving-related-psychomotor-skills-assessed-by-a-driving-simulator-or-an-on-road-driving-task-a-systematic-review
#9
Diana H Ferreira, Jason W Boland, Jane L Phillips, Lawrence Lam, David C Currow
BACKGROUND: Driving cessation is associated with poor health-related outcomes. People with chronic diseases are often prescribed long-term opioid agonists that have the potential to impair driving. Studies evaluating the impact of opioids on driving-related psychomotor skills report contradictory results likely due to heterogeneous designs, assessment tools and study populations. A better understanding of the effects of regular therapeutic opioid agonists on driving can help to inform the balance between individual's independence and community safety...
December 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29243546/changes-in-medication-use-in-a-cohort-of-patients-with-advanced-cancer-the-international-multicentre-prospective-european-palliative-care-cancer-symptom-study
#10
Kristel Paque, Monique Elseviers, Robert Vander Stichele, Koen Pardon, Marianne J Hjermstad, Stein Kaasa, Tinne Dilles, Martine De Laat, Simon Van Belle, Thierry Christiaens, Luc Deliens
BACKGROUND: Information on medication use in the last months of life is limited. AIM: To describe which medications are prescribed and deprescribed in advanced cancer patients receiving palliative care in relation to time before death and to explore associations with demographic variables. DESIGN: Prospective study, using case report forms for monthly data collection. Medication included cancer treatment and 19 therapeutic groups, grouped into four categories for: (1) cancer therapy, (2) specific cancer-related symptom relief, (3) other symptom relief and (4) long-term prevention...
December 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29235422/-the-importance-of-planning-for-the-future-burden-and-unmet-needs-of-caregivers-in-advanced-heart-failure-a-mixed-methods-study
#11
Sonja McIlfatrick, Leanne C Doherty, Mary Murphy, Lana Dixon, Patrick Donnelly, Kenneth McDonald, Donna Fitzsimons
BACKGROUND: While studies have evaluated caregiver outcomes in heart failure, the burden and support needs when caring for someone with advanced heart failure at the end of life have yet to be outlined. AIM: To identify psychosocial factors associated with caregiver burden and evaluate the support needs of caregivers in advanced heart failure. DESIGN: A sequential mixed methods study comprising two phases: (1) postal survey with advanced heart failure patients and their caregivers and (2) interviews with current and bereaved caregivers...
December 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29235421/how-should-we-talk-about-palliative-care-death-and-dying-a-qualitative-study-exploring-perspectives-from-caregivers-of-people-with-advanced-cancer
#12
Anna Collins, Sue-Anne McLachlan, Jennifer Philip
BACKGROUND: Health professionals commonly underestimate caregiver needs for information about palliative care, death and dying and may feel poorly prepared to discuss these issues. Few studies have sought caregiver perspectives of these communication practices. AIM: To explore caregiver perspectives on communication about death, dying and the introduction to palliative care, with a view towards a series of caregiver-informed recommendations for use in clinical practice...
December 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29235415/decisional-control-preferences-among-patients-with-advanced-cancer-an-international-multicenter-cross-sectional-survey
#13
Sriram Yennurajalingam, Luis Fernando Rodrigues, Omar M Shamieh, Colombe Tricou, Marilène Filbet, Kyaw Naing, Akhileshwaran Ramaswamy, Pedro Emilio Perez-Cruz, Mary Jocylyn S Bautista, Sofia Bunge, Mary Ann Muckaden, Sarah Fakrooden, Vikash Sewram, Antonio Noguera Tejedor, Shobha S Rao, Janet L Williams, Diane D Liu, Minjeong Park, Zhanni Lu, Hilda Cantu, David Hui, Suresh K Reddy, Eduardo Bruera
BACKGROUND: Understanding patients' decision control preferences is important in providing quality cancer care. Patients' decisional control preference can be either active (patients prefer to make decisions themselves), shared (collaborative between patient, their physician, and/or family), or passive (patients prefer that the decisions are made by either the physician and/or their family). AIM: To determine the frequency and predictors of passive decision control preferences among advanced cancer patients...
December 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29235393/needs-of-people-with-advanced-dementia-in-their-final-phase-of-life-a-multi-perspective-qualitative-study-in-nursing-homes
#14
Holger Schmidt, Yvonne Eisenmann, Heidrun Golla, Raymond Voltz, Klaus Maria Perrar
BACKGROUND: People with advanced dementia present an important target group for palliative care. They suffer a range of symptoms, and their verbal communication abilities are highly restricted. At present, little is known about their needs in the final phase of life. AIM: To identify the needs of people with advanced dementia in their final phase of life and to explore the aspects relevant to first recognize and then meet these needs. DESIGN: Multi-perspective qualitative study using grounded theory methodology conducting group discussions, individual interviews, and participant observation...
December 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29235927/risk-factors-for-hospital-death-in-conditions-needing-palliative-care-nationwide-population-based-death-certificate-study
#15
Barbara Gomes, Maria João Pinheiro, Sílvia Lopes, Maja de Brito, Vera P Sarmento, Pedro Lopes Ferreira, Henrique Barros
BACKGROUND: Most people would prefer to die at home as opposed to hospital; therefore, understanding mortality patterns by place of death is essential for health resources allocation. AIM: We examined trends and risk factors for hospital death in conditions needing palliative care in a country without integrated palliative care. DESIGN: This is a death certificate study. We examined factors associated with hospital death using logistic regression...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29235420/a-self-care-problem-solving-and-mindfulness-intervention-for-informal-caregivers-of-people-with-motor-neurone-disease-a-pilot-study
#16
Anna Ugalde, Susan Mathers, Nicole Hennessy Anderson, Peter Hudson, Liliana Orellana, Cathy Gluyas
BACKGROUND: Informal caregivers of people with motor neurone disease (MND) take on an extensive role. Caregivers are at increased risk of experiencing psychological distress and burden, yet, there is a lack of intervention programmes to support them. AIM: The aim of this study was to investigate the feasibility and acceptability of a therapeutic group intervention promoting self-care, problem-solving and mindfulness to informal caregivers of people with MND. DESIGN: Pilot study that utilised a one-arm pre- and post-design...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29235418/dying-persons-perspectives-on-or-experiences-of-participating-in-research-an-integrative-review
#17
Melissa J Bloomer, Alison M Hutchinson, Laura Brooks, Mari Botti
BACKGROUND: Conducting research with dying persons can be controversial and challenging due to concerns for the vulnerability of the dying and the potential burden on those who participate with the possibility of little benefit. AIM: To conduct an integrative review to answer the question 'What are dying persons' perspectives or experiences of participating in research? DESIGN: A structured integrative review of the empirical literature was undertaken...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29235386/how-is-palliative-care-understood-in-the-context-of-dementia-results-from-a-massive-open-online-course
#18
Fran McInerney, Kathleen Doherty, Aidan Bindoff, Andrew Robinson, James Vickers
BACKGROUND: A palliative approach to the care of people with dementia has been advocated, albeit from an emergent evidence base. The person-centred philosophy of palliative care resonates with the often lengthy trajectory and heavy symptom burden of this terminal condition. AIM: To explore participants' understanding of the concept of palliative care in the context of dementia. The participant population took an online course in dementia. DESIGN: The participant population took a massive open online course on 'Understanding Dementia' and posted answers to the question: 'palliative care means …' We extracted these postings and analysed them via the dual methods of topic modelling analysis and thematic analysis...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29154724/understanding-how-a-palliative-specific-patient-reported-outcome-intervention-works-to-facilitate-patient-centred-care-in-advanced-heart-failure-a-qualitative-study
#19
Pauline M Kane, Clare I Ellis-Smith, Barbara A Daveson, Karen Ryan, Niall G Mahon, Brendan McAdam, Regina McQuillan, Cecelia Tracey, Christine Howley, Geraldine O'Gara, Caroline Raleigh, Irene J Higginson, Fliss Em Murtagh, Jonathan Koffman
BACKGROUND: Palliative care needs of patients with chronic heart failure are poorly recognised. Policy makers advise a patient-centred approach to holistically assess patients' needs and care goals. Patient-reported outcome measures are proposed to facilitate patient-centred care. AIM: To explore whether and how a palliative care-specific patient-reported outcome intervention involving the Integrated Palliative care Outcome Scale influences patients' experience of patient-centred care in nurse-led chronic heart failure disease management clinics...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29139332/the-views-of-adults-with-huntington-s-disease-on-assisted-dying-a-qualitative-exploration
#20
Laurence Regan, Nancy J Preston, Fiona J R Eccles, Jane Simpson
BACKGROUND: Assisted dying is frequently debated publicly and research often includes the views of health professionals on this issue. However, the views of people with life-limiting conditions, for whom this issue is likely to have a different resonance, are less well represented. AIM: The purpose of this study was to explore the views of people who live with the inevitability of developing Huntington's disease, a genetically transmitted disease which significantly limits life, on assisted dying...
November 1, 2017: Palliative Medicine
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