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Journal of Palliative Care

Marcus J P Geist, Jens Kessler, Susanne Frankenhauser, Hubert J Bardenheuer
BACKGROUND: Persistent bleeding is a common reason for admitting patients with advanced cancer to a palliative care unit. Several reports show a successful therapeutic use of the antifibrinolytic agent tranexamic acid in palliative care patients having hemorrhages. However, it is not administered routinely in severe bleeding situations in palliative care, and general dosing recommendations are unclear. CASE PRESENTATION: We report on 3 patients who were treated with tranexamic acid due to symptomatic hemorrhage complicating different malignant processes...
January 1, 2017: Journal of Palliative Care
Radka Bužgová, Lucie Sikorová, Radka Kozáková, Darja Jarošová
BACKGROUND: Currently, there are no studies aimed at evaluating the quality of life (QoL) of patients with end-stage disease during hospitalization and the factors that influence it. AIM: The aim of the research was to identify predictors of change in the QoL of patients hospitalized due to advanced stage of disease. METHODS: The sample consisted of 140 patients with end-stage disease who were hospitalized on this account. For evaluation of QoL, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was used...
January 1, 2017: Journal of Palliative Care
Masako Mayahara, JoEllen Wilbur, Sean O'Mahony, Susan Breitenstein
Informal hospice caregivers play a key role in managing patients' pain at home, but lack of adherence to doctor-prescribed analgesic regimens and medication errors are significant barriers to truly effective pain management. A digital pain diary may improve caregiver management of pain at home; however, most digital pain tools available today were developed without input from patients or caregivers. Accordingly, the purpose of this study was to develop a digital pain application (1) for hospice caregivers to record patient pain and analgesic use and (2) for nurses to monitor administration of analgesics by caregivers...
January 1, 2017: Journal of Palliative Care
Jacob G S Davidson, Dawn M Guthrie
OBJECTIVES: To estimate the prevalence and correlates of disruptive pain in a sample of seriously ill home care patients in the Canadian province of Ontario. METHODS: The design was a cross-sectional analysis of secondary data from 2757 patients aged 65+. RESULTS: Overall, 69.0% (n = 1902) had any level of pain and 41.6% (n = 1146) indicated that their pain disrupted their usual activities. In the univariate analysis of demographics, the risk of disruptive pain decreased significantly with increasing age ( P < ...
January 1, 2017: Journal of Palliative Care
Daniel Burnier
This article analyzes the writings of Elisabeth Kübler-Ross through the discursive lens of the phrase "dying with dignity." For her, the phrase meant allowing someone to die comfortably his/her own death. This phrase has to be understood in relationship with the final "stage of acceptance" of her model. Describing this key part of her well-known scientific output, she often used, in the early 1970s, the phrase "dying in peace and dignity." An evaluation of the evidence suggests that because the concept of dignity was co-opted by the pro-euthanasia movement during this decade, the language of dignity was little by little abandoned by her...
January 1, 2017: Journal of Palliative Care
Anna Voeuk, Cheryl Nekolaichuk, Robin Fainsinger, Ann Huot
BACKGROUND: Palliative sedation can be used for refractory symptoms during end-of-life care. However, continuous palliative sedation (CPS) for existential distress remains controversial due to difficulty determining when this distress is refractory. OBJECTIVES: The aim was to determine the opinions and practices of Canadian palliative care physicians regarding CPS for existential distress. METHODS: A survey focusing on experience and views regarding CPS for existential distress was sent to 322 members of the Canadian Society of Palliative Care Physicians...
January 2017: Journal of Palliative Care
Piret Paal, Eckhard Frick, Traugott Roser, Guy Jobin
This article elaborates on the hazards of spiritual history taking. It provides expert insights to consider before entering the field. In summer 2012, a group of spiritual care experts were invited to discuss the complexity of taking spiritual histories in a manner of hermeneutic circle. Thematic analysis was applied to define the emerging themes. The results demonstrate that taking a spiritual history is a complex and challenging task, requiring a number of personal qualities of the interviewer, such as 'being present', 'not only hearing, but listening', 'understanding the message beyond the words uttered', and 'picking up the words to respond'...
January 2017: Journal of Palliative Care
William P Tormey
A 47-year-old woman who was receiving palliative care for metastatic breast cancer, which included oxycodone, was found dead in bed. The femoral blood level of oxycodone at autopsy was 1200 µg/L, which is a value within the lethal range. Could the cause of death be attributed to misadventure or suicide? Would the coroner consider a recommendation of therapeutic drug monitoring in palliative care which could have a serious negative impact on pain relief practice? A narrative verdict was the outcome linking the primary cause of death with the drug cocktail found at autopsy...
January 2017: Journal of Palliative Care
Maria Heckel, Sonja Bussmann, Martin Weber, Christoph Ostgathe, Stephanie Stiel
BACKGROUND: In studies enrolling informal caregivers of patients in palliative care, it is necessary to ensure that findings are not influenced by factors such as mental disorders. AIM: This study aims to describe the influence of anxiety and depression on bereaved informal caregivers' retrospective ratings of the quality of dying and death (QoDD) of their loved ones. DESIGN: Informal caregivers of deceased patients from 2 German palliative care (PC) units took part in a validation study of the German version of the original QoDD-Deutsch-Angehörige (QoDD-D-Ang) during the fourth week following the patient's death at the earliest...
January 2017: Journal of Palliative Care
Shiraz Malik, Russell Goldman, Nanor Kevork, Kirsten Wentlandt, Amna Husain, Nancy Merrow, Lisa W Le, Camilla Zimmermann
PURPOSE: To describe prevalence and characteristics associated with family physician and general practitioner (FP/GP) provision of home palliative care (HPC). METHODS: We surveyed FP/GPs in an urban health region of Ontario, Canada, to determine their current involvement in HPC, the nature of services provided, and perceived barriers and enablers. RESULTS: A total of 1439 surveys were mailed. Of the 302 FP/GP respondents, 295 provided replies regarding engagement in HPC: 101 of 295 (33%) provided HPC, 76 (26%) were engageable with further support, and 118 (40%) were not engageable regardless of support...
January 2017: Journal of Palliative Care
Hamid Raziee, Refik Saskin, Lisa Barbera
AIM: To determine factors associated with home death in patients with cancer in Ontario, particularly to assess the association between death at home and (1) patients' rural/urban residence and (2) neighborhood income in urban areas. MATERIALS AND METHODS: We conducted a retrospective cross-sectional study in Ontario (2003-2010) using linked administrative databases. In order to account for clustering phenomenon, multivariable generalized estimating equation model was used to evaluate factors associated with home death...
January 2017: Journal of Palliative Care
Barbara Allen, Donald D Kautz
No abstract text is available yet for this article.
2015: Journal of Palliative Care
Paul Rousseau
No abstract text is available yet for this article.
2015: Journal of Palliative Care
Mainak Majumdar, Bernadette Wilks, David Charlesworth
No abstract text is available yet for this article.
2015: Journal of Palliative Care
Jacky Siu-Hung Wong, Mary Gottwald
No abstract text is available yet for this article.
2015: Journal of Palliative Care
Radka Bužgová, Radka Kozáková, Lucie Sikorová
BACKGROUND: An important aim of palliative care is to ensure the highest possible quality of life (QoL) for the family members of patients. AIM: We aimed to determine the QoL of family members of hospitalized patients with end-stage disease, as well as differences in QoL based on socio-demographic characteristics and the patient's functional status, psychological distress, and QoL. METHODS: Study participants were 292 family members of terminally ill patients at University Hospital, Ostrava, Czech Republic...
2015: Journal of Palliative Care
Benson Chun To Wong, Lorraine Cake, Lynn Kachuik, Kayvan Amjadi
We investigated use of the tunnelled catheter in a large palliative population with malignancy-associated ascites employing retrospective analysis of a prospectively maintained patient database of tunnelled peritoneal catheter insertions for refractory malignancy-associated ascites or new rapidly accumulating ascites. We found that a 100 percent procedural success rate was achieved with 395 tunnelled catheters inserted in 386 patients. Catheters remained in situ for 66 days, on average. In a total of 22 cases (5...
2015: Journal of Palliative Care
Aimee J Sarti, Frances Fothergill Bourbonnais, Angèle Landriault, Stephanie Sutherland, Pierre Cardinal
AIM: There is a paucity of data on the provision of palliative care in the critical care settings of smaller community hospitals. This study aimed to identify the gaps that affect the provision of palliative care in a community critical care setting. SETTING: The study was set in a 10-bed, open intensive care unit and emergency department at a community hospital. METHODS: Mixed methods were used. Quantitative data included those drawn from databases and surveys; qualitative data included those collected from interviews, focus groups, and onsite walk-throughs and were analyzed with inductive coding techniques...
2015: Journal of Palliative Care
Amy R Knowlton, Trang Q Nguyen, Allysha C Robinson, Paul T Harrell, Mary M Mitchell
Current or former injection drug users with human immunodeficiency virus (HIV) are at high risk for pain, which adversely affects their quality of life and may increase their risk for illicit drug use or relapse. We explored associations between pain symptoms and substance use among injection-drug-using study participants with HIV who had histories of heroin use. Using generalized estimating equations and controlling for prior substance use, we found that pain in each six-month period was associated with the use of heroin and prescription opioids, but not the use of nonopioid drugs or alcohol...
2015: Journal of Palliative Care
Beverley J Smith, Lisa Chong, Seungree Nam, Ronald Seto
Primary caregivers (PCGs) are closely involved in preparing meals and feeding patients who are at the end of life, yet their responses to patients' swallowing difficulties have not been extensively analyzed. This study aimed to reach an understanding of PCGs' beliefs, values, and responses to dysphagia and dietary modifications in the palliative care setting. A total of 14 PCGs were interviewed and asked to share their thoughts and feelings about patients' dysphagia symptoms and the diet changes resulting from these symptoms...
2015: Journal of Palliative Care
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