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BMC Palliative Care

Barbara A Jack, Tracy K Mitchell, Mary R O'Brien, Sergio A Silverio, Katherine Knighting
BACKGROUND: Good end-of-life care planning is vital to ensure optimal care is provided for patients and their families. Two key factors are open and honest advance care planning conversations between the patient (where possible), family, and health care professionals, focusing on exploring what their future wishes are; and the development of an advance care plan document. However, in paediatric and neonatal settings, there has been little research to demonstrate how advance care planning conversations take place...
July 13, 2018: BMC Palliative Care
Katharina Fetz, Hendrik Vogt, Thomas Ostermann, Andrea Schmitz, Christian Schulz-Quach
BACKGROUND: The implementation of standardised, valid and reliable measurements in palliative care is subject to practical and methodological challenges. One aspect of ongoing discussion is the value of systematic proxy-based assessment of symptom burden in palliative care. In 2011, an expert-developed proxy-based instrument for the assessment of symptom burden in palliative patients, the Palliative Symptom Burden Score (PSBS), was implemented at the Specialised Palliative Care Unit of the University Medical Centre in Dusseldorf, Germany...
July 7, 2018: BMC Palliative Care
Anne Black, Tamsin McGlinchey, Maureen Gambles, John Ellershaw, Catriona Rachel Mayland
BACKGROUND: There is limited understanding of the 'lived experience' of palliative care patient within the acute care setting. Failing to engage with and understand the views of patients and those close to them, has fundamental consequences for future health delivery. Understanding 'patient experience' can enable care providers to ensure services are responsive and adaptive to individual patient need. METHODS: The aim of this study was to explore the 'lived experience' of a group of patients with palliative care needs who had recently been in-patients in one acute hospital trust in the north-west of England...
July 6, 2018: BMC Palliative Care
Emma Kirby, Zarnie Lwin, Katherine Kenny, Alex Broom, Holi Birman, Phillip Good
BACKGROUND: The end of life represents a therapeutic context that acutely raises cultural and linguistic specificities, yet there is very little evidence illustrating the importance of such dynamics in shaping choices, trajectories and care practices. Culture and language interplay to offer considerable potential challenges to both patient and provider, with further work needed to explore patient and caregiver perspectives across cultures and linguistic groups, and provider perspectives...
July 2, 2018: BMC Palliative Care
Sandra Martins Pereira, Joana Araújo, Pablo Hernández-Marrero
BACKGROUND: Education sessions about palliative care among teenagers are uncommon in developed countries. However, very little is known either about the impact of this type of intervention or about how this age-group perceives its impact. The purpose of this study was therefore to (i) implement an education program about palliative care among teenagers and (ii) to investigate the impact of the program on the participants. METHODS: An action-research study was conducted at a local community parish in Portugal in November 2015...
June 29, 2018: BMC Palliative Care
Ruth Piers, Gwenda Albers, Joni Gilissen, Jan De Lepeleire, Jan Steyaert, Wouter Van Mechelen, Els Steeman, Let Dillen, Paul Vanden Berghe, Lieve Van den Block
BACKGROUND: Advance care planning (ACP) is a continuous, dynamic process of reflection and dialogue between an individual, those close to them and their healthcare professionals, concerning the individual's preferences and values concerning future treatment and care, including end-of-life care. Despite universal recognition of the importance of ACP for people with dementia, who gradually lose their ability to make informed decisions themselves, ACP still only happens infrequently, and evidence-based recommendations on when and how to perform this complex process are lacking...
June 21, 2018: BMC Palliative Care
Joshua Wales, Allison M Kurahashi, Amna Husain
BACKGROUND: Home is a preferred place of death for many people; however, access to a home death may not be equitable. The impact of socioeconomic status on one's ability to die at home has been documented, yet there remains little literature exploring mechanisms that contribute to this disparity. By exploring the experiences and insights of physicians who provide end-of-life care in the home, this study aims to identify the factors perceived to influence patients' likelihood of home death and describe the mechanisms by which they interact with socioeconomic status...
June 20, 2018: BMC Palliative Care
Ilaria Massa, Oriana Nanni, Flavia Foca, Marco Maltoni, Stefania Derni, Nicola Gentili, Giovanni Luca Frassineti, Andrea Casadei Gardini, Martina Valgiusti, Dino Amadori, Elena Prati, Mattia Altini, Davide Gallegati, Elisabetta Sansoni
BACKGROUND: Appropriate cessation of chemotherapy and timely referral of patients to hospice services are crucial for the quality of care near death. We investigated the quality of care in our Cancer Institute in very advanced metastatic colorectal cancer patients treated in real life. PATIENTS AND METHODS: We performed a retrospective analysis of electronic medical data of patients with metastatic colorectal cancer who were candidates for chemotherapy during the study period (1 January 2007-30 June 2014) and died before 31 December 2014...
June 19, 2018: BMC Palliative Care
Lisa Hjelmfors, Anna Strömberg, Maria Friedrichsen, Anna Sandgren, Jan Mårtensson, Tiny Jaarsma
BACKGROUND: The aim of this paper was to describe the development of an intervention that is developed to improve communication about the heart failure (HF) trajectory and end-of-life care. We also present data that provides a first insight in specific areas of feasibility of the intervention. METHODS: Co-design was used and patients, family members and health care professionals were constructive participants in the design process of the intervention. Feasibility of the intervention was tested in two areas; acceptability and limited efficacy...
June 11, 2018: BMC Palliative Care
Laurence Jee Peng Leong, Gregory Brian Crawford
BACKGROUND: With ageing of Australians, the numbers of residential aged care (RAC) residents is rising. This places a spotlight on decisions about appropriate care for this population, including hospitalisation and end-of-life (EOL) care. The aim was to study a sample of RAC residents who attended and died in hospital, to quantify measurable components of EOL care so as to describe the extent of palliative care required. METHODS: A retrospective case-note review of hospital records was conducted in Adelaide, Australia...
June 9, 2018: BMC Palliative Care
Takashi Takeuchi, Kanako Ichikura, Kanako Amano, Wakana Takeshita, Kazuho Hisamura
BACKGROUND: Although recent studies have increasingly reported physical and psychological problems associated with cancer and its treatment, social problems of cancer patients and their families have not been sufficiently elucidated. The present study aimed to identify cancer-associated social problems from the perspectives of both patients and their spouses and to compare and analyze differences in their problems. METHODS: This was a cross-sectional internet-based study...
June 8, 2018: BMC Palliative Care
Marieke Zwakman, Lisa M Verberne, Marijke C Kars, Lotty Hooft, Johannes J M van Delden, René Spijker
BACKGROUND: In the rapidly developing specialty of palliative care, literature reviews have become increasingly important to inform and improve the field. When applying widely used methods for literature reviews developed for intervention studies onto palliative care, challenges are encountered such as the heterogeneity of palliative care in practice (wide range of domains in patient characteristics, stages of illness and stakeholders), the explorative character of review questions, and the poorly defined keywords and concepts...
June 2, 2018: BMC Palliative Care
Jaume Canal-Sotelo, Javier Trujillano-Cabello, Philip Larkin, Núria Arraràs-Torrelles, Ramona González-Rubió, Mariona Rocaspana-Garcia, Eva Barallat-Gimeno
BACKGROUND: Breakthrough cancer pain (BTcP) is defined according to its principal characteristics: high intensity, short time interval between onset and peak intensity, short duration, potential recurrence over 24 h and non-responsiveness to standard analgesic regimes. The Edmonton Classification System for Cancer Pain (ECS-CP) is a classification tool that evaluates different dimensions of pain. The aim of this study was to measure prevalence and the main characteristics of BTcP in a sample of advanced cancer patients and to explore the complexity observed when ECS-CP is incorporated into BTcP diagnostics algorithm...
May 28, 2018: BMC Palliative Care
Maaike Kok, Gertruud F M van der Werff, Jenske I Geerling, Jaap Ruivenkamp, Wies Groothoff, Annette W G van der Velden, Monique Thoma, Jaap Talsma, Louk G P Costongs, Reinold O B Gans, Pauline de Graeff, Anna K L Reyners
BACKGROUND: Advance Care Planning (ACP) and its documentation, accessible to healthcare professionals regardless of where patients are staying, can improve palliative care. ACP is usually performed by trained facilitators. However, ACP conversations would be more tailored to a patient's specific situation if held by a patient's clinical healthcare team. This study assesses the feasibility of ACP by a patient's clinical healthcare team, and analyses the documented information including current and future problems within the palliative care domains...
May 24, 2018: BMC Palliative Care
Burkhard Dasch, Claudia Bausewein, Berend Feddersen
BACKGROUND: Due to increasing life expectancy, more and more older people are suffering from dementia and comorbidities. To date, little information is available on place of death for dementia patients in Germany. In addition, the association of place of death and comorbidities is unknown. METHODS: A population-based cross-sectional survey was conducted in Westphalia-Lippe (Germany), based on the analysis of death certificates from 2011. Individuals with dementia ≥ 65 years were identified using the documented cause of death...
May 24, 2018: BMC Palliative Care
Josie Dixon, Martin Knapp
BACKGROUND: ACP involving a facilitated conversation with a health or care professional is more effective than document completion alone. In policy, there is an expectation that health and care professionals will provide ACP support, commonly within their existing roles. However, the potential contributions of different professionals are outlined only broadly in policy and guidance. Research on opportunities and barriers for involving different professionals in providing ACP support, and feasible models for doing so, is currently lacking...
May 24, 2018: BMC Palliative Care
Marie Friedel, Bénédicte Brichard, Christine Fonteyne, Marleen Renard, Jean-Paul Misson, Els Vandecruys, Corinne Tonon, Françoise Verfaillie, Georgette Hendrijckx, Nathalie Andersson, Ilse Ruysseveldt, Katrien Moens, Jean-Marie Degryse, Isabelle Aujoulat
BACKGROUND: Although continuity of care in paediatric palliative care (PPC) is considered to be an essential element of quality of care, it's implementation is challenging. In Belgium, five paediatric liaison teams (PLTs) deliver palliative care. A Royal Decree issued in 2010 provides the legal framework that defines the PLTs' missions, as ensuring continuity of curative and palliative care between the hospital and home for children diagnosed with life-limiting conditions. This national study describes how PLTs ensure continuity of care by describing their activities and the characteristics of the children they cared for from 2010 to 2014...
May 22, 2018: BMC Palliative Care
G Sorin, R Vialet, B Tosello
BACKGROUND: Neonatal deaths are often associated with the complex decision to limit or withdraw life-sustaining interventions (LSIs) rather than therapeutic impasses. Despite the existence of a law, significant disparities in clinical procedures remain. This study aimed to assess deaths occurring in a Neonatal Intensive Care Unit (NICU) and measure the impact of a traceable Limitation or Withdrawal of Active Treatment (LWAT) file on the treatment of these newborns. METHODS: In this monocentric retrospective study, we reviewed all consecutive neonatal deaths occurring during two three-year periods among patients in the NICU at the North Hospital of Marseille: cohort 1 (from 2009 to 2011 without the LWAT file) and cohort 2 (from 2013 to 2015 after introduction of the LWAT file)...
May 17, 2018: BMC Palliative Care
Claire Poulalhon, Laureen Rotelli-Bihet, Sébastien Moine, Anne Fagot-Campagna, Régis Aubry, Philippe Tuppin
BACKGROUND: Only limited data are available concerning the diseases managed before death and hospital palliative care (HPC) use according to place of death in France. We therefore conducted an observational study based on administrative health data in a large population to identify the diseases treated one year before death in 2013, the place of stay with or without hospital palliative care, and the place of death. METHODS: French health insurance general scheme beneficiaries were identified in the National Health data Information System (Snds) with a selection of information...
May 16, 2018: BMC Palliative Care
Inge Spronk, Jako S Burgers, François G Schellevis, Liesbeth M van Vliet, Joke C Korevaar
BACKGROUND: Shared decision-making (SDM) in the management of metastatic breast cancer care is associated with positive patient outcomes. In daily clinical practice, however, SDM is not fully integrated yet. Initiatives to improve the implementation of SDM would be helpful. The aim of this review was to assess the availability and effectiveness of tools supporting SDM in metastatic breast cancer care. METHODS: Literature databases were systematically searched for articles published since 2006 focusing on the development or evaluation of tools to improve information-provision and to support decision-making in metastatic breast cancer care...
May 11, 2018: BMC Palliative Care
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