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BMJ Supportive & Palliative Care

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https://www.readbyqxmd.com/read/29444775/persistent-inequalities-in-hospice-at-home-provision
#1
Jackie Buck, Liz Webb, Lorraine Moth, Lynn Morgan, Stephen Barclay
OBJECTIVE: To describe the nature and scope of a new Hospice at Home (H@H) service and to identify its equality of provision. METHODS: Case note review of patients supported by a H@H service for 1 year from September 2012 to August 2013 (n=321). Descriptive analysis to report frequencies and proportions of quantitative data extracted from service logs, referral forms and care records; thematic analysis of qualitative data from care record free text. RESULTS: Demand outstripped supply...
February 14, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29440050/carer-experience-of-end-of-life-service-provision-a-social-network-analysis
#2
Rosemary Leonard, Debbie Horsfall, John Rosenberg, Kerrie Noonan
OBJECTIVE: To identify the position of formal service providers in the networks of those providing end-of-life care in the home from the perspective of the informal network. METHODS: Using third-generation social network analysis, this study examined the nature and strength of relationships of informal caring networks with formal service providers through individual carer interviews, focus groups of caring networks and outer network interviews. RESULTS: Service providers were usually highly valued for providing services, equipment, pain management and personalised care for the dying person plus support and advice to the principal carer about both caring tasks and negotiating the health system...
February 10, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29440149/cancer-cachexia-rationale-for-the-menac-multimodal-exercise-nutrition-and-anti-inflammatory-medication-for-cachexia-trial
#3
REVIEW
Tora S Solheim, Barry J A Laird, Trude R Balstad, Asta Bye, Guro Stene, Vickie Baracos, Florian Strasser, Gareth Griffiths, Matthew Maddocks, Marie Fallon, Stein Kaasa, Kenneth Fearon
Cancer cachexia is a multifactorial syndrome characterised by an ongoing loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support alone. Cachexia has a high prevalence in cancer and a major impact on patient physical function, morbidity and mortality. Despite the consequences of cachexia, there is no licensed treatment for cachexia and no accepted standard of care. It has been argued that the multifactorial genesis of cachexia lends itself to therapeutic targeting through a multimodal treatment...
February 9, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29440148/interventions-in-hospitalised-patients-with-cancer-the-importance-of-impending-death-awareness
#4
Eric Cornelis Theodorus Geijteman, Marcella van der Graaf, Frederika E Witkamp, Sanne van Norden, Bruno H Stricker, Carin C D van der Rijt, Agnes van der Heide, Lia van Zuylen
OBJECTIVES: Burdensome and futile interventions with the aim of prolonging life should be avoided in dying patients. However, current clinical practice has hardly been investigated.We examined the number and type of diagnostic and therapeutic medical interventions in hospitalised patients with cancer in their last days of life. In addition, we investigated if physician awareness of impending death affected the use of these interventions. METHODS: Questionnaire study and medical record study...
February 9, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29434048/hospital-end-of-life-care-in-haematological-malignancies
#5
Yvan Beaussant, Etienne Daguindau, Adrien Chauchet, Philippe Rochigneux, Christophe Tournigand, Régis Aubry, Lucas Morin
OBJECTIVE: To investigate patterns of care during the last months of life of hospitalised patients who died from different haematological malignancies. METHODS: Nationwide register-based study, including all hospitalised adults ≥20 years who died from haematological malignancies in France in 2010-2013. Outcomes included use of invasive cancer treatments and referral to palliative care. Percentages are adjusted for sex and age using direct standardisation. RESULTS: Of 46 629 inpatients who died with haematological malignancies, 24...
February 6, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29420197/muscle-metastases-rare-problem-with-unusual-solution
#6
Becky Hirst, Jack Powell
Skeletal muscle is an unusual site for metastasis from malignancy. We report a patient who presented with calf metastases from a squamous cell carcinoma of lung. Attempts were made to control his pain conservatively for almost 2 years before he was referred for a below-knee amputation. He did well following this and was able to stop the majority of his analgesic drugs.
February 1, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29420196/enhanced-patient-research-participation-a-photovoice-study-in-blantyre-malawi
#7
Maya Jane Bates, Jane Ardrey, Treza Mphwatiwa, Stephen Bertel Squire, Louis Willem Niessen
OBJECTIVES: Patient involvement in palliative care research is a desirable if challenging goal. Photovoice is an action research method in which affected communities gather photographs to document and discuss their communities' strengths and concerns. Engagement with policymakers is a separately stated goal. Photovoice is increasingly used in health-related research but has not been widely described in the palliative care literature. We report on experiences and lessons learnt using Photovoice in Blantyre, Malawi to encourage its wider use in research and practice...
February 1, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29363550/bereaved-caregivers-of-patients-with-high-grade-glioma-a-systematic-review
#8
REVIEW
Karin Piil, Sara Nordentoft, Anders Larsen, Mary Jarden
OBJECTIVE: Caregivers to patients with primary malignant brain tumours neglect their own physical and emotional needs during the disease trajectory. The aim of the systematic review was to explore how informal caregivers of patients with primary malignant brain tumour (high-grade glioma (HGG)) experience and manage their life situation after the death of the patient. METHODS: A systematic literature search was carried out in December 2016 and revised in September 2017...
January 23, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29363549/communication-about-the-impending-death-of-patients-with-cancer-to-the-family-a-nationwide-survey
#9
Masanori Mori, Tatsuya Morita, Naoko Igarashi, Yasuo Shima, Mitsunori Miyashita
OBJECTIVES: Explanation about the impending death of imminently dying patients with cancer is important for their families. However, little is known about how clinicians explain impending death and how families perceive the explanation. We aimed to clarify bereaved families' perception of the need for improvements in the explanation about impending death and to explore the factors contributing to the need. METHODS: In a nationwide survey of 818 bereaved families of patients with cancer admitted to inpatient hospices in Japan, we evaluated family-perceived need for improvements in the explanation about impending death and families' experiences of the explanation...
January 23, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29353254/relationship-between-patients-and-family-caregivers
#10
EDITORIAL
Geraldine Foley
No abstract text is available yet for this article.
January 20, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29353253/experiential-learning-to-increase-palliative-care-competence-among-the-indigenous-workforce-an-australian-experience
#11
Shaouli Shahid, Stuart Ekberg, Michele Holloway, Catherine Jacka, Patsy Yates, Gail Garvey, Sandra C Thompson
OBJECTIVES: Improving Indigenous people's access to palliative care requires a health workforce with appropriate knowledge and skills to respond to end-of-life (EOL) issues. The Indigenous component of the Program of Experience in the Palliative Approach (PEPA) includes opportunities for Indigenous health practitioners to develop skills in the palliative approach by undertaking a supervised clinical placement of up to 5 days within specialist palliative care services. This paper presents the evaluative findings of the components of an experiential learning programme and considers the broader implications for delivery of successful palliative care education programme for Indigenous people...
January 20, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29353252/systematic-review-of-general-practice-end-of-life-symptom-control
#12
REVIEW
Geoffrey K Mitchell, Hugh E Senior, Claire L Johnson, Julia Fallon-Ferguson, Briony Williams, Leanne Monterosso, Joel J Rhee, Peta McVey, Matthew P Grant, Michèle Aubin, Harriet Tg Nwachukwu, Patsy M Yates
BACKGROUND: End of life care (EoLC) is a fundamental role of general practice, which will become more important as the population ages. It is essential that general practice's role and performance of at the end of life is understood in order to maximise the skills of the entire workforce. OBJECTIVE: To provide a comprehensive description of the role and performance of general practitioners (GPs) and general practice nurses (GPNs) in EoLC symptom control. METHOD: Systematic literature review of papers from 2000 to 2017 were sought from Medline, PsycINFO, Embase, Joanna Briggs Institute and Cochrane databases...
January 20, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29331953/efficacy-tolerability-and-acceptability-of-oxycodone-for-cancer-related-pain-in-adults-an-updated-cochrane-systematic-review
#13
REVIEW
Mia Schmidt-Hansen, Michael I Bennett, Stephanie Arnold, Nathan Bromham, Jennifer S Hilgart
OBJECTIVES: To assess the efficacy, tolerability and acceptability of oxycodone for cancer pain in adults METHODS: We searched CENTRAL, MEDLINE, MEDLINE In-Process, Embase, SCI, Conference Proceedings Citation Index-Science, BIOSIS, PsycINFO and four trials registries to November 2016. RESULTS: We included 23 randomised controlled trials with 2144 patients analysed for efficacy and 2363 for safety. Meta-analyses showed no significant differences between controlled-release (CR) and immediate-release oxycodone in pain intensity or adverse events but did show significantly better pain relief after treatment with CR morphine compared with CR oxycodone...
January 13, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29321159/impact-of-specialist-palliative-care-on-coping-with-parkinson-s-disease-patients-and-carers
#14
Nathan J Badger, Dorothy Frizelle, Debi Adams, Miriam J Johnson
OBJECTIVES: UK guidelines recommend palliative care access for people with Parkinson's disease; however, this remains sporadic, and it is unknown whether specialist palliative care helps patients and carers cope with this distressing condition. This study aimed to explore whether, and how, access to specialist palliative care services affected patients' and carers' coping with Parkinson's disease. METHODS: Semistructured interviews were conducted, audio-recorded and verbatim transcribed...
January 9, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29307863/opioid-errors-in-inpatient-palliative-care-services-a-retrospective-review
#15
Nicole Heneka, Tim Shaw, Debra Rowett, Samuel Lapkin, Jane L Phillips
Opioids are a high-risk medicine frequently used to manage palliative patients' cancer-related pain and other symptoms. Despite the high volume of opioid use in inpatient palliative care services, and the potential for patient harm, few studies have focused on opioid errors in this population. OBJECTIVES: To (i) identify the number of opioid errors reported by inpatient palliative care services, (ii) identify reported opioid error characteristics and (iii) determine the impact of opioid errors on palliative patient outcomes...
January 4, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29305500/euthanasia-and-palliative-sedation-in-belgium
#16
Raphael Cohen-Almagor, E Wesley Ely
The aim of this article is to use data from Belgium to analyse distinctions between palliative sedation and euthanasia. There is a need to reduce confusion and improve communication related to patient management at the end of life specifically regarding the rapidly expanding area of patient care that incorporates a spectrum of nuanced yet overlapping terms such as palliative care, sedation, palliative sedation, continued sedation, continued sedation until death, terminal sedation, voluntary euthanasia and involuntary euthanasia...
January 4, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29305499/national-quality-indicators-and-policies-from-15-countries-leading-in-adult-end-of-life-care-a-systematic-environmental-scan
#17
REVIEW
Claudia Virdun, Tim Luckett, Karl A Lorenz, Jane Phillips
BACKGROUND: The importance of measuring the quality of end-of-life care provision is undisputed, but determining how best to achieve this is yet to be confirmed. This study sought to identify and describe national end-of-life care quality indicators and supporting policies used by countries leading in their end-of-life care provision. METHODS: A systematic environmental scan that included a web search to identify relevant national policies and indicators; hand searching for additional materials; information from experts listed for the top 10 (n=15) countries ranked in the 'quality of care' category of the 2015 Quality of Death Index study; and snowballing from Index experts...
January 4, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29305498/end-of-life-care-in-the-western-world-where-are-we-now-and-how-did-we-get-here
#18
REVIEW
Catherine Guilbeau
OBJECTIVES: Recent movements in end-of-life care emphasise community care for the dying; however, integrating community with medical care continues to be a work in progress. Historically tracing brain hemispheric dominance, Ian McGilchrist believes we are overemphasising functionality, domination and categorisation to the detriment of symbolism, empathy and connectedness with others. The aim of this historical review is to bring McGilchrist's sociobiological narrative into dialogue with the history and most recent trends in end-of-life care...
January 4, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29248898/confidence-in-palliative-care-issues-by-medical-students-and-internal-medicine-residents
#19
Ana Carolina Montouro Storarri, Giovana Dalmedico de Castro, Lilian Castiglioni, Patricia Maluf Cury
BACKGROUND: Palliative care (PC) is a relatively new field in Brazil, but this knowledge is of great importance in medical practice. OBJECTIVE: To evaluate the degree of confidence among medical students and first-year and second-year internal medicine residents in addressing issues of death and terminal illness with patients and their families. METHOD: A modified version of the Self-Efficacy in Palliative Care Scale was applied to 293 students in their first year to sixth year at the School of Medicine of São José do Rio Preto and to 43 residents in their first year or second year of medical practice at the same institution in Brazil, in 2015...
December 16, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29158211/updates
#20
Andrew Wilcock, Sarah Charlesworth
No abstract text is available yet for this article.
December 2017: BMJ Supportive & Palliative Care
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