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BMJ Supportive & Palliative Care

Naomi Taylor, Yi Fan Liang, Robert Tinnion
OBJECTIVES: Following publication of detailed national neonatal palliative care guidance, practical regional guidance, in the form of multidisciplinary 'checklists', was implemented aiming to improve the quality of neonatal palliative care. METHODS: Case note audit was used to examine the quality of locally delivered neonatal palliative care before and after regional guidance implementation. RESULTS: 27 patients were allocated to the 'before' cohort and 10 to the 'after' cohort...
September 16, 2018: BMJ Supportive & Palliative Care
Christine R Sanderson, David C Currow
No abstract text is available yet for this article.
September 4, 2018: BMJ Supportive & Palliative Care
Cielito C Reyes, Karen O Anderson, Carmen E Gonzalez, Haley Candra Ochs, Monica Wattana, Gyanendra Acharya, Knox H Todd
OBJECTIVES: Pain and depression frequently co-occur in patients with cancer. Although pain is a common reason for emergency department (ED) presentation by these patients, depression frequently goes unrecognised during an ED visit. In this study, we assessed the risk for depression in patients with cancer presenting to the ED for uncontrolled pain and assessed the extent to which the risk for depression was associated with survival in this population. METHODS: Participants were consecutive patients with cancer taking Schedule II opioids (n=209) who presented to the ED of a tertiary cancer centre for uncontrolled pain...
August 31, 2018: BMJ Supportive & Palliative Care
Kathy Eagar, Sabina Petranella Clapham, Samuel Frederic Allingham
OBJECTIVES: To explore differences in severe symptom outcomes for palliative care patients receiving hospital care compared with those receiving care at home. METHODS: Change in symptom distress from the start of an episode of palliative care to just prior to death was measured for 25 679 patients who died under the care of a hospital or home-based palliative care team between January 2015 and December 2016. Logistic regression models controlled for differences between hospital and home and enabled a comparison of the number of severe symptoms just prior to death...
August 31, 2018: BMJ Supportive & Palliative Care
Dominic O'Connor, Ailish Daly, Conor Mulvin, Olive Lennon
OBJECTIVES: To assess the effects of a single exercise session per week for 6 weeks on quality of life (QoL), fatigue and exercise participation in male and female cancer survivors with follow-up at 6 months. A secondary aim was to identify if the timing of exercise delivery determined its effect. METHODS: An exploratory prospective cohort study design was implemented. Twenty-five patients undergoing or who had completed cancer treatment (11 active treatment; 14 completed treatment) undertook exercise and educational sessions (Fit for Life) 1×/week...
August 31, 2018: BMJ Supportive & Palliative Care
Joao Gabriel Rosa Ramos, Roger Daglius Dias, Rogerio da Hora Passos, Paulo Benigno Pena Batista, Daniel Neves Forte
OBJECTIVES: Prognostication is an essential ability to clinicians. Nevertheless, it has been shown to be quite variable in acutely ill patients, potentially leading to inappropriate care. We aimed to assess the accuracy of physician's prediction of hospital mortality in acutely deteriorating patients referred for urgent intensive care unit (ICU) admission. METHODS: Prospective cohort of acutely ill patients referred for urgent ICU admission in an academic, tertiary hospital...
August 31, 2018: BMJ Supportive & Palliative Care
Suman Budhwani, Walter P Wodchis, Camilla Zimmermann, Rahim Moineddin, Doris Howell
Patients with advanced cancer can experience illness trajectories similar to other progressive chronic disease conditions where undertaking self-management (SM) and provision of self-management support (SMS) becomes important. The main objectives of this study were to map the literature of SM strategies and SMS needs of patients with advanced cancer and to describe SMS interventions tested in this patient population. A scoping review of all literature published between 2002 and 2016 was conducted. A total of 11 094 articles were generated for screening from MEDLINE, Embase, PsychINFO, CINAHL and Cochrane Library databases...
August 18, 2018: BMJ Supportive & Palliative Care
Clare White, Jenny Sproule, Paula Brogan, Max Watson
BACKGROUND: Patient held records need to be evaluated in palliative care settings. OBJECTIVES: To evaluate how patients, families and professionals in a specialist palliative setting use a patient held record created through close consultation with patients and carers. METHODS: A mixed methods prospective longitudinal cohort study in the UK-adult patients under community specialist palliative care nurse review or attending day hospice were given questionnaires at record introduction and after 4-6 weeks...
August 18, 2018: BMJ Supportive & Palliative Care
Helena Dunbar, Bernie Carter, Jayne Brown
BACKGROUND: Limited knowledge exists of parents' perceptions and experiences of children's hospices and how these contribute to the varied access and uptake of services. AIM: This study aimed to explore parents' perspectives and experiences of a hospice, to understand the barriers and/or facilitators to accessing a hospice, and what characteristics parents wanted from hospice provision. METHODS: A two-phase qualitative study underpinned by a constructivist grounded theory methodology was employed...
August 14, 2018: BMJ Supportive & Palliative Care
Charlie C Hall, Jean Lugton, Juliet Anne Spiller, Emma Carduff
OBJECTIVES: Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) discussions with patients and their caregivers have been subjected to intense ethical and legal debate in recent years. Legal cases and national guidelines have tried to clarify the best approach to DNACPR discussions; however, there is little evidence of how best to approach them from the patient, family or caregiver perspective. This paper describes published accounts of patient, family and caregiver experiences of discussions about advance cardiopulmonary resuscitation (CPR) decision making...
August 14, 2018: BMJ Supportive & Palliative Care
Elizabeth Mary Burns
No abstract text is available yet for this article.
August 10, 2018: BMJ Supportive & Palliative Care
Jordana Natalie Peake, Emma Beecham, Linda J M Oostendorp, Briony F Hudson, Patrick Stone, Louise Jones, Monica Lakhanpaul, Myra Bluebond-Langner
Studies indicate research ethics committee (REC) approval and clinician gatekeeping are two key barriers in recruiting children and young people (CYP) with life-limiting conditions (LLCs) and life-threatening illnesses (LTIs) and their families to research. OBJECTIVES: To explore the reported experiences, difficulties and proposed solutions of chief investigators (CIs) recruiting CYP with LLCs/LTIs and families in the UK. METHODS: 61 CIs conducting studies with CYP with LLCs/LTIs and their families, identified from the UK National Institute of Health Research portfolio, completed an anonymous, web-based questionnaire, including both closed and open-ended questions...
July 31, 2018: BMJ Supportive & Palliative Care
Sanhapan Wattanapisit, Apichai Wattanapisit, Anong Meepuakmak, Pornnipa Rakkapan
Purple urine bag syndrome (PUBS) is a rare condition characterised by urine discolouration. The management of PUBS remains controversial. Four females (mean age 84.5±9.7 years) with palliative conditions (two cancer and two non-cancer cases) presenting PUBS were identified. Urine bags were changed in all cases. Urinary catheters were changed in three cases. Oral antibiotics were prescribed in two cases and used in one case. Urine discolouration was resolved in all cases. One patient (without antibiotic treatment) died on day 5 after presentation of PUBS...
July 25, 2018: BMJ Supportive & Palliative Care
Claire E Johnson, Peta McVey, Joel Jin-On Rhee, Hugh Senior, Leanne Monterosso, Briony Williams, Julia Fallon-Ferguson, Matthew Grant, Harriet Nwachukwu, Michèle Aubin, Patsy Yates, Geoffrey Mitchell
BACKGROUND: With an increasing ageing population in most countries, the role of general practitioners (GPs) and general practice nurses (GPNs) in providing optimal end of life (EoL) care is increasingly important. OBJECTIVE: To explore: (1) patient and carer expectations of the role of GPs and GPNs at EoL; (2) GPs' and GPNs' contribution to advance care planning (ACP) and (3) if primary care involvement allows people to die in the place of preference. METHOD: Systematic literature review...
July 25, 2018: BMJ Supportive & Palliative Care
Suthida Suwanvecho, Buntharika Suwanvecho, Krit Pongpirul
No abstract text is available yet for this article.
July 25, 2018: BMJ Supportive & Palliative Care
Michael Macfarlane, Stephanie Shayler, Louisa Nelms, Derek Willis
OBJECTIVES: The 2014 Court of Appeals decision with respect to Tracey vs Cambridge University Hospital ('the Tracey judgement') changed the requirements for discussing Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions with patients. This study is a retrospective case note review aiming to identify any changes in practice around discussing DNACPR decisions in hospices following the judgement. METHODS: 150 case notes from 2013 (before the Tracey judgement) were compared with 150 case notes from 2015 (following the Tracey judgement)...
July 25, 2018: BMJ Supportive & Palliative Care
Gunnhild Jakobsen, Morten Engstrøm, Peter Fayers, Marianne J Hjermstad, Stein Kaasa, Marianne Kloke, Rainer Sabatowski, Pal Klepstad
OBJECTIVE: Sleep is often disturbed in patients with advanced cancer. There is limited knowledge about sleep in patients with cancer treated with strong opioids. This study examines sleep quality in patients with advanced cancer who are treated with a WHO Step III opioid for pain. METHODS: An international, multicentre, cross-sectional study with 604 adult patients with cancer pain using WHO Step III opioids. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) global score (range; 0-21; score >5 indicates poor sleep)...
July 17, 2018: BMJ Supportive & Palliative Care
Lucy Ison, Dominique Wakefield, Irene Carey
No abstract text is available yet for this article.
July 4, 2018: BMJ Supportive & Palliative Care
Marie Solange Bernatchez, Josée Savard, Michèle Aubin, Hans Ivers
OBJECTIVES: High rates of sleep difficulties have been found in patients with advanced cancer. However, not much is known about factors that are associated with sleep impairments in this population and that could constitute their potential risk factors or consequences. This study conducted in patients with cancer receiving palliative care aimed to evaluate the relationships of subjective (sleep diary; Insomnia Severity Index, ISI) and objective (actigraphy) sleep-wake variables with several physical and psychological symptoms, maladaptive sleep behaviours, erroneous beliefs about sleep, quality of life, time to death and environmental factors...
June 30, 2018: BMJ Supportive & Palliative Care
Amelia Harshfield, Gary A Abel, Stephen Barclay, Rupert A Payne
OBJECTIVE: To examine the concordance between dates of death recorded in UK primary care and national mortality records. METHODS: UK primary care data from the Clinical Practice Research Datalink were linked to Office for National Statistics (ONS) data, for 118 571 patients who died between September 2010 and September 2015. Logistic regression was used to examine factors associated with discrepancy in death dates between data sets. RESULTS: Death dates matched in 76...
June 27, 2018: BMJ Supportive & Palliative Care
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