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BMJ Supportive & Palliative Care

Mark Taubert
No abstract text is available yet for this article.
October 19, 2016: BMJ Supportive & Palliative Care
Katherine E Sleeman, Irene J Higginson
No abstract text is available yet for this article.
October 19, 2016: BMJ Supportive & Palliative Care
Sarah Amador, Claire Goodman, Louise Robinson, Elizabeth L Sampson
BACKGROUND: People living and dying with non-cancer diagnoses, including dementia, have poorer access to generalist and specialist palliative care than people with cancer, and experience worse outcomes in terms of pain and symptom control, and quality and experience of care. In the UK, the National Council for Palliative Care (NCPC) ran a national survey of services for end-of-life care for people with dementia (2008) in which 16 services were identified, and reported on case studies and examples of good practice...
October 14, 2016: BMJ Supportive & Palliative Care
Mila Petrova, Julia Riley, Julian Abel, Stephen Barclay
BACKGROUND: Electronic Palliative Care Coordination Systems (EPaCCS) are England's pre-eminent initiative in enabling advance care planning and improved communication and coordination at the end of life. EPaCCS have been under development for 8 years after being proposed, as Locality Registers, in the 2008 End of Life Care Strategy for England. EPaCCS are electronic registers or tools and processes for sharing data which aim to enable access to information about dying patients. Striking outcomes have been reported around EPaCCS, such as 77...
September 16, 2016: BMJ Supportive & Palliative Care
Amara Callistus Nwosu, Daniel Monnery, Victoria Louise Reid, Laura Chapman
OBJECTIVES: Podcasts have the potential to facilitate communication about palliative care with researchers, policymakers and the public. Some podcasts about palliative care are available; however, this is not reflected in the academic literature. Further study is needed to evaluate the utility of podcasts to facilitate knowledge-transfer about subjects related to palliative care. The aims of this paper are to (1) describe the development of a palliative care podcast according to international recommendations for podcast quality and (2) conduct an analysis of podcast listenership over a 14-month period...
August 31, 2016: BMJ Supportive & Palliative Care
Lutz Beckert, Rachel Wiseman, Suzanne Pitama, Amanda Landers
OBJECTIVES: Non-invasive ventilation (NIV) is widely used as a lifesaving treatment in acute exacerbations of chronic obstructive pulmonary disease; however, little is known about the patients' experience of this treatment. This study was designed to investigate the experiences and perceptions of participants using NIV. The study interprets the participants' views and explores implications for clinical practice. METHODS: Participants with respiratory failure requiring NIV were interviewed 2 weeks after discharge...
August 31, 2016: BMJ Supportive & Palliative Care
Mel Clark Taveros, Elizabeth J Chuang
CONTEXT: Prescription opioid and heroin abuse has increased substantially in recent years. Enrolment on opioid agonist therapy programmes is consequently increasing as well. As a result of these trends, more patients who present with acute pain secondary to a malignancy are also on chronic methadone maintenance therapy (MMT) for substance abuse. This combination of diagnoses presents a pain management challenge for palliative care providers. OBJECTIVES: This paper aims to gather and review the available medical literature pertaining to the use of opioid analgesia in methadone-maintained patients...
August 26, 2016: BMJ Supportive & Palliative Care
Tracy A Smith, Meera Agar, Christine R Jenkins, Jane M Ingham, Patricia M Davidson
OBJECTIVE: Non-invasive ventilation (NIV) is widely used in the management of acute and acute-on-chronic respiratory failure. Understanding the experiences of patients treated with NIV is critical to person-centred care. We describe the subjective experiences of individuals treated with NIV for acute hypercapnic respiratory failure. DESIGN: Qualitative face-to-face interviews analysed using thematic analysis. SETTING: Australian tertiary teaching hospital...
August 26, 2016: BMJ Supportive & Palliative Care
Kevin M Gorey, Emma Bartfay, Sindu M Kanjeekal, Frances C Wright, Caroline Hamm, Isaac N Luginaah, Guangyong Zou, Eric J Holowaty, Nancy L Richter, Madhan K Balagurusamy
BACKGROUND: Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California. METHODS: We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies...
August 23, 2016: BMJ Supportive & Palliative Care
Lucy Grant, Amrit Sangha, Sara Lister, Theresa Wiseman
OBJECTIVE: This study developed and piloted an educational intervention to support healthcare professionals (HCPs) to provide supportive care for families when a parent has cancer. METHODS: Programme development followed the Medical Research Council (MRC) framework, beginning with examination of theory and research, and consultation with experts. The programme content incorporated attachment theory, child development and family systems theory. It was piloted thrice with HCPs from a cancer centre...
August 16, 2016: BMJ Supportive & Palliative Care
Ruth Kleinpell, Eduard E Vasilevskis, Louis Fogg, E Wesley Ely
OBJECTIVE: To examine the association of the use of hospice care on patient experience and outcomes of care. Promoting high-value, safe and effective care is an international healthcare imperative. However, the extent to which hospice care may improve the value of care is not well characterised. METHODS: A secondary analysis of variations in care was conducted using the Dartmouth Atlas Report, matched to the American Hospital Association Annual Survey Database to abstract organisational characteristics for 236 US hospitals to examine the relationship between hospice usage and a number of variables that represent care value, including hospital care intensity index, hospital deaths, intensive care unit (ICU) deaths, patient satisfaction and a number of patient quality indicators...
August 16, 2016: BMJ Supportive & Palliative Care
Sally Paul, Viviene E Cree, Scott A Murray
OBJECTIVES: Palliative care services have, up to now, paid insufficient attention to social aspects of dying and bereavement and this has affected how patients and their families experience end of life and bereavement within their communities. New public health approaches to palliative care offer a different way forward by seeking to develop communities that support death and bereavement. Such approaches are now a priority for the majority of hospices in the UK and work with schools has been identified as a key area of work...
August 11, 2016: BMJ Supportive & Palliative Care
Clare Harley, Simon Pini, Lucille Kenyon, Amrit Daffu-O'Reilly, Galina Velikova
BACKGROUND: Many advanced cancers are managed as chronic diseases, yet there are currently no international guidelines for the support of patients living with chronic cancer. It is important to understand whether care and service arrangements meet the needs of this rapidly growing patient group. This study aimed to develop and validate a questionnaire to capture patients' experiences of living with chronic cancer and their views of clinical and support services. METHODS: The research was carried out between 1 July 2010 and 21 February 2013...
August 10, 2016: BMJ Supportive & Palliative Care
Kirby Jeter, Siobhan Blackwell, Lucy Burke, David Joyce, Catherine Moran, Emma Victoria Conway, Iseult Cremen, Brenda O'Connor, Pauline Ui Dhuibhir, Declan Walsh
OBJECTIVES: Patients with advanced cancer do not report all symptoms, so assessment is best done systematically. However, for such patients, completion rates of some symptom instruments are <50%. Symptoms can be quantified by various scales including the Categorical Response Scale (CRS), Numerical Rating Scale (NRS) and Visual Analogue Scale (VAS). Patient preferences for CRS, NRS and VAS in symptom assessment and their clinical utility in 3 cancer symptoms: pain, tiredness and appetite loss were determined...
August 10, 2016: BMJ Supportive & Palliative Care
Michael Chapman, Nikki Johnston, Clare Lovell, Liz Forbat, Wai-Man Liu
OBJECTIVES: Specialist palliative care is not a standardised component of service delivery in nursing home care in Australia. Specialist palliative care services can increase rates of advance care planning, decrease hospital admissions and improve symptom management in such facilities. New approaches are required to support nursing home residents in avoiding unnecessary hospitalisation and improving rates of dying in documented preferred place of death. This study examined whether the addition of a proactive model of specialist palliative care reduced resident transfer to the acute care setting, and achieved a reduction in hospital deaths...
August 5, 2016: BMJ Supportive & Palliative Care
Nikki Johnston, Clare Lovell, Wai-Man Liu, Michael Chapman, Liz Forbat
BACKGROUND: Improving access to palliative care for older adults living in residential care is recognised internationally as a pressing clinical need. The integration of specialist palliative care in residential care for older adults is not yet standard practice. OBJECTIVE: This study aimed to understand the experience and impact of integrating a specialist palliative care model on residents, relatives and staff. METHODS: Focus groups were held with staff (n=40) and relatives (n=17)...
August 3, 2016: BMJ Supportive & Palliative Care
Joseph Clark, Clare Gardiner, Amy Barnes
CONTEXT: An increasing amount of health policy is formulated at global level. At this global level, palliative care has attracted support primarily from normative institutions (WHO), not funding agencies. To attract greater global attention from policymakers, it has been argued that an international approach to research is required. However, the extent to which an international approach is being undertaken is unknown. OBJECTIVES: To systematically identify and thematically synthesise all international palliative care research, defined as research involving two or more countries, or focused on the global level...
August 2, 2016: BMJ Supportive & Palliative Care
Jason W Boland, Lisa Dikomitis, Amy Gadoud
BACKGROUND: Medical students and doctors are becoming better prepared to care for patients with palliative care needs and support patients at the end of life. This preparation needs to start at medical school. OBJECTIVE: To assess how medical students learn about death, dying and palliative care during a clinical placement using reflective essays and to provide insights to improve medical education about end-of-life care and/or palliative care. METHODS: Qualitative study in which all reflective essays written by third-year medical students in 1 year from a UK medical school were searched electronically for those that included 'death', 'dying' and 'palliative care'...
August 2, 2016: BMJ Supportive & Palliative Care
Leszek Pawłowski, Monika Lichodziejewska-Niemierko, Iga Pawłowska, Wojciech Leppert, Piotr Mróz
BACKGROUND: Volunteers working in hospice and palliative care facilities in Poland undertake various activities which are performed in accordance with legal regulations and the individual policies of each hospice. The aim of this study was to explore the roles and training of volunteers working in hospice and palliative care settings. METHODS: A cross-sectional survey was carried out that investigated the services performed by volunteers and their preparation for work within residential hospices...
July 29, 2016: BMJ Supportive & Palliative Care
Gloria Roldan Urgoiti, Aynharan Sinnarajah, Seema Hussain, Desiree Hao
Delirium in patients with cancer is associated with poor outcomes, but reversible causes need to be ruled out. We report the case of a 59-year-old woman who was presented with behavioural and cognitive changes over 2 weeks. She was non-verbal and combative, requiring involuntary admission and declaration of incompetence to make healthcare treatment decisions. Infectious and metabolic investigations and initial brain imaging were unremarkable. She was diagnosed with limited-stage small cell lung cancer and a paraneoplastic neuropsychiatric syndrome...
July 28, 2016: BMJ Supportive & Palliative Care
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