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palliative psychiatry

Dean Schuyler
Through this column, we hope that practitioners in general medical settings will gain a more complete knowledge of the many patients who are likely to benefit from brief psychotherapeutic interventions. A close working relationship between primary care and psychiatry can serve to enhance patient outcome.
June 29, 2017: Primary Care Companion to CNS Disorders
Bannin De Witt Jansen, Kevin Brazil, Peter Passmore, Hilary Buchanan, Doreen Maxwell, Sonja J McIlfatrick, Sharon M Morgan, Max Watson, Carole Parsons
BACKGROUND: Pain management is a cornerstone of palliative care. The clinical issues encountered by physicians when managing pain in patients dying with advanced dementia, and how these may impact on prescribing and treatment, are unknown. AIM: To explore physicians' experiences of pain management for patients nearing the end of life, the impact of these on prescribing and treatment approaches, and the methods employed to overcome these challenges. DESIGN: Qualitative, semi-structured interview study exploring barriers to and facilitators of pain management, prescribing and treatment decisions, and training needs...
October 1, 2016: Palliative Medicine
Yoichi Nakamura, Yusuke Takamiya, Mari Saito, Koichi Kuroko, Tatsuko Shiratsuchi, Kenzaburo Oshima, Yuko Ito, Satoshi Miyake
BACKGROUND: This study aimed to examine the status of undergraduate palliative care education among Japanese medical students using data from a survey conducted in 2015. METHODS: A questionnaire was originally developed, and the survey forms were sent to universities. The study's objectives, methods, disclosure of results, and anonymity were explained to participating universities in writing. Responses returned by the universities were considered to indicate consent to participate...
June 7, 2017: BMC Palliative Care
Anna C Muriel, Joanne Wolfe, Susan D Block
As the field of Pediatric Palliative Care continues to develop, it is important to consider the scope of practice and the utility of collaboration with other specialties, including child and adolescent psychiatry. The integration of psychiatry and palliative medicine has been explored in adult practice, but has not yet been elaborated in pediatrics. This article proposes a clinical model of care that highlights the overlapping and unique expertise that each discipline brings, in a continuum of collaboration, and proposes an integrated care model for the most complex patients and families...
August 23, 2016: Journal of Palliative Medicine
Manuel Trachsel, Scott A Irwin, Nikola Biller-Andorno, Paul Hoff, Florian Riese
BACKGROUND: As a significant proportion of patients receiving palliative care suffer from states of anxiety, depression, delirium, or other mental symptoms, psychiatry and palliative care already collaborate closely in the palliative care of medical conditions. Despite this well-established involvement of psychiatrists in palliative care, psychiatry does not currently explicitly provide palliative care for patients with mental illness outside the context of terminal medical illness. DISCUSSION: Based on the WHO definition of palliative care, a, a working definition of palliative psychiatry is proposed...
July 22, 2016: BMC Psychiatry
Benjamin C Forster, Helen Proskurin, Brian Kelly, Melanie R Lovell, Ralf Ilchef, Josephine M Clayton
OBJECTIVE: People with a life-limiting physical illness experience high rates of significant psychological and psychiatric morbidity. Nevertheless, psychiatrists often report feeling ill-equipped to respond to the psychiatric needs of this population. Our aim was to explore psychiatry trainees' views and educational needs regarding the care of patients with a life-limiting physical illness. METHOD: Using semistructured interviews, participants' opinions were sought on the role of psychiatrists in the care of patients with a life-limiting illness and their caregivers, the challenges faced within the role, and the educational needs involved in providing care for these patients...
June 20, 2016: Palliative & Supportive Care
Suzanne Timmons, Emma O'Shea, Desmond O'Neill, Paul Gallagher, Anna de Siún, Denise McArdle, Patricia Gibbons, Sean Kennelly
BACKGROUND: Admission to an acute hospital can be distressing and disorientating for a person with dementia, and is associated with decline in cognitive and functional ability. The objective of this audit was to assess the quality of dementia care in acute hospitals in the Republic of Ireland. METHODS: Across all 35 acute public hospitals, data was collected on care from admission through discharge using a retrospective chart review (n = 660), hospital organisation interview with senior management (n = 35), and ward level organisation interview with ward managers (n = 76)...
May 31, 2016: BMC Geriatrics
David Buxton
No abstract text is available yet for this article.
October 2015: Journal of the American Academy of Child and Adolescent Psychiatry
Lisa Humphrey, Mary Lynn Dell
Using a case study, in this article we seek to highlight how the distinct developmental needs of adolescent and young adult patients facing a life-threatening condition require a different approach to patient care by pediatric health care workers. The case underscores pitfalls in using a pediatric construct of care in areas of pain management, social stressors, and advanced care planning, and suggests programs to implement for improvement, including partnership with psychiatry, substance abuse, and palliative care specialists...
September 2015: Seminars in Pediatric Neurology
Alison M Heru
Although family research supports family-centered care for all medical specialties, the benefit of family-centered care has not been fully realized in outpatient practice. Physicians, including psychiatrists, are not routinely taught how to work with families and may not be aware of the evidence-base for family interventions. However, some medical specialties, such as family medicine and palliative care, have a clinical practice that routinely includes the family. Clinicians working in medical clinics, such as diabetes clinics, know that successful management of chronic illness requires family involvement...
September 2015: Journal of Psychiatric Practice
Johane P Allard, Heather Keller, Khursheed N Jeejeebhoy, Manon Laporte, Don R Duerksen, Leah Gramlich, Helene Payette, Paule Bernier, Elisabeth Vesnaver, Bridget Davidson, Anastasia Teterina, Wendy Lou
BACKGROUND: In hospitals, length of stay (LOS) is a priority but it may be prolonged by malnutrition. This study seeks to determine the contributors to malnutrition at admission and evaluate its effect on LOS. MATERIALS AND METHODS: This is a prospective cohort study conducted in 18 Canadian hospitals from July 2010 to February 2013 in patients ≥ 18 years admitted for ≥ 2 days. Excluded were those admitted directly to the intensive care unit; obstetric, psychiatry, or palliative wards; or medical day units...
May 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Felicity Ng, Gregory B Crawford, Anna Chur-Hansen
BACKGROUND: Treatment of depression in the palliative care setting is complicated by varied treatment preferences, a small body of research, and unique challenges associated with the end-of-life. Little is known about the treatment practices of medical practitioners in this setting. OBJECTIVE: This study aimed to investigate and characterise the treatment approaches of palliative medicine specialists for depression. DESIGN: Semistructured, in-depth interviews were conducted to explore explanatory models of depression from palliative medicine specialists, including a focus on treatment...
June 2016: BMJ Supportive & Palliative Care
Wendy G Anderson, Jenica W Cimino, Natalie C Ernecoff, Anna Ungar, Kaitlin J Shotsberger, Laura A Pollice, Praewpannarai Buddadhumaruk, Shannon S Carson, J Randall Curtis, Catherine L Hough, Bernard Lo, Michael A Matthay, Michael W Peterson, Jay S Steingrub, Douglas B White
RATIONALE: Surrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit (ICU) clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers. OBJECTIVE: To determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness...
February 2015: Annals of the American Thoracic Society
S-M Paddick, R N Kalaria, E B Mukaetova-Ladinska
BACKGROUND: In high-income countries with ageing populations, delirium is most prevalent in older adults and in palliative and intensive care settings. The prevalence and aetiology of delirium are likely to differ in low income countries, including sub-Saharan Africa (SSA), due to different population demographics, disease burden and exposure to pathogens. We reviewed published literature relating to the prevalence, clinical features and underlying causes of delirium in SSA and compare this with that published in high-income countries in order to identify knowledge and clinical service gaps, and priorities for further research...
January 15, 2015: Journal of the Neurological Sciences
Jennifer M Sexton, Stamatis Zeris, Pamela Stitzlein Davies, Elizabeth Trice Loggers, Jesse R Fann
No abstract text is available yet for this article.
April 2016: Academic Psychiatry
Daigo Ikegami, Akira Yamashita, Minoru Narita
Recent human brain imaging studies have examined differences in activity in the nucleus accumbens (N.Acc.) in response to heat stimuli between controls and patients with chronic pain, and have revealed that the N.Acc. plays a role in predicting the value of a noxious stimulus and its offset, and in the consequent changes in the motivational state. Nevertheless, the molecular mechanisms of change in the circuitry involved in emotion and motivation in response to chronic pain stimuli were not fully explored. On the other hand, it has been considered that micro RNAs (miRNAs) play important roles as key modulators of post-transcriptional gene expression...
November 2013: Nihon Shinkei Seishin Yakurigaku Zasshi, Japanese Journal of Psychopharmacology
Ben A Rich
The specialty of psychiatry has a long-standing, virtually monolithic view that a desire to die, even a desire for a hastened death among the terminally ill, is a manifestation of mental illness. Recently, psychiatry has made significant inroads into hospice and palliative care, and in doing so brings with it the conviction that dying patients who seek to end their suffering by asserting control over the time and manner of their inevitable death should be provided with psychotherapeutic measures rather than having their expressed wishes respected as though their desire for an earlier death were the rational choice of someone with decisional capacity...
October 2014: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
Jin-Ji Wu, Yanji Cui, Yoon-Sil Yang, Moon-Seok Kang, Sung-Cherl Jung, Hyeung Keun Park, Hye-Young Yeun, Won Jung Jang, Sunjoo Lee, Young Sook Kwak, Su-Yong Eun
OBJECTIVES: Aromatherapy massage is commonly used for the stress management of healthy individuals, and also has been often employed as a therapeutic use for pain control and alleviating psychological distress, such as anxiety and depression, in oncological palliative care patients. However, the exact biological basis of aromatherapy massage is poorly understood. Therefore, we evaluated here the effects of aromatherapy massage interventions on multiple neurobiological indices such as quantitative psychological assessments, electroencephalogram (EEG) power spectrum pattern, salivary cortisol and plasma brain-derived neurotrophic factor (BDNF) levels...
June 2014: Complementary Therapies in Medicine
Joan J Ryoo, Jennifer L Malin, Diana L Ordin, Sabine M Oishi, Benjamin Kim, Steven M Asch, Ren He, Michael K Gould
INTRODUCTION: In a national, integrated health care system, we sought to identify facility-level attributes associated with better quality of lung cancer care. METHODS: Adherence to 23 quality indicators across four domains (Diagnosis and Staging, Treatment, Supportive Care, End-of-Life Care) was assessed through abstraction of electronic records from 4804 lung cancer patients diagnosed in 2007 at 131 Veterans Health Administration facilities. Performance was reported as proportions of eligible patients fulfilling adherence criteria...
April 2014: Journal of Thoracic Oncology
D Meagher, D Adamis, M Leonard, P Trzepacz, S Grover, F Jabbar, K Meehan, M O'Connor, C Cronin, P Reynolds, J Fitzgerald, N O'Regan, S Timmons, C Slor, J de Jonghe, A de Jonghe, B C van Munster, S E de Rooij, A Maclullich
BACKGROUND: Delirium is a common neuropsychiatric syndrome with considerable heterogeneity in clinical profile. Identification of clinical subtypes can allow for more targeted clinical and research efforts. We sought to develop a brief method for clinical subtyping in clinical and research settings. METHODS: A multi-site database, including motor symptom assessments conducted in 487 patients from palliative care, adult and old age consultation-liaison psychiatry services was used to document motor activity disturbances as per the Delirium Motor Checklist (DMC)...
April 2014: International Psychogeriatrics
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