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Palliative Medicine

Daniel Stow, Gemma Spiers, Fiona E Matthews, Barbara Hanratty
BACKGROUND: The number of older people living and dying with frailty is rising, but our understanding of their end-of-life care needs is limited. AIM: To synthesise evidence on the end-of-life care needs of people with frailty. DESIGN: Systematic review of literature and narrative synthesis. Protocol registered prospectively with PROSPERO (CRD42016049506). DATA SOURCES: Fourteen electronic databases (CINAHL, Cochrane, Embase, EThOS, Google, Medline, NDLTD, NHS Evidence, NICE, Open grey, Psychinfo, SCIE, SCOPUS and Web of Science) searched from inception to October 2017 and supplemented with bibliographic screening and reference chaining...
February 18, 2019: Palliative Medicine
Lisa Jane Brighton, Wei Gao, Morag Farquhar, Sara Booth, Sabrina Bajwah, William D-C Man, Charles C Reilly, Deokhee Yi, Irene J Higginson, Matthew Maddocks
BACKGROUND: Holistic breathlessness services have been developed for people with advanced disease and chronic breathlessness, leading to improved psychological aspects of breathlessness and health. The extent to which patient characteristics influence outcomes is unclear. AIM: To identify patient characteristics predicting outcomes of mastery and distress due to breathlessness following holistic breathlessness services. DESIGN: Secondary analysis of pooled individual patient data from three clinical trials...
February 15, 2019: Palliative Medicine
Carmen Quiñoa-Salanova, Josep Porta-Sales, Cristina Monforte-Royo, Montserrat Edo-Gual
BACKGROUND: Family caregivers play a key role in the lives of patients with multiple myeloma. However, very little is known about the impact that the disease (its diagnosis, course and prognosis) has on the main family caregiver. AIM: To achieve a deeper understanding of the lived experience of individuals who are the primary caregiver of a relative with multiple myeloma and to shed light on their needs. DESIGN: Interpretative phenomenological study...
February 14, 2019: Palliative Medicine
Bella Vivat, Lucy Bemand-Qureshi, Jane Harrington, Sarah Davis, Patrick Stone
BACKGROUND: Little research has explored the detail of practice when using sedative medications at the end of life. One work package of the I-CAN-CARE research programme investigates this in UK palliative care. AIMS: To investigate current practices when using sedative medication at the end of life in London, UK, by (1) qualitatively exploring the understandings of palliative care clinicians, (2) examining documented sedative use in patient records and (3) comparing findings from both investigations...
February 12, 2019: Palliative Medicine
Zlatana Nenova, John Hotchkiss
BACKGROUND: Chronic kidney disease palliative care guidelines would benefit from more diverse and objectively defined health status measures. AIM: The aim is to identify high-risk patients from administrative data and facilitate timely and uniform palliative care involvement. DESIGN: It is a retrospective cohort study. SETTING/PARTICIPANTS: In total, 45,368 Veterans, with chronic kidney disease Stage 3, 4, or 5, were monitored for up to 6 years and categorized into three groups, based on whether they died, started dialysis, or avoided both outcomes...
February 12, 2019: Palliative Medicine
Justin M Glasgow, Zugui Zhang, Linsey D O'Donnell, Roshni T Guerry, Vinay Maheshwari
BACKGROUND: Hospital-based palliative care consultation is consistently associated with reduced hospitalization costs and more importantly with improved patient quality of life. As healthcare systems move toward value-based purchasing rather than fee-for-service models, understanding how palliative care consultation is associated with value-based purchasing metrics can provide evidence for expanded health system support for a greater palliative care presence. AIM: To understand how a palliative care consultation impacts rates of patient readmission and hospital-acquired infections associated with value-based purchasing metrics...
February 7, 2019: Palliative Medicine
Bill Lord, Emily Andrew, Amanda Henderson, David J Anderson, Karen Smith, Stephen Bernard
BACKGROUND: Paramedics may be involved in the care of patients experiencing a health crisis associated with palliative care. However, little is known about the paramedic's role in the care of these patients. AIM: To describe the incidence and nature of cases attended by paramedics and the care provided where the reason for attendance was associated with a history of palliative care. DESIGN: This is a retrospective cohort study. SETTING/PARTICIPANTS: Adult patients (aged >17 years) attended by paramedics in the Australian state of Victoria between 1 July 2015 and 30 June 2016 where terms associated with palliative care or end of life were recorded in the patient care record...
February 5, 2019: Palliative Medicine
Jean Norris, James Barker, Odette Buelens, Odette Spruijt
BACKGROUND: Intractable pruritus affects an estimated 83% of patients with advanced cutaneous T-cell lymphoma. Palliative care strategies to improve outcomes for these patients are lacking. Lignocaine antagonises kappa opioid antagonist-induced scratching in mice models and may relieve cutaneous T-cell lymphoma-pruritus. PRACTICE CHALLENGE: The aim of this retrospective case series was to evaluate our clinical experience with low-dose continuous subcutaneous infusion lignocaine for intractable pruritus associated with cutaneous T-cell lymphoma, from 2000 to 2015...
February 4, 2019: Palliative Medicine
Peter Eastman, David C Currow, Belinda Fazekas, Linda Brown, Brian Le
No abstract text is available yet for this article.
February 4, 2019: Palliative Medicine
Lene Kirkhus, Jūratė Šaltytė Benth, Bjørn Henning Grønberg, Marianne Jensen Hjermstad, Siri Rostoft, Magnus Harneshaug, Geir Selbæk, Torgeir Bruun Wyller, Marit Slaaen Jordhøy
BACKGROUND: Maintaining quality of life including physical functioning is highly prioritized among older cancer patients. Geriatric assessment is a recommended approach to identify patients with increased vulnerability to stressors (frailty). How frailty affects quality of life and physical functioning in older cancer patients has scarcely been investigated. AIM: Focusing on physical functioning and global quality of life, we investigated whether frailty identified by a geriatric assessment was associated with higher risk of quality-of-life deterioration during cancer treatment and follow-up...
February 4, 2019: Palliative Medicine
Dorothy McCaughan, Eve Roman, Alexandra G Smith, Anne C Garry, Miriam J Johnson, Russell D Patmore, Martin R Howard, Debra A Howell
BACKGROUND: People with haematological malignancies have different end-of-life care patterns from those with other cancers and are more likely to die in hospital. Little is known about patient and relative preferences at this time and whether these are achieved. AIM: To explore the experiences and reflections of bereaved relatives of patients with leukaemia, lymphoma or myeloma, and examine (1) preferred place of care and death; (2) perceptions of factors influencing attainment of preferences; and (3) changes that could promote achievement of preferences...
January 30, 2019: Palliative Medicine
Sandra Martins Pereira, Pablo Hernández-Marrero
No abstract text is available yet for this article.
January 28, 2019: Palliative Medicine
Christina Gerlach, Swantje Goebel, Sascha Weber, Martin Weber, Katherine E Sleeman
BACKGROUND: Early integration of palliative care can improve outcomes for people with cancer and non-cancer diagnoses. However, prediction of survival for individuals is challenging, in particular in patients with haematological malignancies who are known to have limited access to palliative care. The 'Surprise'-Question can be used to facilitate referral to palliative care. AIM: To explore experiences, views and perceptions of haemato-oncologists on the use of the 'Surprise'-Question in the haemato-oncology outpatients clinics of a university hospital in Germany...
January 28, 2019: Palliative Medicine
Elise Button, Michael Bolton, Raymond J Chan, Shirley Chambers, Jason Butler, Patsy Yates
No abstract text is available yet for this article.
January 28, 2019: Palliative Medicine
Brian H Le, Celia Marston, Christopher Kerley, Peter Eastman
No abstract text is available yet for this article.
January 28, 2019: Palliative Medicine
Josep Porta-Sales, Iris Crespo, Cristina Monforte-Royo, Mar Marín, Sonia Abenia-Chavarria, Albert Balaguer
BACKGROUND: An important concern of healthcare professionals when exploring the wish to hasten death with patients is the risk of causing them some type of distress. AIM: To assess the opinion of hospitalized patients with advanced cancer about the proactive assessment of the wish to hasten death. DESIGN: Descriptive, cross-sectional study. SETTING/PARTICIPANTS: We assessed 193 advanced cancer patients admitted to an oncology ward for the wish to hasten death using a semi-structured clinical interview...
January 28, 2019: Palliative Medicine
Sarah-May Blaschke, Penelope Schofield, Keryn Taylor, Anna Ugalde
BACKGROUND: Debate about appropriate and ethically acceptable end-of-life choices is ongoing, which includes discussion about the legalization of voluntary assisted dying. Given health professionals' role in caring for patients at the end life, their stance towards assisting a person with dying can have implications for policy development and implementation in jurisdictions where law changes are being considered. AIM: To explore end-of-life care professionals' attitudes towards voluntary assisted dying 6 months prior to vote on legalization...
January 28, 2019: Palliative Medicine
Judith Ac Rietjens, Wichor M Bramer, Eric Ct Geijteman, Agnes van der Heide, Wendy H Oldenmenger
BACKGROUND: Healthcare professionals and researchers in the field of palliative care often have difficulties finding relevant articles in online databases. Standardized search filters may help improve the efficiency and quality of such searches, but prior developed filters showed only moderate performance. AIM: To develop and validate a specific search filter and a sensitive search filter for the field of palliative care. DESIGN: We used a novel, objective method for search filter development...
January 28, 2019: Palliative Medicine
Marco Warth, Jens Kessler, Friederike Koehler, Corina Aguilar-Raab, Hubert J Bardenheuer, Beate Ditzen
BACKGROUND: Patients with a terminal disease report a high need for psychosocial and spiritual support. Previous literature reviews on psychosocial interventions in palliative care were restricted to certain subtypes of techniques, included a wide range of patients, conditions, and settings, or required a number of sessions unrealistic to be achieved in patients nearing the end of their lives. AIM: The aim of this study was to review and synthesize the evidence on brief psychosocial interventions (i...
January 16, 2019: Palliative Medicine
Catriona Rachel Mayland, Christina Gerlach, Katrin Sigurdardottir, Marit Irene Tuen Hansen, Wojciech Leppert, Andrzej Stachowiak, Maria Krajewska, Eduardo Garcia-Yanneo, Vilma Adriana Tripodoro, Gabriel Goldraij, Martin Weber, Lair Zambon, Juliana Nalin Passarini, Ivete Bredda Saad, John Ellershaw, Dagny Faksvåg Haugen
BACKGROUND: The provision of care for dying cancer patients varies on a global basis. In order to improve care, we need to be able to evaluate the current level of care. One method of assessment is to use the views from the bereaved relatives. AIM: The aim of this study is to translate and pre-test the 'Care Of the Dying Evaluation' (CODETM ) questionnaire across seven participating countries prior to conducting an evaluation of current quality of care. DESIGN: The three stages were as follows: (1) translation of CODE in keeping with standardised international principles; (2) pre-testing using patient and public involvement and cognitive interviews with bereaved relatives; and (3) utilising a modified nominal group technique to establish a common, core international version of CODE...
January 10, 2019: Palliative Medicine
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