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Latest & greatest articles for palliative care
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Integrated respiratory and palliativecare may improve outcomes in advanced lung disease The unaddressed palliativecare needs of patients with advanced, nonmalignant, lung disease highlight the urgent requirement for new models of care. This study describes a new integrated respiratory and palliativecare service and examines outcomes from this service. The Advanced Lung Disease Service (ALDS) is a long-term, multidisciplinary, integrated service. In this single-group cohort study, demographic (...) and palliativecare was associated with improved end-of-life care and reduced unscheduled healthcare usage.
Qualitative Analysis of PalliativeCare for Pediatric Patients With Cancer at Bugando Medical Center: An Evaluation of Barriers to Providing End-of-Life Care in a Resource-Limited Setting Purpose Palliativecare remains an urgent, neglected need in the developing world. Global disparities in end-of-life care for children, such as those with advanced cancers, result from barriers that are complex and largely unstudied. This study describes these barriers at Bugando Medical Center, one of three (...) consultant hospitals in Tanzania, to identify areas for palliativecare development suitable to this context. Methods In-depth interviews were conducted with 20 caregivers of pediatric patients with cancer and 14 hospital staff involved in pediatric end-of-life care. This was combined with 1 month of participant observation through direct clinical care of terminally ill pediatric patients. Results Data from interviews as well as participant observation revealed several barriers to palliativecare
Social Worker-Aided PalliativeCare Intervention in High-risk Patients With Heart Failure (SWAP-HF): A Pilot Randomized Clinical Trial. Palliativecare considerations are typically introduced late in the disease trajectory of patients with advanced heart failure (HF), and access to specialty-level palliativecare may be limited.To determine if early initiation of goals of care conversations by a palliativecare-trained social worker would improve prognostic understanding, elicit advanced care (...) preferences, and influence care plans for high-risk patients discharged after HF hospitalization.This prospective, randomized clinical trial of a social worker-led palliativecare intervention vs usual care analyzed patients recently hospitalized for management of acute HF who had risk factors for poor prognosis. Analyses were conducted by intention to treat.Key components of the social worker-led intervention included a structured evaluation of prognostic understanding, end-of-life preferences, symptom
PalliativecarePalliativecare - Medical information | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Palliativecare Last reviewed: February 2019 Last updated: January 2018 Summary Palliativecare is specialised medical care for people with serious illness that focuses on the best quality of life for both the patient and his or her family. Center to Advance PalliativeCare. Overview for policymakers: palliativecare. http://www.capc.org/ (last (...) accessed 24 April 2017). https://www.capc.org/policymakers/overview/ Kelley AS, Morrison RS. Palliativecare for the seriously ill. N Engl J Med. 2015;373:747-755. http://www.nejm.org/doi/full/10.1056/NEJMra1404684 http://www.ncbi.nlm.nih.gov/pubmed/26287850?tool=bestpractice.com To palliate comes from the Latin word 'palliare', meaning 'to cloak', or to ease symptoms without curing the underlying disease. The primary goal of palliativecare is to provide quality of life for the patient and family
What is the impact and effectiveness of the 7 day CNS service on palliativecare patients and their families? Review Methods Search Strategy: A systematic search was conducted across a wide-ranging set of data- bases: ProQuest British Nursing Index, Ovid Medline, including In-Process & Other Non- Indexed Citations, Ovid Embase, Ovid Healthcare Management Information Consortium, Ebsco CINAHL and Cochrane Library. The preliminary search strategy was developed on Ovid Medline using both text words (...) and Medical subject headings from inception of the databases to February 2018, restricted to English language. The search strategy was modified to capture indexing systems of the other databases. (Search strategies available upon request). To identify additional papers, electronic tables of content for the last two years were scanned for the following journals: ? BMJ Supportive PalliativeCare Journal ? Cancer Nursing Practice Palliative Medicine ? European Journal of Palliativecare ? International
What are the models and outcomes of Public and Patient Involvement (PPI) in cancer and palliativecare research? Review Methods: Search Strategy: A systematic search was conducted across a wide-ranging set of databases: Ovid Medline, including In-Process & Other Non-Indexed Citations, Ovid E pub Ahead of Print, Ovid Embase, Ovid PsycINFO, Ebsco CINAHL and Cochrane Library. The preliminary search strategy was developed on Ovid Medline using both text words and Medical subject headings from (...) checked for any relevant studies. The searches generated 195 citations after removing duplicates and irrelevant records. Figure 1 represents the flow of information through the different phases of the review. Inclusion: · Studies that include strategy, models, guideline, toolkit, framework, evaluation, impact, performance, audit, procedure, codes of conduct, ethics, impact, challenges, facilitators, financing and training aspects of PPI implementation in cancer and palliativecare research. · Studies
Effect of Inpatient PalliativeCare During Hematopoietic Stem-Cell Transplant on Psychological Distress 6 Months After Transplant: Results of a Randomized Clinical Trial Purpose Inpatient palliativecare integrated with transplant care improves patients' quality of life (QOL) and symptom burden during hematopoietic stem-cell transplant (HCT). We assessed patients' mood, post-traumatic stress disorder (PTSD) symptoms, and QOL 6 months post-transplant. Methods We randomly assigned 160 patients (...) with hematologic malignancies who underwent autologous or allogeneic HCT to inpatient palliativecare integrated with transplant care (n = 81) or transplant care alone (n = 79). At baseline and 6 months post-transplant, we assessed mood, PTSD symptoms, and QOL with the Hospital Anxiety and Depression Scale and Patient Health Questionnaire, PTSD checklist, and Functional Assessment of Cancer Therapy-Bone Marrow Transplant. To assess symptom burden during HCT, we used the Edmonton Symptom Assessment Scale. We
PalliativeCare in Heart Failure: Rationale, Evidence, and Future Priorities Patients with heart failure (HF) and their families experience stress and suffering from a variety of sources over the course of the HF experience. Palliativecare is an interdisciplinary service and an overall approach to care that improves quality of life and alleviates suffering for those living with serious illness, regardless of prognosis. In this review, we synthesize the evidence from randomized clinical trials (...) of palliativecare interventions in HF. While the evidence base for palliativecare in HF is promising, it is still in its infancy and requires additional high-quality, methodologically sound studies to clearly elucidate the role of palliativecare for patients and families living with the burdens of HF. Yet, an increase in attention to primary palliativecare (e.g., basic physical and emotional symptom management, advance care planning), provided by primary care and cardiology clinicians, may be a vehicle
Integrated Outpatient PalliativeCare in Oncology Management Briefs eBrief-no134 -- Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no134 -- Health Services Research & Development Management eBrief no. 134 » Issue 134 November 2017 The report is a product of the VA/HSR&D Evidence Synthesis Program. Evidence Report: Integrated Outpatient PalliativeCare in Oncology More than (...) 500,000 Americans, including 40,000 Veterans, are diagnosed with advanced cancer annually in the United States. Often provided concurrently with oncology care, palliativecare improves quality of life by managing patients' physical symptoms, as well as psychosocial and spiritual distress. Palliativecare occurs across a continuum, ideally beginning at the time when a serious illness has been diagnosed and continuing until the end of life. Integration of palliativecare and oncology care is now
One Emergency Medicine Resident. One Month of PalliativeCare. Ten lessons. One Emergency Medicine Resident. Ten Lessons in PalliativeCare. One Emergency Medicine Resident. One Month of PalliativeCare. Ten lessons. In by Brittany Ellis October 17, 2017 As emergency medicine residents, we work side-by-side with a wealth of specialities to gain clinical and diagnostic skills and to learn what happens to our patients when they leave the ED. We strive to distill the information we need to make (...) ourselves better clinicians and improve the transition of patients from the ED to inpatient teams. However, only rarely do we get to see where our patients came from, what happened prior to their ED arrival, and where they will go when they leave the hospital. Over the past month I have done just that as a senior resident on community and in-patient palliativecare teams. It was more challenging and rewarding than I had ever imagined. Below I share my top ten lessons from these experiences that I hope
Guidelines on Management of Pain in Cancer and/or PalliativeCare | Cancer Care Ontario Google Tag Manager You are using an outdated browser. We suggest you update your browser for a better experience. for update. Browse Guidelines Browse Pathway Maps Sort by You are here / / Guidelines on Management of Pain in Cancer and/or PalliativeCare Guidelines & Advice Guidelines on Management of Pain in Cancer and/or PalliativeCare ID: ES 18-4 Sep 2017 Type of Content: Guidelines & Advice, Evidence (...) as a source of information for the Ontario PalliativeCare Network (OPCN). Patient Population Patients with cancer or other diseases requiring palliativecare. Intended Guideline Users The intended users of this evidence summary are staff of the Patient Reported Outcomes and Symptom Management Program of CCO and staff of the Ontario PalliativeCare Network. This evidence summary may also be of interest to physicians, nurses, caregivers, and patients dealing with cancer or palliativecare symptom
Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving PalliativeCare: A Randomized Clinical Trial. The use of benzodiazepines to control agitation in delirium in the last days of life is controversial.To compare the effect of lorazepam vs placebo as an adjuvant to haloperidol for persistent agitation in patients with delirium in the setting of advanced cancer.Single-center, double-blind, parallel-group, randomized clinical (...) trial conducted at an acute palliativecare unit at MD Anderson Cancer Center, Texas, enrolling 93 patients with advanced cancer and agitated delirium despite scheduled haloperidol from February 11, 2014, to June 30, 2016, with data collection completed in October 2016.Lorazepam (3 mg) intravenously (n = 47) or placebo (n = 43) in addition to haloperidol (2 mg) intravenously upon the onset of an agitation episode.The primary outcome was change in Richmond Agitation-Sedation Scale (RASS) score (range
Palliativecare and management of troublesome symptoms for people with chronic obstructive pulmonary disease. People with advanced chronic obstructive pulmonary disease (COPD) have distressing physical and psychological symptoms, often have limited understanding of their disease, and infrequently discuss end-of-life issues in routine clinical care. These are strong indicators for expert multidisciplinary palliativecare, which incorporates assessment and management of symptoms and concerns (...) , patient and caregiver education, and sensitive communication to elicit preferences for care towards the end of life. The unpredictable course of COPD and the difficulty of predicting survival are barriers to timely referral and receipt of palliativecare. Early integration of palliativecare with respiratory, primary care, and rehabilitation services, with referral on the basis of the complexity of symptoms and concerns, rather than prognosis, can improve patient and caregiver outcomes. Models
European Association for Neuro-Oncology (EANO) guidelines for palliativecare in adults with glioma Patients with glioma present with complex palliativecare needs throughout their disease trajectory. The life-limiting nature of gliomas and the presence of specific symptoms related to neurological deterioration necessitate an appropriate and early palliativecare approach. The multidisciplinary palliativecare task force of the European Association of Neuro-Oncology did a systematic review (...) of the available scientific literature to formulate the best possible evidence-based recommendations for the palliativecare of adult patients with glioma, with the aim to reduce symptom burden and improve the quality of life of patients and their caregivers, particularly in the end-of-life phase. When recommendations could not be made because of the scarcity of evidence, the task force either used evidence from studies of patients with systemic cancer or formulated expert opinion. Areas of palliativecare
Prevalence of burnout in health professionals working in palliativecare: a systematic review. More than ever, the current increasing need for palliativecare leads to health professionals providing this type of care which further leads to multiple challenges, and stressful and demanding situations. The multiple challenges of working in palliativecare put health professionals working in this context at the risk of burnout.To examine the evidence on the prevalence of burnout among health (...) professionals working in palliative care.The current review included studies that encompass qualified health professionals working in palliativecare, caring for patients 18 years of age or older.The current review considered studies reporting on the point prevalence of burnout, measured by a burnout scale, such as, but not limited to, the Maslach Burnout Inventory, Burnout Measure and Copenhagen Burnout Inventory.The current review considered studies conducted in the context of specialist palliativecare
PalliativeCare Development in Africa: Lessons From Uganda and Kenya Despite increased access to palliativecare in Africa, there remains substantial unmet need. We examined the impact of approaches to promoting the development of palliativecare in two African countries, Uganda and Kenya, and considered how these and other strategies could be applied more broadly.This study reviews published data on development approaches to palliativecare in Uganda and Kenya across five domains: education (...) and training, access to opioids, public and professional attitudes, integration into national health systems, and research. These countries were chosen because they are African leaders in palliativecare, in which successful approaches to palliativecare development have been used.Both countries have implemented strategies across all five domains to develop palliativecare. In both countries, successes in these endeavors seem to be related to efforts to integrate palliativecare into the national health
Raise the Bar, Not the Threshold Value: Meeting Patient Preferences for Palliative and End-of-Life Care 29623615 2018 11 14 2509-4254 2 2 2018 Jun PharmacoEconomics - open Pharmacoecon Open Raise the Bar, Not the Threshold Value: Meeting Patient Preferences for Palliative and End-of-Life Care. 93-95 10.1007/s41669-017-0039-y McCaffrey Nikki N http://orcid.org/0000-0003-3684-3723 Deakin Health Economics, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia. nikki.mccaffrey (...) 15904746 Patient. 2017 Jun;10(3):353-365 28271387 Palliat Med. 2008 Oct;22(7):787-95 18755830 Support Care Cancer. 2015 Jan;23(1):103-10 24996829 Palliat Med. 2017 Apr;31(4):291-292 28281407 PLoS One. 2015 Mar 09;10(3):e0115544 25751629 J Clin Oncol. 2012 Oct 10;30(29):3611-7 22965960 JAMA. 2000 Nov 15;284(19):2476-82 11074777 J Pain Symptom Manage. 2016 Aug;52(2):318-328.e5 27216362 BMC Palliat Care. 2013 Feb 15;12:7 23414145 Soc Sci Med. 2015 Jan;124:48-56 25461861 Int J Health Policy Manag. 2016 Jun